癌末病人存活期之預後量表的探討

The Survival Prognostic Scales for Patients with Terminal Cancers

高以信(Yee-Shin Kao) ； 賴育民(Yu-Min Lai) ； 江瑞坤(Jui-Kun Chiang) ； 黃慧雅(Hui-Ya Huang)

《安寧療護雜誌》 13卷4期 (2008/11) Pp. 447-457

https://doi.org/10.6537/TJHPC.2008.13(4).5

摘要

預估癌末病人存活期的議題，是在安寧療護照顧場所最常被病人與家屬所提及的問題之一；但臨床醫師對癌末病人存活期的預估，常呈現過於樂觀的高估。回顧過去的文獻，我們嘗試找出自癌末病人找出有關的基本資料，身體功能狀態，臨床症狀與徵候，血液常規和生化檢查所建構成的預後量表，並討論其中信效度較好的量表，如Pirovano''''s Palliative Prognostic Score scale, Morita''''s Palliative Prognostic Index, Chuang''''s cancer prognostic score，以及Bozcuk''''s intrahospital cancer mortality risk model。希望經由本篇的討論，能讓從事安寧醫療工作者，當面對這類問題時，可以從中選擇一適當的量表來做回應；並藉由真誠的態度與病人及家屬溝通來提升安寧療護之照顧品質。

關鍵字

癌末 ； 存活期 ； 安寧療護 ； 預後量表

並列摘要

One of the most frequent issues raised by patients and families is the estimation of survival in the palliative care unit for advanced cancer patients. However, clinician estimations of survival time are usually inaccurate and often overoptimistic. We reviewed previous researches on this subject and try to find some reliable prognostic scales, such as Pirovano's Palliative Prognostic Score scale, Morita's Palliative Prognostic Index, Chuang's cancer prognostic score, and Bozcuk's intrahospital cancer mortality risk model, incorporating patient's demographic data, performance status, clinical symptoms and signs with laboratory results. We also discuss the way the staff can use the appropriate prognostic scale to communicate honestly with patients and/or their family about the estimation of patient's survival, in order to improve the quality of palliative care provided in the hospice ward.

並列關鍵字

terminal cancer ； survival ； hospice palliative care ； prognostic scale