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題名：整合性癌症照護模式對口腔癌首次手術病人症狀困擾及健康照護需求之效果評價
書刊名：榮總護理
作者：張碧華／張家慧／周玉書／林錦津／賴秀津／江佩蓉／程稚盛／黃佩菁
作者(外文)：Chang, Pi-hua／Chang, Chia-hui／Chou, Yu-shu／Lin, Chin-chin／Lai, Hsiu-chin／Chiang, Pei-jung／Cheng, Chi-sheng／Huang, Pei-ching
出版日期：2017
卷期：34:3
頁次：頁227-238
主題關鍵詞：整合性癌症照護；口腔癌；手術；症狀困擾；健康照護需求；Integrated cancer care；Oral cancer；Surgery；Symptom distress；Health care needs
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:33
  • 點閱點閱:3
口腔癌手術造成病人身體外觀及生活重心改變，迫切需要疾病與治療相關的照護活動，以因應突如其來的衝擊。本研究目的為評價口腔癌首次手術病人接受「整合性癌症照護模式」在症狀困擾及健康照護需求的差異。研究方法採縱貫性實驗設計，對象為2015年5月～2016年6月中部某醫學中心口腔癌首次手術病人，共收案96人，對照組49位；實驗組47位。實驗組於住院期間接受「整合性癌症照護模式」服務；對照組為常規性照護。研究工具為基本屬性及疾病/治療資料、症狀困擾量表及健康照護需求量表，測量時間在手術前、出院前、出院後1個月及3個月。結果顯示「整合性癌症照護模式」執行率為89.4%，實驗組出院前心理健康照護需求顯著低於手術前(β=-.353, p=.028)；實驗組症狀困擾在出院後1個月(β=.152, p=.028)及3個月(β=.141, p=.044)顯著高於對照組；共變項以化學治療因素影響較顯著；兩組在身體及社會健康照護需求則無差異。建議調整「整合性癌症照護模式」之連續性照護時間，以利了解提供減緩症狀與滿足需求的新契機，以達整合性照護的價值與意義。
Background: Patents with oral cancer require urgent disease and treatment-related care to cope with the impact of facial disfigurement and changes in life focus due to surgery. Purpose: This study evaluated the effectiveness of an integrated cancer care program on the symptom distress and health care needs of patients with oral cancer. Methods: A longitudinal and experimental design was adopted for this study. We provided the integrated cancer care program to patients with oral cancer who had undergone initial surgery during hospitalization. All patients were evaluated at four time points: presurgery (baseline, T1), predischarge (T2), 1 month postdischarge (T3), and 3 months postdischarge (T4). Data were analyzed using a generalized estimating equation. The followed variables were symptom distress and health care needs (with physical, psychological, and social dimensions). Results: A total of 96 participants were recruited and randomly assigned to a control group (n= 49) and experimental group (n= 47). Partients in the experimental group received the integrated cancer care program at a medical center in central Taiwan. The executive rate of the program was 89.4%. Fatigue and dry mouth were two recurring symptoms in both groups from presurgery to 3 months postdischarge. The predischarge mental health care need was lower in the experimental group than in the control group (β= -.353, p= .028). Because of chemotherapy, symptom distress at 1 (β= .152, p= .028) and 3 (β= .141, p= .044) months postdischarge was higher in the experimental group. No significant changes in physical and social health care needs were observed. Conclusions and implications: Overall, the study results revealed that the multidisciplinary medical team could reinforce the functions of the integrated cancer care program and assist patients with oral cancer in coping with disease and treatment-related changes. Thus, the program implemented in this study was deemed successful in improving symptom distress and reducing health care needs among patients with oral cancer.
期刊論文
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3.賴裕和(19980800)。門診接受化學治療病人之症狀困擾及居家護理需求探討。護理研究，6(4)，279-289。new window  延伸查詢new window
4.黃惠美、周幸生、陳玉枝(20140800)。乳癌無縫服務--以某醫學中心實證模式建構整合性乳癌病人照護為例。源遠護理，8(2)，5-11。  延伸查詢new window
5.Chen, S. C.、Liao, C. T.、Lin, C. C.、Chang, J. T. C.、Lai, Y. H.(2009)。Distress and care needs in newly diagnosed oral cavity cancer patients receiving surgery。Oral Oncology，45(9)，815-820。  new window
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7.林佳慧、曾雯琦、蔣尚霖、蔣立琦(20121200)。以病人為中心照護對臨床的成效。護理雜誌，59(6)，104-110。new window  延伸查詢new window
8.張美玉、徐莞雲、徐倩儀、林麗英(20160900)。新診斷癌症病人生活品質之相關因素探討。榮總護理，33(3)，293-302。new window  延伸查詢new window
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11.Huang, B.、Chen, H.、Deng, Y.、Yi, T.、Wang, Y.、Jiang, Y.(2016)。Diagnosis, disease stage, and distress of Chinese cancer patients。Annals of Translational Medicine，4(4)，73。  new window
12.Jesse, M. T.、Ryan, M. E.、Eshelman, A.、Ghanem, T.、Williams, A. M.、Miller-Matero, L. R.、Yaremchuk, K.(2015)。Integrated psychological care in head and neck cancer: Views from health care providers, patients, and supports。The Laryngoscope，125(6)，1345-1351。  new window
13.Kodner, D. L.、Spreeuwenberg, C.(2002)。Integrated care: Meaning, logic, applications, and implications--a discussion paper。International Journal of Intergrated Care，2(4)。  new window
14.Mignogna, M. D.、Fedele, S.、Russo, L. L.(2004)。The world cancer report and the burden of oral cancer。European Journal of Cancer Prevention，13(2)，139-142。  new window
15.Mochizuki, Y.、Matsushima, E.、Omura, K.(2009)。Perioperative assessment of psychological state and quality of life of head and neck cancer patients undergoing surgery。International Journal of Oral and Maxillofacial Surgery，38(2)，151-159。  new window
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17.Ouwens, M. M.、Hermens, R. R.、Hulscher, M. M.、Merkx, M. A.、van den Hoogen, F. J.、Grol, R. P.、Marres, H. A.(2009)。Impact of an integrated care program for patients with head and neck cancer on the quality of care。Head & Neck，31(7)，902-910。  new window
18.Ouwens, M. M.、Marres, H. A.、Hermens, R. R.、Hulscher, M. M.、van den Hoogen, F. J.、Grol, R. P.、Wollersheim, H. C.(2007)。Quality of integrated care for patients with head and neck cancer: Development and measurement of clinical indicators。Head & Neck，29(4)，378-386。  new window
19.Ouwens, M.、Hulscher, M.、Hermens, R.、Faber, M.、Marres, H.、Wollersheim, H.、Grol, R.(2009)。Implementation of integrated care for patients with cancer: A systematic review of interventions and effects。International Journal for Quality in Health Care，21(2)，137-144。  new window
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21.Singer, S. J.、Burgers, J.、Friedberg, M.、Rosenthal, M. B.、Leape, L.、Schneider, E.(2011)。Defining and measuring integrated patient care: Promoting the next frontier in health care delivery。Medical Care Research and Review，68(1)，112-127。  new window
22.Valentijn, P. P.、Boesveld, I. C.、van der Klauw, D. M.、Ruwaard, D.、Struijs, J. N.、Molema, J. J. W.、Vrijhoef, H. J. M.(2015)。Towards a taxonomy for integrated care: A mixed-methods study。International Journal of Integrated Care，15(1)，e003。  new window
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其他
1.衛生福利部國民健康署(2016)。中華民國103年癌症登記報告，https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=7330， 。  延伸查詢new window
 
 
 
 
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