2005年台灣安寧共同照護計畫實施之成效

The Performance of Taiwanese Hospice Share-Care Project in 2005

徐翠霞(Tsui-Hsia Hsu) ； 蕭淑純(Shu-Chun Hsiao) ； 孔憲蘭(Shin-Lan Koong) ； 賴允亮(Yung-Liang Lai) ； 賴明亮(Ming-Liang Lai) ； 陳慶餘(Ching-Yu Chen) ； 曹朝榮(Chao-Jung Tsao) ； 陳榮基(Rong-Chi Chen) ； 周希諴(George Hsi Hsien Chou) ； 黃信彰(Shinn-Jang H)

《安寧療護雜誌》 12卷2期 (2007/05) Pp. 129-142

https://doi.org/10.6537/TJHPC.2007.12(2).1

摘要

台灣安寧緩和醫療的推動已逾10年，但依統計資料顯示每年超過三萬人死於癌症，卻僅約12%的癌症病人接受安寧緩和醫療。爲將安寧緩和醫療落實於現有的醫療體系，使更多癌症末期病人享有安寧緩和醫療，行政院衛生署國民健康局於2004年委託台灣安寧照顧協會建立安寧共同照護模式並試辦此計畫，依據2004年的試辦經驗，於2005年擴大至34家醫院辦理。此計畫試辦10個月，共服務7,205位癌末病人，顯示當年度癌症死亡病人中有19%的病人接受過安寧共同照護，其中有34.37%的病人接受照護後轉安寧病房或安寧居家服務。每位病人接受安寧共照護理師之平均訪視時間爲178.24分鐘，平均訪視次數爲2.98次。疼痛、疲憊、呼吸困難、便秘、腹水等，爲最常被處理的生理症狀，60%以上的病人與家屬有心理社會方面的照護需求，其中以死亡與瀕死調適的照護需求較高，且被提供照護的比例達75%以上。病人與家屬對安寧共同照護的整體滿意度達4.87分（滿分5分），且98%的原團隊醫護人員也認爲安寧共同照護是有幫助的，特別是協助照護病人、處理病人社會心理問題及照護知識與技能之提升等。依試辦結果顯示安寧共同照護模式不僅將癌末病人安寧緩和醫療利用率提高7%，更成功的將安寧療護理念、知識與照護技能轉移至非安寧療護的醫護團隊。

關鍵字

安寧共同照護 ； 安寧緩和

並列摘要

The promotion of hospice and palliative care has already for 10 years in Taiwan, but the statistical data manifestation die in cancer over 30,000 people every year, only 12% cancer patients to accept hospice and palliative care. For to make more cancer terminal patients accept the hospice and palliative care, the Bureau of Health Promotion Department of Health entrusted Taiwan Hospice Organization to construct a hospice share-care project and tried to do this project at 34 hospitals in 2005. This project tried to do for 10 months, serving 7,205 terminal cancer patients totally. This shows 19% cancer death patients who had accepted hospice share-care in that year, and there were 34.37% patients transferred to hospice ward or hospice home care after accepting hospice share-care. Each patient accepted care the average time was 178.24 minutes and the average times was 2.98 times. Pain, fatigue, dyspnea, constipation, ascites, were the most physiology symptoms. There were ＞60% patients and family need be provided psychosocial care, among them, the caring need of the adjustment dies was higher, and ＞75% patients were provided the caring. The satisfaction of the patients and family members is 4.87 (The full marks is 5), 98% members of non hospice-palliative care who think the hospice share-care to do good to the terminal cancer patients, including help to care patients, processing patient's psychosocial problems, and promote the care knowledge and technical ability. The result of the project raises the hospice coverage rates, and the concept, knowledge and care technique of hospice are transferred to non hospice-palliative care team.

並列關鍵字

hospice shared-care ； palliative care