潛在性生命末期病人安寧療護之需求

Demand of Hospice Care in Potential End-of-life Patients

馮容莊(Rung-Chuang Feng) ； 俞克弘(Ker-Huang Yu) ； 吳孟嬪(Meng-Ping Wu)

《北市醫學雜誌》 12卷附冊 (2015/06) Pp. 68-85

https://doi.org/10.6200/TCMJ.2015.12.SP.08

摘要

目的：台北市某社區型醫院於2015年初，著手推動「都會型社區安寧療護」模式，為能充分了解都會型安寧療護之需求狀況，進行「潛在性生命末期病人」之篩檢。方法：本調查乃隨機以四月的某一天，當天所有住院病人進行D-day普篩，爾後則以每日之新入住病人進行篩檢。根據「安寧緩和照護需求表」，由兩位護理師及兩位主治醫師進行生命末期與安寧療護需求評估調查，所得調查資料直接鍵入「生命末期病人篩檢資訊系統」。結果：「潛在性生命末期病人」篩檢總人數為6233人，安寧緩和照護需求ABCD得分大於等於6分者共533人，佔總篩檢數8.55%，其中經醫師篩檢屬生命末期者計有64人，僅佔總篩檢數1.03%；另醫師篩檢屬生命末期且須安寧照護則有54人，佔總篩檢數0.87%，符合潛在性生命末期病人界定有479人，佔總篩檢數7.68%。結論：醫護人員對於潛在性生命末期病人及其家屬應及早提供完整且誠實的疾病狀況說明，引導進入末期醫療決定，以提供人性化的終期照護。

關鍵字

生命末期 ； 安寧療護

並列摘要

Objective: A regional hospital in Taipei promoted a metropolitan hospice care model in early 2015 to screen for potential end-of-life patients and evaluate their need for hospice care. Method: We randomly chose a day in April and initiated the D-day mass screening for all admitted patients. Subsequently, new admitted patients were screened every day. Patients were assessed by two nurses and two attending physicians by using the Need of Palliative Care questionnaire, and all data were stored in the End-of-life Screening Information System. Results: A total of 6233 patients were screened in this program. Among these patients, 533 (8.55%) scored ≥ 6 in ABCD scores of the need of palliative care and 479 (7.68%) met the end-of-life criteria. However, only 64 (1.03%) patients were classified as end-of-life patients and 54 (0.97%) required hospice care, as judged by the attending physicians. Conclusion: Health care professionals should provide complete and direct explanation of disease conditions to the end-of-life patients and their family members at an early stage, and guide them to the decision of a humanistic end-of-life care.

並列關鍵字

end-of-life ； palliative care