晚期癌症病人即時緩和療護之概念分析

Timely Palliative Care for Patients with Advanced Cancer: A Concept Analysis

10.6530/YYN.202407_18(2).0009

林靖雅(Ching-Ya Lin)；潘雪幸(Hsueh-Hsing Pan)

晚期癌症 ； 即時緩和療護 ； 概念分析 ； advanced cancer ； timely palliative care ； concept analysis

源遠護理

18卷2期（2024 / 07 / 01）

72 - 76

繁體中文;英文

「晚期癌症病人即時緩和療護」是依晚期癌症病人個別性需求，在適合的時間點，主動提供病人症狀緩解、減輕痛苦，協助病人及家屬處理心理、社會、靈性問題，以提升病人及家屬生活品質之緩和療護。目前國內外皆有文獻探討緩和療護、安寧療護，但仍缺乏對晚期癌症病人即時緩和療護之概念分析。本文運用Walker及Avant（2019）所發展之概念分析模式，進行晚期癌症病人即時緩和療護之概念分析。從字典及文獻歸納出其定義性特徵為：（一）在適合的時間點；（二）主動提供；（三）提供病人生理症狀緩解或減輕痛苦之措施，及協助病人及家屬處理心理、社會及靈性問題。前置因子為：轉介的適合時機未明確、跨團隊的臨床照護、部分病人尚不需緩和療護、病人的個別性及醫療體系；後果為：改善病人生活品質、症狀、情緒、滿意度、存活期及臨終照護品質，改善家屬生活品質及滿意度，促進醫病溝通、減少病人住院天數、再住院率及醫療保健支出。透過對晚期癌症病人即時緩和療護概念的了解，期能提升晚期癌症病人及家屬之生活及照護品質，以擁有生命的尊嚴為目標。

This paper describes timely palliative care for patients with advanced cancer and is based on the individual needs of the patient. At the appropriate time, timely palliative care actively provides patients with symptom and pain relief, and assists patients and their families in managing psychological, social, and spiritual problems resulting from the patient's condition which require attention. Palliative care aims to improve the quality of life of patients with advanced cancer and their families. Past domestic and foreign studies have discussed palliative and hospice care; however, there has thus far been no concept analysis of timely palliative care for patients with advanced cancer. This article uses the concept analysis model developed by Walker and Avant (2019) to conduct a concept analysis of timely palliative care for patients with advanced cancer. The defining characteristics of timely palliative care for patients with advanced cancer are summarized from the literature as follows: (1) Actively provide palliative care at the appropriate time, (2) Provide measures to relieve the patient's physical symptoms or pain, and assist the patient and family members to manage psychological, social and spiritual issue arising from the patient's condition. The antecedents are as follows: the appropriate time of referral is not determined, clinical care across medical teams, some patients with advanced cancer may not require palliative care, the individuality of the patient and the medical system. The consequences of applying timely palliative care are as follows: improving the patient's quality of life, symptoms, emotional well-being, life satisfaction, survival period, quality of end-of-life care, the quality of life and satisfaction of family members, as well as promoting communication between doctors and patients and reducing the number of days of hospitalization, rehospitalization rate, and medical care expenditures. Through clarifying the concept of timely palliative care for patients with advanced cancer, we hope to improve the quality of life and care of these patients with advanced cancer and their families, with the goal of promoting their dignity at the end-of-life stage.