由癌末病人家屬看安寧共同照護模式下末期照護品質之研究

The quality of hospital-based palliative care team from the view of families in terminal cancer patients

陳瑞儀(Jui-Yi Chen)

指導教授 ： 胡文郁

國立臺灣大學/醫學院/護理學研究所/碩士(2007年)

https://doi.org/10.6342/NTU.2007.02410

摘要

本研究目的為由癌末病人家屬看安寧共同照護模式下末期照護品質，採準實驗設計，自2007年3月至2007年6月於北台灣某醫學中心進行資料收集，利用癌末病人家屬末期照護需求及滿意度量表、癌末病人生活品質量表及家屬生活品質量表進行前測，之後依照護模式的不同分為原單位治療且未接受安寧緩和醫療共同照顧模式(30位)、原單位治療但有接受安寧緩和醫療共同照顧模式(30位)以及轉入安寧病房(30位)三組，約一週後，再以癌末病人家屬末期照護需求及滿意度量表、癌末病人生活品質量表及家屬生活品質量表進行後測，以瞭解癌末病人家屬對安寧共同照護模式下末期照護的品質。
重要研究結果發現安寧共同照護模式後，(一)、癌末病人家屬仍有高度的末期照護需求。(二)、安寧共同照護模式可以有效的提升家屬末期照護的滿意度，但比安寧病房組差，比原單位組佳。(三)、安寧共同照護模式可以有效的提升癌末病人的生活品質，但比安寧病房組差，比原單位組佳。(四)、安寧共同照護模式可以有效的提升癌末病人家屬生活品質，且與安寧病房提升的程度相當。(五)、安寧共同照護模式可以有效的提高簽署不施行心肺復甦術同意書的比例。因此，安寧共同照護模式為臨床實務中值得推廣的末期醫療照護模式。

關鍵字

安寧共同照護 ； 家屬 ； 照護品質 ； 需求 ； 生活品質

並列摘要

The aim of this study is to explore the care quality of hospital-based palliative care team in the view of families in terminal cancer patients. A quasi-experimental design was used in this investigation. From March 2007 to June 2007, there were ninety families who were eligible in this study and had been investigated in a medical center of northern Taiwan. Three questionnaires including: a self-designed one for the needs and satisfaction of the family, the MQOL-Taiwan version questionnaires and WHOQOL-BREF were used in the pre-test. After the pretest was completed, three groups that received different types of palliative care participated in this study. There were thirty families of the terminal cancer patients who received: some palliative team services in the ordinary ward; traditional supportive care in the ordinary ward; and comprehensive palliative team services in the palliative care unit, respectively. The same three questionnaires were applied again in the three groups, to understand the differences of care quality in the families of terminal cancer patients.
The results of this study were: 1) the families of the terminal cancer patients still had a high level of care needs, even after palliative care team services were given; 2) palliative team services can effectively improve the satisfaction of the families, some palliative team services given in the ordinary ward had a higher satisfaction level than the traditional supportive care given in the ordinary ward, but had a lower satisfaction level than the comprehensive palliative team services given in the palliative care unit; 3) palliative team services can effectively improve the life quality of terminal cancer patients, some palliative team services given in the ordinary ward had better life quality than the traditional supportive care given in the ordinary ward, but had lower life quality than the comprehensive palliative team services given in the palliative care unit; 4) palliative team services can effectively improve the life quality of families of the terminal cancer patients, which is similar to some of the palliative team services given in the ordinary ward and the comprehensive palliative team services given in the palliative care unit; 5) care given by palliative team services can effectively increase the ratio of signing the DNR (Do Not Resuscitate) form. Therefore, palliative care services are worthy to expand the area of clinical application in the care model for terminal cancer patients.

並列關鍵字

palliative care team ； family ； quality of care ； need ； quality of life

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