以症狀評估與控制為基礎之遠距癌症居家安寧療護系統

Design of a home telehospice system based on symptom assessment and control in cancer

孫志豪(Chih-Hao Sun)

指導教授 ： 邱泓文

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00141

摘要

癌症為台灣民國99 年10 大死因之首，標準化發生率已達到每10 萬人276.5人且逐年增加，死亡風險更達到12.45%，往往使病患逐步邁向死亡，癌症末期的諸多症狀常使病患在死亡前承受許多痛苦，無法善終。面對這種無法治癒的疾病時，選擇以安寧緩和療護為主的照護模式是一種較好且較有效益的方式。安寧療護為藉由專業的醫療團隊，提供正確完整之身、心、靈的醫療照護，對末期病患的各種不適症狀進行緩和醫療，並給予末期病患與其家屬生活及心靈上的協助，使病患能夠善終，家屬能度過哀慟時期。
對病患及家屬而言，選擇在家接受安寧療護，即所謂居家安寧療護是較佳且對病患較好的方式，然而常因許多因素導致病患無法如願，主要因素為家屬缺乏在家照護病患的知識及信心，以及無法獲得立即性的協助等，但現今遠距醫療愈來愈發達，這些因素已經可以利用遠距醫療技術來解決，國外已有相關研究發展，但在台灣，以居家安寧療護為主的遠距醫療技術研究卻仍處於萌芽階段。
本研究以症狀評估與控制為基礎，以癌症為例，納入末期癌症常見之症狀，建立一個輔助癌症末期病患及家屬在家接受居家安寧療護之照護輔助系統。使用者能夠隨時評估癌症末期病患可能出現的各種不適症狀，了解病患的症狀狀況，並在評估後能夠得到及時的建議及指引，適時地照護病患，針對需定期處置的項目，系統並提供定時提醒的功能輔助使用者穩定的照護病患，使用者也可將評估的結果紀錄並供日後查詢。另外，專業人員可隨時觀看病患的紀錄，並回覆建議給使用者，使用者若有需要，亦可與專業人員做諮詢，得到專業建議。希望透過系統化的管理模式，能夠增進使用者居家安寧療護的能力與信心，提高癌症末期病患及其照護者的自我管理能力。

關鍵字

癌症 ； 症狀評估與控制 ； 遠距安寧療護 ； 安寧療護系統

並列摘要

Cancer is leading to the top 10 causes of death in 2010 year. It's estimated that the cancer standardized incidence rate has been to 276.5 and increased year by year. The risk of death has been 12.45% that cause patients death. Many symptoms of advanced cancer usually make patients endure huge pain before they die. When it comes to this incurable disease like cancer, hospice is a better and more effective way than medical care to terminal cancer patient. Hospice is
a type of care and a philosophy of care that focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. It’s also focus on assisting patient’s family.
For terminal cancer patients and their family, it is a better way to take hospice in home, however, patient usually can’t adopt it due to family’s lack of care
knowledge and self confidence, and they can’t find immediate assist when they are giving care to patient in home. Nowadays the medical technology develops more and more, it can be solved by telemedicine infrastructure. There are some achievements in other countries, but now in Taiwan, it is still under development.
In this study, we developed a home telehospice system which is based on symptom assessment and control in cancer. Users will be able to assess the terminal cancer patient’s common symptoms whenever they want, and then can implement some medical treatment suggested by the system. For some
periodical treatments, users can be reminded by the system. They also can review the history what they‘ve recorded for patients. Moreover, caregivers can reply their suggestions after review history. Finally, users will be able to
communication their caregivers when they need. Let users and caregivers grasp the patient’s medical condition at any time. We expect this study can improve terminal cancer patients and their family’s self-management capability.

並列關鍵字

cancer ； symptom assessment and control ； telehospice ； hospice system

參考文獻

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