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題名:癌症病人中斷回診追蹤之因素探討
書刊名:醫務管理期刊
作者:羅翊文吳易霖陳金淵 引用關係
作者(外文):Luo, Yi-wenWu, Yi-linChern, Jin-yuan
出版日期:2018
卷期:19:4
頁次:頁316-336
主題關鍵詞:癌症中斷回診追蹤癌症登記資料庫電話問卷調查羅吉斯迴歸CancerInterrupted follow upCancer registry databaseTelephone surveyLogistic regression analysis
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(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:2
  • 點閱點閱:12
目的:回診追蹤是癌症防治重要的一環,惟目前探討病人中斷回診追蹤的文獻仍不多見且結果不一,有鑑於此,本研究擬結合人口屬性、不同癌別及疾病特徵檢測其對回診追蹤之影響力並瞭解中斷原因,供臨床照護者發展更完善之照護模式時之參考。方法:資料來源為南部某醫學中心之癌症登記資料庫,研究對象為5,623人,而中斷回診者有471人,以羅吉斯迴歸模式進行影響因素分析。另,隨機抽樣219位存活者進行結構式「中斷回診追蹤問卷」之電話訪談,有效回收176份。結果:就研究對象之個別屬性而言,女性、39歲以下、居住其它縣市、罹患婦癌/乳癌/內分泌及神經系統者、0期/1期患者以及確診後第4年者中斷回診追蹤之比例相對較高。而二元羅吉斯回歸之分析也發現,年齡、居住地、整併期別、癌別與診斷年分具顯著預測力,整體模式之解釋力及適配度呈現良好。中斷原因以轉院為主,其次是等候時間太長、距離太遠與自覺身體狀況良好;再者,不同年齡層之中斷回診原因有所不同。結論:面對罹癌人數逐年增加且逐漸年輕化的趨勢,如何提供年輕族群(39歲以下)、早期期別、不同癌別等特定族群有效的衛教活動,進而提升定期回診追蹤之意願,值得臨床照護提供者及衛生政策制訂者思考。
Objectives: For 35 years in a row, cancer has been the leading cause of death in Taiwan, and follow-up is considered an important measure for the prevention of recurrence. To date, however, there are few studies related to interrupted follow-up issues. Further, the results and conclusions are inconsistent. Therefore, this study aimed to contribute to existing literature by examining the predictive effect of patient's demographic and disease's characteristics on the causes of interrupted follow-up in a more comprehensive approach. Methods: Data were extracted from the Cancer Registry Database of a medical center in southern Taiwan. 5,623 cases were included. There were 471 cases with interrupted follow-up by July 14, 2017. Binary logistic regression statistics were analyzed to examine the predictive model performance. In addition, a telephone survey with structured questionnaire was implemented among randomly selected 219 survivors, with 176 valid responses. Results: Overall, female patients, aged under 39, residing outside the hospital's city, with gynecological cancer/neuroendocrine tumors, stage 0 or 1, or in the fourth year after diagnostic confirmation, were relatively more likely than their counterparts to stop their follow-ups. The binomial logistic regression model showed that age, residence, cancer stage and year of diagnosis were significant predictors. Transfer to other hospital was the main cause for interruption, followed by long waiting time at the physician's office, far-distance transportation from residence to hospital, and self-perception of good health. Besides, causes differed across different age groups. Conclusions: Facing increasing cancer prevalence and a trend of younger incidence age, health care providers need to pay more attention about enhancing the patient's willingness to conduct regular follow-up visit through effective design of health education program for each specific group of patients.
