雲林地區基層醫師的安寧緩和療護觀點

The Perspectives of Hospice and Palliative Care of General Practitioners in Yin Lin

許煌汶(Huang-Wen Hsu) ； 張俊郎(Chun-Lang Chang) ； 林姿妙(Tzy-Miao Lin) ； 沈雪娥(Hsueh-Er Shen)

《生死學研究》 4期 (2006/07) Pp. 85-117

https://doi.org/10.29844/JLDS.200607.0003

摘要

安寧緩和療護是對罹患無法治癒疾病的病人，提供積極的全人照顧，來緩解或消除病人身體、心理、社會與靈性的問題，讓病人及家屬獲得最好的可能生活品質。高居台灣十大死因之首的癌症，於2004年有36,357位國人死於癌症，而僅約不到二成的癌末病人接受過安寧緩和療護的照顧。未來國家癌症防治五年計畫，期望能將安寧緩和療護的涵蓋率提升至五成。
雲林地區於2004年有l,747位縣民死於癌症，而目前縣內只有一家區域醫院提供安寧居家照護，以及4位安寧專科醫師，安寧緩和療護資源運用的可近性明顯不足。然而，以基層醫師為主的社區醫療與居家照護，是推動社區化安寧緩和療護的必要手段，也是提高安寧療護涵蓋率的重要策略之一。
為了瞭解雲林地區基層醫師對安寧緩和療護的看法，以及參與安寧緩和療護的意願與困境。本研究採郵寄問卷的調查方式，進行資料蒐集，分析結果發現99.4%的基層醫師都認同安寧緩和療護的理念，71.4%的醫師有意願參加安寧緩和療護教育訓練課程，以及58.3%的醫師願意參與安寧療護的服務。這些初步的結果可以作為相關安寧機構及衛生單位，在擬定基層醫師安寧療護教育課程以及推廣社區化安寧緩和療護的參考。

關鍵字

基層醫師 ； 安寧緩和療護

並列摘要

Hospice and palliative care is an active total care of patients whose diseases is not responsive to curative treatment. The goal of hospice and palliative care is the achievement of the best possible quality of life for patients and their families thru control of pain and other physical symptoms, and palliation of psychological, social and spiritual problems. The leading cause of death in Taiwan is cancer, and there are 36375 Taiwanese dying of cancer in 2004. The goal of estimated coverage by hospice and palliative care services in Taiwan national cancer control program within next five years is the achievement of fifty percent coverage rate from the current twenty percent.
There are 1747 persons died of cancer in Yin Lin in 2004. Because of only one district general hospital providing hospice home care and four hospice palliative care specialists, the accessibility of hospice and palliative care is obviously inadequate. General practitioners-based community palliative care and home care are the essential approach for the expansion of community hospice and palliative care, and are also the one of important strategies in enhancing the coverage by hospice and palliative care.
In order to understand the perspectives of hospice palliative care of general practitioners (GPs) in Yin Lin, their willingness to serve as a terminal care physician, and their barriers in the practice of the terminal care, the postal questionnaires were used for data collectioin in this study. The results of this study revealed that 99.4% GPs agreed with the principles of hospice and palliative care and 58.3% GPs were willing to care for terminally ill patients. We presented our initial study and discussed for reference in the development of community hospice and palliative care in Taiwan.

並列關鍵字

general practitioners ； hospice and palliative care