癌末病患病危出院對喪親家屬之衝擊

The Impact of Discharging Patients Home with Advanced Disease to Their Family Members

王淑貞(Shu-Chen Wang) ； 王英偉(Ying-Wei Wang)

《安寧療護雜誌》 7卷3期 (2002/08) Pp. 185-196

https://doi.org/10.6537/TJHPC.2002.7(3).1

摘要

本文研究的目的，是探討喪親家屬對癌末病人因疾病惡化而從緩和病房返家，病人及家屬所面臨的照護問題及家屬對緩和病房服務的滿意度，以作為持續性安寧緩和照護之出院計劃參考及未來電話悲傷關懷之規劃。本研究採回溯性方法，於某一家緩和病房，以半結構問卷，電話訪談36位從89年5月至11月為期七個月，因癌末病危出院而在家往生病人之家屬。
本研究以描述性統計方法進行分析，結果發現，病人在往生前仍存有未完成的事、焦慮、躁動不安、疼痛、呼吸困難、出血等生、心理問題；約有一半以上的家屬認為病人接受緩和照護後的整體生活品質非常好或很好。家屬所面臨的問題：缺乏處理病人的問題、社會與心理問題、及社會資源的支援不足。有七位家屬感現有的出院服務不足；但有30位家屬認為本研究之電話訪談，能讓他們有機會抒發對病人的情緒與思念感到滿意。由研究結果得知，緩和療護應提供更完善的病危出院規劃，針對個別家屬需求指導，而電話訪談喪親家屬，提供家屬情緒表達機會，以達成全人、全家、全程、及全隊的服務目標。

關鍵字

末期病人 ； 病危出院 ； 照護問題

並列摘要

The purpose of this study is to investigate the impact of discharging patient home due to their terminal conditions on bereaved family members. A retrospective survey was carried out in a hospital-based palliative care unit. A total of 36 bereaved family members were interviewed over the phone. Participants were family members of advanced cancer sufferers who discharged from the unit due to terminal conditions and died at home during May to November, 2000. They answered the questions from a semi-structured questionnaire posed by the author. Concerning the patients' condition on the last day of life: accounted to have unfinished business, reported to have anxiety, to be irritable, to be suffer pain, to have breathless, and to have haematemesis. The global quality of life in the last stage of life of patients: the majority of participants felt it to be excellent and good. As for family members' conditions: patient's physical, psychosocial problems, and insufficient information about health care. The participants felt very grateful that the palliative care service is still concern about them after the death of the patient. A good discharge planning can improve the quality of care of patient.

並列關鍵字

advanced disease ； discharge due to terminal ； problems of family caregiving