醫學中心推動癌症無痛學院之經驗與成效

The Experiences and Outcomes of Promoting Cancer Painless College at a Medical Center

10.6880/TJON.201903/SP_19.15

黃綉雲(Hsiu-Yun Huang)；林佩昭(Pei-Chao Lin)；周碧玲(Pi-Ling Chou)；曾月美(Yueh-Mei Tseng)；吳麗娟(Li-Chuan Wu)

無痛醫院 ； 無痛學院 ； 癌症疼痛 ； 疼痛處置 ； Painless Hospital ； Painless College ； cancer pain ； pain management

腫瘤護理雜誌

19卷增訂刊（2019 / 03 / 01）

183 - 193

繁體中文

國外醫院評鑑多年來持續將疼痛評估與處置落實於評鑑標準中，2018年疼痛照護成為台灣疾病照護品質認證的項目之一。疼痛控制在癌症病患處置上扮演重要角色，本院為南部之醫學中心，基於提升醫療與護理品質推行「無痛學院」，目前持續推動中。無痛學院之使命與任務為：精進疼痛教育成效、培育疼痛處置專家、提升疼痛控制品質，因著使命與任務，無痛學院的推動已經有初步成效並累積經驗。未來無痛學院持續推動的重點包含：落實臨床實務與制度、持續臨床研究、持續疼痛教育、提升智能照護等面向。本文藉推動癌症無痛學院之經驗與成效，分享予同儕醫院、社區醫護機構與教育單位參考，期能落實國家政策、提升醫療照護品質、善盡醫院之社會責任。

Pain assessment and management have already been an integral part of the hospital evaluation criteria of many countries worldwide for many years, and in 2018, pain care also became an item assessed as part of the health care and treatment quality certification process in Taiwan. Pain control plays an important role in the management of cancer patients. Our hospital is a medical center located in southern Taiwan that is currently attempting to establish a ＂pain management college,＂ with the aim of raising its medical and nursing quality. The mission and objectives of this college are to improve the effectiveness of pain education; train pain management experts; and to improve the quality of pain control. Guided by this mission and these goals, our efforts to develop the pain management college have achieved initial success and allowed for the accumulation of experience. Going forward, the pain management college's development will focus on the implementation of clinical practices and systems, the continuation of clinical research and pain education, and improvements with regard to smart care. This study shares the experiences and results pertaining to the establishment of a medical college of cancer pain management, which can be used as a reference for other hospitals, community healthcare institutions, and educational institutions. It is hoped that the study will contribute to the implementation of national policies, improvements to the country's quality of medical care, and the fulfillment of the hospital's social responsibilities.

