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題名：婦癌病人介入個案管理照護於化學藥物治療完成率之成效
書刊名：榮總護理
作者：李娜蓉／陳秀蓮／李惠玲／洪雯玲／陳汝芬／吳聖良
作者(外文)：Lee, Na-rong／Chen, Shiu-lien／Lee, Hui-ling／Hung, Wen-ling／Chen, Ru-fen／Wu, Shang-liang
出版日期：2017
卷期：34:2
頁次：頁167-178
主題關鍵詞：個案管理照護；化學藥物治療；婦癌；Case management care；Chemotherapy；Gynecological cancer
原始連結：連回原系統網址new window
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腫瘤個案管理已成為台灣癌症照護的主流模式，此模式介入的照護成效可做為臨床個案管理照護策略調整的參考。國內外對運用個案管理照護於婦癌病人化學藥物治療( 化療) 完成率之探討付之闕如，本研究比較介入建構完整的婦癌個案管理模式世代的病人與非介入個案管理模式世代的病人，接受化療首次療程的完成率及其三個年度間的改變情形。採回溯性世代研究法進行兩個世代之比較，共收案563 位婦癌病人，其中非個案管理世代有196 位，個案管理世代有367 位。每個世代皆回溯病人三年化學藥物治療完成率，共追蹤六年。本研究以Excel 統計分析，結果發現個案管理世代病人的化療完成率較非個案管理世代的高且每年維持在90% 以上；經廣義估計方程式比較化療完成率，個案管理世代之化療完成率連續三年均較高，達統計顯著差異(t = 3.624, p = .000)。本研究結果顯示個案管理照護對婦癌病人接受首次化療療程的完成率能逐年穩定成長且有上升之趨勢，透過腫瘤個案管理能提供婦癌病人整合且連續性照護，及早解決病人無法繼續接受化療的問題，可更有效地提升婦癌病人的化療完成率，增進癌症照護品質。
Cancer case management has become the main mode of cancer care in Taiwan. This mode of care and intervention has resulted in better efficiency and monitoring of clinical cases. Few domestic studies have investigated the completion rate of chemotherapy in gynecological cancer patients using case management strategies. This study compared gynecological cancer patients with constructs involving complete case management and noncase management. The rate of completion of the first chemotherapy treatment and the change between 3 years were examined. A retrospective cohort study was performed on all gynecological cancer patients. The study group was divided into before and after case management implementation in patient care, and a 3-year chemotherapy completion rate was calculated for each group. A total of 563 cases of gynecological cancer patients were included in this statistical analysis, of which 196 were cases of nongynecological cancer management, and 367 were cases of female cancer management. Completion rates were backtracked for a total of 6 years. Each generation is back to the patient for 3 years to complete the rate of chemotherapy. Intervention of case managers yielded a higher chemotherapy completion rate (＞ 90%) than nonmanaged cases. Completion rates in case management in gynecologic cancer were higher than for nonmanaged cases, yielding a significant difference (t = 3.624, p = .000). The results of this study demonstrate that case management care for female cancer patients receiving chemotherapy treatment produces completion rates that increase annually, with a stable trend of rising. The results demonstrate improved patient chemotherapy completion rates. Promotion and implementation of cancer case management should allow for improved chemotherapy completion rates. Cancer case management can be used to provide gynecological cancer patients with integrated and continuous care. The problem of patients being unable to continue to receive treatment can be solved early, thereby, improving the rate of chemotherapy of gynecological cancer patients and enhancing the quality of cancer care.
