頁籤選單縮合
題 名 | 家庭會議在安寧病房的實行情形=Family Conference in a Hospice Palliative Care Unit |
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作 者 | 陳健文; 蕭學誠; 林明慧; 吳彬源; 陳振文; 黃信彰; 蔡世滋; | 書刊名 | 臺灣家庭醫學雜誌 |
卷 期 | 13:1 2003.03[民92.03] |
頁 次 | 頁31-39 |
分類號 | 419.77 |
關鍵詞 | 家庭會議; 安寧病房; Family conference; Hospice; Palliative care; Discharge planning; Communication; |
語 文 | 中文(Chinese) |
中文摘要 | 本研究目的在了解家庭會議在安寧病房的實際運作情形。本研究所定義之家庭會議,指因病患病情或治療需要等不同目的,由醫師主導,邀請病患家庭成員於約定時間至醫院進行正式溝通會談的過程。研究對象為本院安寧病房後段床位,於88年10月1日起至89年9月30日止共154人次住院病患。由主持家庭會議之醫師,於會議進行時針對會議內容及相關資料,登錄於家庭會議記錄單。研究期間計針對69人次(44.8%)住院病患舉行過98次家庭會議。其中男性占48人次(69.6%),女性占21人次(30.4%),平均年齡為68.2歲(±13.2),平均住院天數為28.8天(±20.0),與同時期住院期間未召開家庭會議之病患平均住院天數7.3天(±5.5)有顯著差異(p<0.001)。會議時間大多發生於日間,但仍有18次(18.4%)是在夜間或假日時間舉行。花費時間有21次(21.4%)少於30分鐘,62次(63.3%)介於30-60分鐘,12次(12.2%)超過60分鐘。病患住院後第一次家庭會議召開時間平均為住院後第13.2天(±10.1)。最後一次家庭會議距出院時間平均為8.3天(±5.2)。家庭會議召開主要目的依次為「解說病情進展及預後」95次(96.9%),「協助家屬或病患處理情緒問題」66次(67.3%),「確認照護計畫方向」50次(51.0%),「整合家屬意見」43次(43.9%),「討論出院準備計畫」43次(43.9%)。團隊其他成員參加頻率分別為護理長37次(37.8%),社工師35次(35.7%),病患全責護理師18次(18.4%)。其中有39次(39.8%)除醫師外未有其他成員參與。家庭成員出席頻率以配偶最高有65次(66.3%),其次為病患之子51次(52%),女兒41次(41.8%),媳婦31次(31.6%)。儘管邀請對象為家庭成員,仍有21次會議(21.4%)僅有1名家族成員代表參加。 雖然健康保險並未提供相對給付,家庭會議之舉行在家庭醫業仍有特定功能。尤其在整合癌末病患照護計畫及安寧療護出院準備計畫過程,家庭會議之召開,更扮演重要角色。 惟包括家庭會議的召開時機與方式,進行程序,主持醫師整合能力,是否達成預期目標等相關研究仍闕如,有待進一步研究探討。 |
英文摘要 | To understand the utilization and the content of family conference (FC) in palliative care practice, we enrolled 154 patients who were admitted to the Hospice Palliative Unit in Taipei VGH between Oct 1, 1999 and Sep 30, 2000. Family conferences conducted by the attending physician during hospice admission were collected. Total 98 sessions of FC were recorded in 69 separate admissions (44.8%). There were significant differences in lengths of stay between patients whom FC was held for or not during admission (28.8±20.0 days vs. 7.3±5.5 days, p<0.001). Eighty FCs (81.6%) were held in the daytime, while eighteen FCs (18.4%) were at the night or holidays. The frequency distribution of spending time was:less than 30 minutes in 21.4%, between 30 and 60 minutes in 63.3%, and over 60 minuets in 12.2%. The purposes of conferences were:disease explanation in 96.9%, managing emotional problems in 67.3%, care planning in 51%, incorporating family opinions in 43.9%, and discharge planning in 43.9%. The attendance rates of family members were:spouse for 66.3%, son for 52.0%, daughter for 41.8%, daughter-in-law for 31.6%, son-in-law for 7.1%, and others for 19.4%. The attending frequency of other team members were: head nurse in 37.8%, social worker in 35.7%, and in-charged nurse in 18.4%. Thirty-nine FCs (39.8%) were accomplished by physician alone. Good communication plays an important role for quality improvement in palliative care. It is necessary to investigate the process and the outcome of family conference. |
本系統中英文摘要資訊取自各篇刊載內容。