1. Bartoszczyk, D. A.,Gilbertson-White, S.(2015).Interventions for nurse-related barriers in can-cer pain management.Oncology Nursing Fo-rum,42(6),634-641.
2. Brant, J. M.,Eaton, L. H.,Irwin, M. M.(2017).Cancer-related pain: Assessment and manage-ment with putting evidence into practice inter-ventions.Clinical Journal of Oncology Nurs-ing,21(3),4-7.
3. Brennan, F.,Carr, D.,Cousins, M.(2016).Access to pain management still very much a human right.Pain Medicine,17(10),1785-1789.
4. Chou, P. L.,Lin, C. C.(2011).A pain education programme to impro -ve patient satisfaction with cancer pain management: A randomized control trial.Journal of Clinical Nursing,20(13-14),1858-1869.
5. Chou, P. L.,Rau, K. M.,Lin, C. C.(2011).Devel-opment and psychom -etric testing of a short version of the Barriers Questionnaire -Taiwan form for cancer patients.Int J Nurs Stud,48(9),1071-1079.
6. Fallon, M.,Giusti, R.,Aielli, F.,Hoskin, P.,Rolke, R.,Sharma, M.,Committee, E. G.(2018).Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines.Annals of Oncology,29(4),166-191.
7. Greco, M. T.,Roberto, A.,Corli, O.,Deandrea, S.,Bandieri, E.,Cavuto, S.,Apolone, G.(2014).Quality of cancer pain management: A update of systematic review of undertreat-ment of patients with cancer.Joural of Clinical Oncology,32(36),4149-4154.
8. Lam, M.,Choi, M.,Lam, H. R. Agarwal, A.,Chow, R.,Chow, S.,Henry, B.(2017).Use of mul-timedia in patient and caregiver educ- ation for cancer pain management: A literature review.Annals of Palliative Medicine,6(1),66-72.
9. Lee, B. O.,Liu, Y.,Wang, Y. H.,Hsu, H. T.,Chen, C. L.,Chou, P. L.,Hsu, W. C.(2015).Medi-ating effect of family caregivers’ hesitancy to use analgesics on homecare cancer patients’ an-algesic adherence.Journal of Pain and Symp-tom Management,50(6),814-821.
10. Lin, J.,Hsieh, R. K.,Chen, J. S.,Lee, K. D.,Rau, K. M.,Shao, Y. Y.,Chiou, T. J.(2018).Satisfac-tion with pain management and impact of pain on quality of life in cancer patients.Asia-Pacif-ic Journal of Clinical Oncology
11. McCarberg, B. H.,Barkin, R. L.(2001).Long-act-ing opioids for chronic pain: Pharmacothera-peutic opportunities to enhance compliance, quality of life, and analgesia.Am J Ther,8(3),181-186.
12. NCCN Organization (2016). NCCN Clinical Prac-tice Guidelines in Oncology: Adult Cancer Pain. Retrieved from https://oralcancer-founda-tion.org/wp-content/uploads/2016/09/pain.pdf
13. Shen, W. C.,Chen, J. S.,Shao, Y. Y.,Lee, K. D.,Chiou, T. J.,Sung, Y. C.,Hsieh, R. K.(2017).Impact of undertreatment of cancer pain with analgesic drugs on patient outcomes: A nation-wide survey of outpatient cancer patient care in Taiwan.Journal of Pain and Symptom Man-agement,54(1),55-65.
14. The Joint Commission. (2018). Facts about Joint Commission Accredita -tion standards for health care organizations: Pain assessment and management. Retrieved from https://www.jointcommission.org/facts_about_joint_com-mission_accreditation_standards_for_health_care_organizations_pain_assessment_and_management/
15. World Health Organization (1986). Cancer Pain Relief. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/43944/9241561009_eng.pdf
16. World Health Organization (2018). WHO’s Cancer Pain Ladder for Adults. Retrieved from http://www.who.int/cancer/palliative/painladder/en/
17. Yeager, K. A.,Williams, B.,Bai, J.,Cooper, H. L. F.,Quest, T.,Meghani, S. H.,Bruner, D. W.(2019).Factors related to adherence to opioids in black patients with cancer pain.Journal of Pain and Symptom Management,57(1),28-36.
18. 吳尚倫, S. L.,謝政智, C. C.(2017)。癌症相關疼痛之藥物治療新觀念。台灣臨床藥學雜誌，25(2)，100-108。
19. 林芷彤, Z. T.,賴淑芬, S. F.,黃怡菁, Y. C.,林玲雅, L. Y.,張玉君, Y. J.,孫茂勝, M. S.(2011)。以病歷審查評估醫院的病人疼痛照護品質。病歷資訊管理，10(2)，48-60。
20. 洪曉佩, S. P.,黃惠美, H. M.,曾麗華, L. H.,明金蓮, J, L.(2015)。護理人員推動無痛醫院的角色。醫院，48(3)，48-57。
21. 胡文郁, W. Y.,陳宛榆, W. Y.,羅淑芬, S. F.,陳書毓, S. Y.,黃瀚心, H. X.,陳幼貴, Y. G.(2013)。成人癌症疼痛臨床照護指引—第一版與第二版修訂對照表。腫瘤護理雜誌，13，100-105。
22. 黃馨慧, X. H.,陳珮郁, P. Y.,陳乃華, N. H.,吳堯達, Y. D.,江靜楓, J. F.,黃仲毅, Z. Y.,王拔群, B. Q.(2018)。疾病照護品質認證—展現醫療照護新價值。醫療品質雜誌，12(4)，4-7。

1. 黃彩眉(Tsai-Mei Huang);嚴美華(Mei-Hua Yen)(2024)。照護一位口腔癌反覆復發接受手術病人之護理經驗。彰化護理。31(3)。90-102。