期刊論文
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2.Tahan, H. A.、Campagna, V.(2010)。Case management roles and functions across various settings and professional disciplines。Professional Case Management，15(5)，245-277。  new window
3.周碧玲、林佳靜(20120200)。醫病關係對癌症病人服藥遵從性與症狀控制的影響。護理雜誌，59(1)，11-15。new window  延伸查詢new window
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5.Sun, V.、Otis-Green, S.、Morgan, R.、Wakabayashi, M.、Hakim, A.、Callado, M. E.、Grant, M.(2013)。Toxicities, complications, and clinical encounters during intraperitoneal chemotherapy in 17 women with ovarian cancer。European Journal of Oncology Nursing，17(3)，375-380。  new window
6.游千代、馮明珠、柯乃熒(20130800)。個案管理之概念分析。護理雜誌，60(4)，99-104。new window  延伸查詢new window
7.王鵬惠、吳香達(20120400)。卵巢癌的節拍性治療法。中華民國婦癌醫學雜誌，2012(1)2，1-4。  延伸查詢new window
8.吳詩萍、許雅娟(20161200)。初次接受化學治療之癌症老年病人之因應行為與症狀困擾相關性之探討。護理雜誌，63(6)，30-40。new window  延伸查詢new window
9.周淑嵐、林梅香、林玉芬、姜亭妤、王靜婷、王昭慧(20150600)。個案管理過程中運用PRECEDE模式探討癌症病人中斷治療影響因素。腫瘤護理雜誌，15(1)，39-46。  延伸查詢new window
10.蔡秀芬、周桂如(20151200)。癌症病人化學治療期間症狀困擾與聆聽音樂習性之分析。榮總護理，32(4)，406-415。new window  延伸查詢new window
11.Chen, Y. C.、Chang, Y. J.、Tsou, Y. C.、Chen, M. C.、Pai, Y. C.(2013)。Effectiveness of nurse case management compared with usual care in cancer patients at a single medical center in Taiwan: A quasiexperimental study。BMC Health Services Research，13(1)，202。  new window
12.Cliby, W. A.、Powell, M. A.、Al-Hammadi, N.、Chen, L.、Miller, J. P.、Roland, P. Y.、Bristow, R. E.(2015)。Ovarian cancer in the United States: Contemporary patterns of care associated with improved survival。Gynecologic Oncology，136(1)，11-17。  new window
13.Colombo, N.、Carinelli, S.、Colombo, A.、Marini, C.、Rollo, D.、Sessa, C.、Group, E. G. W.(2012)。Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up。Annals of Oncology，23(suppl. 7)，vii27-vii32。  new window
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15.Di Mattei, V. E.、Carnelli, L.、Carrara, L.、Bernardi, M.、Crespi, G.、Rancoita, P.、Mangili, G.(2016)。Chemotherapy-Induced nausea and vomiting in women with gynecological cancer: A preliminary single-center study investigating medical and psychosocial risk factors。Cancer Nursing，39(6)，E52-E59。  new window
16.Hershman, D. L.、Shao, T.、Kushi, L. H.、Buono, D.、Tsai, W. Y.、Fehrenbacher, L.、Neugut, A. I.(2011)。Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer。Breast Cancer Research and Treatment，126(2)，529-537。  new window
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18.Li, P.、Li, F.、Fang, Y.、Wan, D.、Pan, Z.、Chen, G.、Ma, G.(2013)。Efficacy, Compliance and Reasons for Refusal of Postoperative Chemotherapy for Elderly Patients with Colorectal Cancer: A Retrospective Chart Review and Telephone Patient Questionnaire。PLOS ONE，8(2)，e55494。  new window
19.Landrum, L. M.、Gold, M. A.、Moore, K. N.、Myers, T. K. N.、McMeekin, D. S.、Walker, J. L.(2008)。Intraperitoneal chemotherapy for patients with advanced epithelial ovarian cancer: A review of complications and completion rates。Gynecology Oncology，108(2)，342-347。  new window
20.Morris, M.、Platell, C.、Fritschi, L.、Iacopetta, B.(2007)。Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients。British Journal of Cancer，96(5)，701-707。  new window
21.van Waart, H.、Stuiver, M. M.、van Harten, W. H.、Geleijn, E.、Kieffer, J. M.、Buffart, L. M.、Aaronson, N. K.(2015)。Effect of lowintensity physical activity and moderateto high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: Results of the PACES randomized clinical trial。Journal of Clinical Oncology，33(17)，1918-1927。  new window
22.Wulff, C. N.、Vedsted, P.、Søndergaard, J.(2012)。A randomised controlled trial of hospital-based case management to improve colorectal cancer patients' healthrelated quality of life and evaluations of care。British Medical Journal open，2(6)，e001481。  new window
23.Wulff, C. N.、Vedsted, P.、Sondergaard, J.(2013)。A randomized controlled trial of hospital-based case management in cancer care: A general practitioner perspective。Family Practice，30(1)，5-13。  new window
24.張黎露(20101200)。腫瘤個案管理師之發展與未來展望。腫瘤護理雜誌，10(增刊)，1-9。  延伸查詢new window
研究報告
1.衛生福利部統計處(20160805)。104年主要死因統計結果分析。  延伸查詢new window
圖書
1.Dawson-Saunders, Beth、Trapp, Robert G.(1990)。Basic and Clinical Biostatistics。Appleton & Lange。  new window
其他
1.衛生福利部國民健康署(20160426)。癌症醫療品質，http://www.hpa.gov.tw/Pages/List.aspx?nodeid=208。  延伸查詢new window
 
 
 
 
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