COVID-19疫情下重症安寧緩和醫療照護之變革

新冠肺炎疫情在世界肆虐，台灣亦無可避免的迎來嚴重的社區群聚傳染，2021年5月到6月期間，大量的確診者因為重症而送進加護中心。家戶間的傳染使得重症病人多是單獨一人進到醫院，從入院到往生皆因傳染病防治規定，無法有親屬陪伴，病人從入院意識清醒到插管急救往生，可能僅短短數日，期間家人尚未解除隔離見上一面，遺體便已火化。除了重症醫療面臨很大的衝擊，緩和醫療的執行更是困難重重。筆者任職於負壓加護中心，見證新冠病毒的疫情肆虐，除了持續在疫情下照顧病人，更期望探討往後面臨此類情形，如何能更好的執行重症安寧療護，幫助家屬順利度過哀傷的過程，此情景之下，希冀重症安寧療護能更廣泛在加護病房推動，此外，預立醫療照護諮商（Advance Care Planning, ACP）更是值得重視，期望藉由我們的努力，能將家屬於面對疫情喪親的遺憾減至最低，給與生命最終的溫柔與祝福。

關鍵字

緩和療護；重症醫療；新冠肺炎

並列摘要

The COVID-19 pandemic is still ongoing. Even though Taiwanese government had made every effert to prevent the epidemic disease, since May, 2021, the outbreak occurred along with a wide community spread. A large amount of severe confirmed cases were sent to intensive care units in hospitals within two months. They got transferred alone because other family members were infected by community spread and got quarantined as well. Some of the cases never met their families and friends again due to the rapid process of complications. They suffered from short of breath, intubation, emergency treatment, expiry, and cremation in few days. During this period, a tremendous shock had changed not only critical care but also palliative care. The writer works in a negative pressure intensive care unit, trying to carry out a research on helping family members went through the grief and providing palliative care simultaneously under similar circumstances. The writer expects to widely apply the palliative care and emphasizes the importance of Advance Care Planning (ACP) in ICU, aiming to comfort both the patient and their families.

並列關鍵字

Palliative care ； Intensive care ； COVID-19

參考文獻

Chua, I. S., Jackson, V., & Kamdar, M. (2020). Webside manner during the COVID-19 pandemic: Maintaining human connection during virtual visits. Journal of Palliative Medicine, 23(11), 1507-1509. https://doi.org/10.1089/jpm.2020.0298

Dujardin, J., Schuurmans, J., Westerduin, D., Wichmann, A. B., & Engels, Y. (2021). The COVID-19 pandemic: A tipping point for advance care planning? Experiences of general practitioners. Palliative Medicine, 35(7), 1238-1248. https://doi.org/10.1177/02692163211016979

Gesi, C., Carmassi, C., Cerveri, G., Carpita, B., Cremone, I. M., & Dell’Osso, L. (2020). Complicated grief: What to expect after the coronavirus pandemic. Frontiers in Psychiatry, 11, 489. https://doi.org/10.3389/fpsyt.2020.00489

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Janssen, D. J. A. (2021). Palliative care in COVID-19. Current Opinion in Supportive and Palliative Care, 15(4), 199-204. https://doi.org/10.1097/spc.0000000000000567

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