期刊論文
1.藍毓莉、陳建智、吳文彬(20120300)。B型肝炎帶原者之健康信念與回診行為關聯性研究。顧客滿意學刊,8(1),69-86。new window  延伸查詢new window
2.林奎利、郭珍妮、林立青、林逢嘉、蘇玫綺(20040900)。癌症患者放射治療後迴診追蹤中斷的原因及分析。放射治療與腫瘤學,11(3),151-156。  延伸查詢new window
3.何玉瑛、葉德豐、張育嘉、陳呈旭、陳錦華(20120900)。影響慢性腎臟病患定期回診因素及定期回診對病程變化的效益。醫務管理期刊,13(3),147-161。new window  延伸查詢new window
4.洪毓陽、洪素鶯、周正亮、陳適安(20140900)。臺灣臨床成效指標系統施行後急性心肌梗塞經心導管介入之患者接受心臟復健現況。臺灣復健醫學雜誌,42(3),153-160。  延伸查詢new window
5.洪景男、曾文盛、陳培展、陳彥廷(20060200)。癌症登記即時統計分析系統之建立。中華放射線醫學雜誌,31(1),29-34。  延伸查詢new window
6.財團法人癌症希望基金會(2015)。重大傷病續卡標準調整, 癌友權益受損?。希望會刊,74。  延伸查詢new window
7.張蕾(2012)。個體醫療需求及其影響因素研究綜述。衛生經濟研究,2,19-22。  延伸查詢new window
8.陳淑茹、李晴雯、呂志得(20071200)。癌症患者於放射治療後中斷回診的原因。北市醫學雜誌,4(9),853-860。  延伸查詢new window
9.Absolom, K.、Eiser, C.、Michel, G.、Walters, S. J.、Hancock, B. W.、Coleman, R. E.、Greenfield, D. M.(2009)。Follow-up care for cancer survivors: Views of the younger adult。Journal of Cancer,101(4),561-567。  new window
10.Arora, N. K.、Reeve, B. B.、Hays, R. D.、Clauser, S. B.、Oakley-Girvan, I.(2011)。Assessment of quality of cancer-related follow-up care from the cancer survivor's perspective。Journal of Clinical Oncology,29(10),1280-1289。  new window
11.Barakat, L. P.、Schwartz, L. A.、Szabo, M. M.、Hussey, H. M.、Bunin, G. R.(2012)。Factors that contribute to post-treatment follow-up care for survivors of childhood cancer。Journal of Cancer Survivorship,6(2),155-162。  new window
12.Berendsena, A. J.、Roorda, C.、Jansenc, L.、de Bock, G. H.(2016)。Patients' beliefs about the aims of breast cancer follow-up: A qualitative study。Maturitas,91,140-144。  new window
13.Brown, S.、Belgaumi, A.、Ajarim, D.、Kofide, A.、AI Saad, R.、Sabbah, R.、Levin, A.(2004)。Loss to follow-up of patients with malignant lymphoma。European journal of cancer care,13(2),180-184。  new window
14.Endo, T.、Kawai, K.、Kamba, T.、Inai, H.、Uchida, K.、Miyazaki, J.、Nishiyama, H.(2014)。Risk factors for loss to follow-up during active surveillance of patients with Stage I seminoma。Japanese journal of clinical oncology,44(4),355-359。  new window
15.Lewis, R. A.、Neal, R. D.、Williams, N. H.、France, B.、Hendry, M.、Russell, D.、Wilkinson, C.(2009)。Follow-up of cancer in primary care versus secondary care: systematic review。British Journal of General Practice,59(564),234-247。  new window
16.Rowland, J. H.、Hewitt, M.、Ganz, P. A.(2006)。Cancer survivorship: A new challenge in delivering quality cancer care。Journal of Clinical Oncology,24(32),5101-5104。  new window
17.Andersen, Ronald M.(1995)。Revisiting the behavioral model and access to medical care: Does it matter?。Journal of Health and Social Behavior,36(1),1-10。  new window
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研究報告
1.衛生福利部統計處(2017)。104年國人死因統計結果。台北:衛生福利部統計處。  延伸查詢new window
學位論文
1.黃子馨(2015)。探討乳癌存活者的就醫經驗與後續追蹤間的相關性(碩士論文)。國立臺灣大學,台北。  延伸查詢new window
2.劉德卿(2012)。以計畫行為理論預測失智症家屬陪同患者就醫的行為意圖(碩士論文)。中原大學。  延伸查詢new window
其他
1.衛生福利部國民健康署(2017)。民國104年癌症登記報告,台北:衛生福利部國民健康署。,http://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=8084。  延伸查詢new window
2.衛生福利部(2010)。全民健康保險乳癌醫療給付改善方案試辦計畫,台北:衛生福利部中央健康保險署。  延伸查詢new window
 
 
 
 
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