影響安寧病房成效因素的探討

A Study of Affecting Hospice Effectiveness Factors

葉宏恩(HUNG-EN YEH)

指導教授 ： 徐純慧副教授

國立臺北大學/商學院/企業管理學系/碩士(2008年)

摘要

「安寧病房」是提供臨終病患緩和醫療照顧的安寧療護照顧模式病房，有別於一般住院病房提供病患積極性的療護，安寧療護以提供臨終病患及其家屬獲得身、心、靈之安適療護與依靠為主，是先進國家尊重人權的重要指標。由於安寧病房療護之特殊需要，其療護團隊所需之人力標準、人事成本以及相關設施與設備自較其他病房為高，致使重視成本效益的醫院行政當局亟思縮減安寧病房編制與規模以減輕其虧損。因此，如何提昇醫院設置安寧病房之成效，以使得政府政策當局以及各醫院願意設置且推動安寧病房，以發揮安寧病房設置之崇高理想，乃本研究之主要動機與目的。
本研究經由文獻探討並選擇國內最早成立且最具完整規模之馬偕醫院安寧病房為研究個案，探討影響安寧病房之成效因素，並構建提昇醫院安寧病房之成效模式。
研究結果發現，影響醫院安寧病房成效之因素，可分為「安寧療護服務」、「安寧團隊運作」、「醫院組織經營」、「政府政策與社會態度」四大構面因素，若由此四大構面之細部內涵一一加以檢視，將可使醫院安寧病房具備「病患與家屬滿意」、「安寧療護團隊與成員具成就/滿意感」、「醫院與組織願支持」、「政府與社會能認同」之成效，本研究並依此研究結果提出影響安寧病房成效因素之研究命題，並對政府政策當局與醫院安寧病房之經營提出建議。

關鍵字

安寧療護 ； 安寧病房

並列摘要

"Hospice" is to provide medical care for dying patients to ease the palliative care ward model, unlike the general hospital wards to provide patients with the enthusiasm of palliative care. Palliative care is to provide dying patients and their families access to physical and mental and spiritual well-being of palliative care. The advanced countries is an important indicator of respect for human rights. As hospice palliative care of special needs, the palliative care team need human standards, personnel costs and related facilities and equipment from higher than those in other wards, which attaches importance to cost-effectiveness of hospital administration to reduce the hospice and prepared to reduce the size of losses . Therefore, how to upgrade the hospital to set up a hospice effectiveness of government policies to enable the authorities and the hospitals are willing to set up and promote the hospice. This is the main motive and purpose of the research.
This study by the literature review and select the earliest and most complete set up the size of the Mackay Memorial Hospital hospice for the case study on the impact of hospice effectiveness, enhance and build peace in the hospital ward of the effectiveness model.
The results showed that affect the effectiveness of hospice ward of the hospital, can be divided into "palliative care services", "peace team operation", "hospital organizational and operational", "Government policies and social attitudes," the four dimensions. If this four Dimensions of detail to view the content, will enable the hospital wards have peace "with patients and their families," "palliative care team members with a success / satisfaction", "hospitals and organizations willing to support", "Government and the community identity "of the results. The result of the research pointed out the effective factors of hospice proposition, and to make recommendations for the government policy toward the hospice ward of the hospital management.

並列關鍵字

hospice palliative care ； hospice ward.

參考文獻

王俊文 葉德豐 曾坤儀(2003)。臺灣醫院評鑑趨勢之探討。中山醫學，14(4)，頁513-522。

王素真(2007)。民眾對安寧療護的認知程度及選擇考慮因素之探討。安寧療護，12(1)，頁44-45。

行政院衛生署國民健康局：95年安寧療護資源覽表。http//。引用2008/4/4。

吳庶深、沈麗靚、張利中(2005)。三位安寧病房宗教師之定位與照顧內容之質性研究。安寧療護，10(4)，頁334-343。

李英芬(2000)。接受安寧居家照顧之家屬的情緒支持。安寧療護，5(1)，頁54-57。