题名

「社區安寧」整合性照護網絡建立與運作之成效

并列篇名

Effectiveness of the Establishment and Operation of the Integrated Care Network for Community Hospice Care

DOI

10.6537/TJHPC.202107_25(3).04

作者

蔡旻秀(Min-Shiow Tsay)；張亦慧(Yi-Hui Chang)；王靜瑜(Ching-Yu Wang)；楊久嫻(Chiu-Hsien Yang)；劉子沄(Zi-Yun Liu)；李純瑩(Chun-Ying Lee)；陳虹錚(Hung-Cheng Chen)；吳建誼(Chien-Yi Wu)

关键词

安寧療護 ； 居家照護 ； 整合照護 ； 社區 ； hospice care ； home care ； integrated care ； community

期刊名称

安寧療護雜誌

卷期/出版年月

25卷3期（2021 / 07 / 01）

页次

253 - 268

内容语文

繁體中文
中文摘要

根據研究顯示，能在宅善終是多數末期病人的心願，然而末期病人變化多端的病情是在宅善終的一大挑戰。現今安寧居家團隊大多是由醫院團隊組成，較無法提供可近性、即時性的安寧居家訪視；此外社區安寧居家因醫療人員投入意願低、缺乏安寧居家相關經驗，使得推動社區安寧居家療護有所困難，進而讓病人及家屬對於在宅善終缺乏信心，導致有些病人與家屬選擇於醫院度過生命終點。本文分享醫院安寧療護團隊藉由輔導社區團隊偕同訪視、定期個案討論及建構照護網絡來共同照護病人，由個案管理師擔任雙向溝通窗口，依據病人和家屬個別需求轉介社區安寧居家團隊來提供可近性、即時性安寧居家服務，協助末期病人無縫接軌回到社區，來落實安寧療護中的全社區照護，最終能有機會在宅善終。
英文摘要

According to previous studies, dying at home is a wish of most terminally ill patients; however, various clinical problems pose a big challenge for terminally ill patients who wish to die at home. Nowadays, most hospice home care teams are made up of hospital-based care, making it hard to afford accessibility and timely home care visits. Besides, it is challenging to promote community hospice home care due to insufficient community medical staff involvement and lack of hospice home care experiences. Therefore, terminally ill patients and their families lack the confidence to die at home, and finally, some of them chose to die in the hospital. In this article, the experienced hospital hospice care team assisted the community hospice care team in visiting terminally ill patients, arranged care discussions regularly, and constructed an integrated hospice home care network. The experienced hospital hospice care team's case manager posed a mutual connection window to help terminally ill patients and their families refer to an appropriate hospice home care team. The home care team aims to help terminally ill patients go back to the community area smoothly and receive accessibility to timely home care based on their needs. It would carry out the whole community hospice care and help patients dying at home.
主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 呂欣怡,林碧珠(2017)。社區安寧照護之未來發展。新臺北護理期刊，19，1-5。
    連結：
  2. 邱世哲,杜瀛岳,黃銘源,李英芬(2015)。案例討論於社區醫療照護團隊教育成效之初探。安寧療護雜誌，20，13-23。
    連結：
  3. 翁瑞萱,徐愫萱,施至遠,黃勝堅(2015)。臺灣社區安寧居家療護之現在與未來。護理雜誌，62，18-24。
    連結：
  4. 黃郁珊,黃淑鶴(2017)。台灣居家安寧療護面臨困境之探討。安寧療護雜誌，22，180-191。
    連結：
  5. Brumley, R,Enguidanos, S,Jamison, P(2007).Increased satisfaction with care and lower costs: results of a randomized trial of in­home palliative care.Journal of the American Geriatrics Society,55,993-1000.
  6. Chen, CY,Thorsteinsdottir, B,Cha, SS(2015).Health care outcomes and advance care planning in older adults who receive home-based palliative care: a pilot cohort study.Journal of palliative medicine,18,38-44.
  7. Gomes, B,Calanzani, N,Curiale, V,McCrone, P,Higginson, IJ(2013).Effectiveness and cost­effectiveness of home palliative care services for adults with advanced illness and their caregivers.Cochrane Database of Systematic Reviews
  8. Hu, WY,Chiu, TY,Dai, YT,Chang, M,Jaing, TH,Chen, CY(2003).Nurses’ willingness and the predictors of willingness to provide palliative care in rural communities of Taiwan.J Pain Sympt Manage,26,760-768.
  9. Lin, HY,Kang, SC,Chen, YC,Chang, YC,Wang, WS,Lo, SS(2017).Place of death for hospice-cared terminal patients with cancer: A nationwide retrospective study in Taiwan.Journal of the Chinese Medical Association,80,227-232.
  10. Riolfi, M,Buja, A,Zanardo, C,Marangon, CF,Manno, P,Baldo, V(2014).Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study.Palliative medicine,28,403-411.
  11. WHO(2002).National cancer control programmes: policies and managerial guidelines.World Health Organization.
  12. World Health Organization. Palliative care. Available at: https://www.who.int/ health-topics/palliative-care. Accessed February 8, 2021.
  13. 吳風鈴,陳慶餘,謝博生(2011)。社區善終照護準備計劃。台灣醫學，15，22-31。
  14. 姚建安(2010)。生命末期社區照護之實務與困境。臺灣醫界，21，64-79。
  15. 翁瑞萱,徐愫萱,洪香蓮(2013)。台灣的末期病人有機會壽終正寢嗎？─在宅往生課題之探討。安寧療護雜誌，18，320-329。
  16. 張曉卉(2014)。政策篇－健保新制上路讓人歡喜讓人憂。安寧照顧會訊，85
被引用次数
  1. 賴威廷,蕭麗萍,陳柏怡,許敏桃,許純華,柯薰貴(2023)。凝視房間裡的大象：臺灣社區安寧緩和之整合性照護－以屏東縣某區域教學醫院為例。護理雜誌，70(4)，95-102。
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