- 期刊
提升某腫瘤科病房醫療團隊病情告知完整性
A Team-Based Oncology Care Project to Promote Truth-Telling Practice and Increase Disclosure Prevalence
摘要
病情告知的問題，不但困擾了病人本身與家屬，也常困擾著照顧他的醫療團隊人員，本病房醫療團隊病情告知平均完整率僅68%，故專案目的為提升腫瘤科病房醫療團隊病情告知完整性，經現況分析醫療團隊病情告知完整性偏低原因有：缺乏病情告知教育訓練、缺乏病情告知流程及監測規範、缺乏病情告知記錄書寫規範、缺乏病情告知環境及輔助工具。藉由相關措施介入有：舉辦病情告知教育訓練、錄製Power cam做為單位病情告知教學工具、制定病情告知規範、設置病情告知環境及輔助工具，使得團隊病情告知平均完整率提升至98%。期待此專案措施能推廣至全院各單位，以提高全院醫療團隊病情告知的完整性，進而達到照護品質的提升。
並列摘要
Truth telling regarding the disclosure of cancer diagnoses and life-limiting prognoses has been challenging for both oncology patients and their multidisciplinary health care providers. A cross-sectional survey once conducted in showed an unsatisfactory rate of 68% when practicing truth telling. Factors contributing to this relatively low prevalence included: a lack of environmental support and a short of staff training and educative means when it comes to informed consent and its process. There also was a shortage of guidelines or tools for monitoring and documenting the outcomes of team members' truth-telling practice. A quality improvement project was designed with a purpose to promote truth-telling practice and increase disclosure of medical information prevalence in the oncology setting. Programs were then developed to re-arrange in-service education to polish team members' truth telling communication skill, media facilitation such as Power cam training, and other systematic support of ancillary equipment to record and document the truth-telling process. After strategizing and promoting the concept and practice of truth-telling, the overall prevalence rate of the team members has increased to a fair rate of 98%. Experience and lessons learned from this project could be generalized to non-oncology medical settings, with hopes to improve the quality of team-based care with mutual trust and moral integrity.