台灣癌症病友導航之癌症資源中心實行的成效與成功因素之初探

背景：我國為提升國民癌症治療及後續照護之品質，成立癌症資源中心為民眾提供癌症治療資訊及相關服務已有十多年，但直至現今仍然較缺乏相關的計畫評估研究，希冀藉由本研究了解目前實行癌症病友導航計畫之癌症資源中心的成效及現況如何，並試著找出實行癌症資源中心之成功因素。研究方法：本研究以個人深度訪談的方式進行研究及樣本資料蒐集，以半結構式的訪談大綱進行一對一的個人深度訪談，並且根據不同的訪談對象擬定各自的訪談大綱。訪談主題為以下兩點：1.病友導航之癌症資源中心帶來的成效及影響 2.病友導航之癌症資源中心成功因素，並分為照護提供者與病友兩份，後續將訪談內容轉變為逐字稿，並進行資料之分析。研究結果：25名受訪者參與包含15位曾經使用資源中心服務的病友以及10位來自不同醫院的資源中心服務提供者。研究結果發現，資源中心能帶給病友最大的幫助與改變為提供正確詢問窗口以及協助其面對疾病的心態等等，且病友認為最大的收穫與幫助有如營養資訊的獲得以及對疾病相關資訊的了解等等；在遇到困難方面，照護提供者方面認為在病友宣傳與院內單位宣傳上最常遇到一些困難，在病友方面則認為他們在接受服務時最常遇到講座名額太少與講座時間不便前往等有關講座方面的問題；最後，在推行資源中心的成功因素部分，則發現院內行政主管的支持與院外外部機構關係的連結是最多人提及的成功因素，另外，單位關係建立、院內同仁認同等也都是實行癌症資源中心重要的成功因素之一。研究結論：病友使用癌症資源中心的服務時，確實能夠滿足自身的大部分需求，而比起營養衛教、人員心理輔導等服務他們更傾向獲得來自同樣身為癌症病友的經驗分享與心理支持；另外，上層行政主管的支持、院內其他單位的支持和與院外相關單位的關係建立是實行癌症資源中心最重要的成功因素。本研究亦相關建議，提供給國健署、希望基金會及院內資源中心單位參考。

關鍵字

癌症資源中心；個人深度訪談；病友導航；成功因素；質性研究

並列摘要

Introduction: In order to improve the quality of cancer treatment and follow-up care for our citizens, the Cancer Resource Center has been established for more than a decade to provide cancer treatment information and related services to the public. However, there has been a lack of program evaluation studies for this issue. This study aims to understand the effects and current status of the Cancer Resource Center, which is currently implementing the Cancer Patient Navigator Program, and to try to identify the successful factors for the implementation of Cancer Resource Center. Methods: The study was conducted by in-depth personal interviews and sample date collection. We conduct in-depth one-on-one interviews with semi-structured interview outlines, and develop individual interview outlines for different interviewees. The following two topics were discussed: 1. Effects and impact of cancer resource center 2. Successful factors of cancer resource center. The interview outlines were divided into two parts: the care provider and the patient, and the interview was subsequently converted into an interview transcript and the data were analyzed. Results: The 25 interviewees included 15 patients who had used the Resource Center services and 10 Resource Center providers from different hospitals. We found that the greatest help and changes that the resource center brought to the patients were providing the right window of inquiry and helping them cope with their illness, etc. The patients felt that the greatest gains and help were the access to nutritional information and understanding of disease related information, etc. In terms of difficulties encountered, the care providers felt that they most often encountered difficulties in promoting their services to the patients and the hospital units, while the patients felt that they most often encountered problems in receiving the services, such as difficulties in accessing the lectures and lecture times. The key successful factors for the implementation of the Resource Center were the support of the administration and the linkage with external organizations as the most mentioned successful factors. In addition, the establishment of unit relationships and the recognition of colleagues within the hospital are among the successful factors for the implementation of the Cancer Resource Center. Conclusion: Cancer Patients are indeed able to meet most of their needs when using the services of the Cancer Resource Center. They prefer to receive experience sharing and psychological support from fellow cancer patients rather than nutritional and health education and psychological counseling services. In addition, the support of the administration, the support of other units within the hospital, and the establishment of relationships with relevant units outside the hospital are the most important successful factors for implementing a Cancer Resource Center. The study also has recommendations for the National Health Service, The HOPE Foundation, and the Cancer Resource Center units.