Holistic Outcome Measurement for Terminally Ill Cancer Patients in Medical Centers in Taiwan

台灣地區醫學中心癌末病患整體性結果評量

楊克平(Ke-Ping Yang) ； 尹祚芊(Teresa J. C. Yin) ； 李麗傳(Li-Chuan Lee) ； 徐南麗(Nanly Hsu) ； 黃瑞美(Jui-Mei Huang)

《The Journal of Nursing Research》 9卷3期 (2001/06) Pp. 43-56

摘要

本橫斷式研究之目的在評量台灣地區醫學中心之癌末病患結果，並測試不同照護型態是否對病患結果有不同的影響。整體性病患結果以病患之生活品質、對照護之滿意度及費用等變項評量之。本研究採立意取樣，針對4所醫學中心，共計224位研究對象參與，含123位癌末病患及101位護理人員。各醫學中心之照護型態可分類為四組：安寧病房、安寧小組會診、安寧居家及傳統式一般照護等。研究結果顯示安寧病房住院患者之生活品質、滿意度均高於傳統式一般照護，其平均住院日及費用亦均低於傳統照護。然而居家安寧照護組卻有最好的心裡層面生活品質。此外，安寧病房護理人員之工作滿意度亦最高。本研究非但提供臨終患者照護品質之評價工具，尚對各種照護型態在病患結果上之影響提供實證性資料，以確保病患死亡過程中之最佳利益。以目前我國健康照護多樣化之服務模式而言，瞭解並選擇最有效的照護型態實有燃眉之急。

關鍵字

整體性病患結果 ； 照護型態 ； 癌末病患

並列摘要

The purpose of this cross-sectional study was to examine holistic patient outcomes for terminally ill cancer patients, as well as to examine whether different care patterns affect patient outcomes differently. Holistic patient outcomes were measured by the patients' quality of life, satisfaction with care, and cost of care. A purposive sampling of 224 subjects including 123 patients and 101 nurses was drawn from four medical centers in Taiwan. Among these settings, various care patterns were adopted and categorized into 4 groups: hospice inpatients, hospice team consultation, home hospice care services, and a conventional acute care group. Results showed that hospice inpatients had a higher quality of life, a higher level of satisfaction with the care and a lower average inpatient cost, whereas conventional care tended to have the highest length of hospital stay. Home hospice care patients had better psychological well-being than those with other care patterns. In addition, nurses' work satisfaction with the inpatients care unit tended to be significantly higher than with the other groups. The study findings not only provide an instrument for evaluating the quality of care, but also contribute to identifying patterns of care that will influence the dying process, which can only be beneficial for patients. Given the wide variety of healthcare services available now, understanding and selecting the most effective care patterns to enhance patient outcomes is of utmost importance in Taiwan.

並列關鍵字

holistic patient outcomes ； care patterns ； terminally ill cancer patients

參考文獻

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