呼應國家肥胖防治策略將實證指引導入健康醫院認證之可行性初探

A Preliminary Assessment on Implementability of ＂Evidences-based Guidelines on Obesity Prevention and Management＂ for Health Promoting Hospital Accreditation

孫子傑(Zih-Jie Sun) ； 李宏昌(Hung-Chang Lee) ； 黃國晉(Kuo-Chin Huang) ； 林文元(Wen-Yuan Lin) ； 鍾秋慧(Chiu-Hui Chung) ； 楊宜青(Yi-Ching Yang) ； 張智仁(Chih-Jen Chang) ； 王英偉(Ying-Wei Wang)

《健康促進研究與實務》 2卷2期 (2019/07) Pp. 1-14

https://doi.org/10.29442/HPRP.201907_2(2).0001

摘要

肥胖與其相關疾病對健康造成的危害是21世紀的重要公共衛生議題。2017年，衛生福利部國民健康署委託台灣肥胖醫學會與臺灣兒科醫學會邀集專家分別編纂完成「成人肥胖防治實證指引」與「兒童肥胖防治實證指引」，作為臨床醫療工作者預防及治療成人與兒童過重與肥胖之輔助工具。2018年衛生福利部國民健康署發表「臺灣肥胖防治策略」，旨在營造易於實踐健康體位的生活環境，依據生命週期之不同年齡層及生活中之多場域，提供重要策略與軟硬體支持性環境。台灣肥胖醫學會及臺灣兒科醫學會呼應「臺灣肥胖防治策略」第三章第四節所揭櫫之「健康照護機構」主軸方針，協助重點醫院試辦「成人與兒童肥胖防治實證指引」導入健康醫院認證標準，從判定病人體位，建立轉介流程，設立體重管理門診，善用衛教輔助工具，進行肥胖症的預防、診斷及治療，並辦理醫院健康體位健促活動，最後完成個案管理與追蹤等，讓指引的內涵真正落實於臨床。然而執行過程所面臨包括人力的缺乏、誘因的不足等問題，都是影響成功導入的一大挑戰。不過利用試辦過程逐步解決問題，並建立有效運作模式，可以提供國民健康署在推動健康醫院肥胖防治上之參考，進而建構肥胖防治共同照護網，達成國家肥胖防治策略的未來目標，成就符合成本效益的實證政策。

關鍵字

肥胖防治 ； 實證指引 ； 策略 ； 健康醫院

並列摘要

Obesity and obesity-related diseases have become critical public health issues of the 21st century. In 2017, the Health Promotion Administration (HPA) of Ministry of Health and Welfare collaborated with the Taiwan Medical Association for the Study of Obesity (TMASO) and the Taiwan Pediatric Association (TPA) to develop the ＂Evidences-based Guidelines on Adult Obesity Prevention and Management＂ and ＂Evidences-based Guidelines on Children Obesity Prevention and Management＂ as assistant tools for medical professionals to facilitate the prevention and management of obesity. In 2018, the HPA further issued ＂Taiwan's Obesity Prevention and Management Strategy＂. In response to the strategy, the TMASO and TPA assisted key health promoting hospitals (HPH) in implementing the two guidelines into HPH Accreditation. The concrete measures included performing patients' anthropometric assessment, establishing the referral process, setting up a weight management clinic, making good use of educational aids, practice the prevention, diagnosis and treatment of obesity, organizing health promotion activities in the hospital, and finally completing case management and follow-ups. However, the lack of manpower and incentives remain as a major challenge to the successful implementation. Nevertheless, the implementation process might help to provide preliminary solutions to some problems and establish an effective operational mode. These results will act as references for the HPA to promote obesity prevention and management in HPH, construct an obesity joint care network, and then facilitate to achieve the goals of the national obesity prevention and management strategy, which also support a cost-effective empirical policy.

並列關鍵字

obesity prevention and management ； evidences-based guideline ； strategy ； Health Promoting Hospital