- 期刊
提升死亡識能以提供高品質晚期癌症照護
Improving Death Literacy for High-Quality End-of-Life Oncology Care
摘要
緩和醫療的早期介入是目前癌症末期照顧的目標，然而提升死亡識能是達到此目標的重要核心。「死亡識能」被認為是一種獲取並理解生命末期與死亡相關議題之知識，並且做出相對應之生命末期照護選擇之技能。透過提升死亡識能的四個面向：知識（Knowledge）、技能（Skill）、經驗學習（Experiential learning）與社會行動（Social action），不僅能夠協助醫療團隊及早辨識出需要早期緩和醫療介入之癌症個案，更能降低病人與家屬對於疾病嚴重度、治療計畫與預後之錯誤期待，接受符合病人心願與臨床建議之生命末期照護，以提升生命末期生活品質。透過多科別團隊的資源與整合，給予癌症病人與家屬從初診斷一直到生命末期時連貫且不中斷的高品質癌症照護，以達到全人、全家、全程、全團隊與全社區之五全照護。然而台灣現有的群體決策（Collective decision-making）文化以及隱瞞病情之習性，將會是阻礙死亡識能建立的重要因素，也是未來國內醫療體系需要克服的一大挑戰。
並列摘要
Early palliative care intervention has been the goal of end stage oncology care, and this could be achieved by improving the death literacy. Death literacy is deemed to be a set of knowledge and skills that make one possible to gain access to understand and act upon end-of-life (EOL) or death care options. Through promoting the four aspects of death literacy-knowledge, skill, experiential learning, and social action, the potential cancer patients who need palliative care could be identified by the multidisciplinary medical team earlier, and the patients' and families' misunderstanding on disease progression, prognosis and care plan could also be minimized. A high-quality oncology care with the integration of palliative care could then be provided to patients in accordance to their wishes to improve their EOL quality. By doing this, patients and families could receive a coherent and consistent care from diagnosis to the EOL. However, the culture of collective decision-making and the custom to not telling the truth to the patients about their disease condition could be the obstacles for the development of death literacy and a challenge for the healthcare system in the future.