醫病共享決策輔助工具

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末期病人準備出院了,他/她適合回家照顧、入住機構,還是轉到其他醫院?

科別 家庭醫學科
主題類別 其他
決策類型 其他照護場所選擇
關鍵字 醫病共享決策、末期病人、出院、照護場所、醫病共享決策輔助工具、PDA、SDM
適用病人條件 末期病人及其家屬 / 當病人於醫院症狀控制穩定準備出院時,後續照護場所的選擇及討論。
可供選擇決策方案 返家照顧,機構照顧,轉院照顧
使用場所 病房心理師
執行者 醫師、護理師、個案管理師、社工、其他
開發團隊、機構 北榮民總醫院家庭醫學部安寧療護科安寧病房
輔助工具研發過程說明

末期病人身體疾病狀況的變動性較高,且日常生活可能需要他人協助。
於此,當病人的發燒、疼痛等急性症狀緩解,住院的治療告一段落、身體狀況相對穩定準備出院時,通常仍會需要一個能夠持續提供其照護支持的場所,以保障後續生活品質、甚至生命善終的權益。
除了個人的價值偏好外,照護環境、照護人力、家庭或個人經濟,以及病人和家屬的身心狀態,皆為需納入出院準備的考量事項,且病人和家屬在這過程中,往往也需要透過資訊的了解、知識和經驗的熟悉學習,來調適所面臨到的不確定感和壓力等。因此,本決策輔助工具以末期病人及其家屬為對象,統整三種常見出院後照護模式的比較(居家照護、機構照護、轉院照護),期望能協助案家對不同照護模式的特點有所了解,並逐步探索出自身需求和在意的事情,以利在出院後照護場所的選擇上,做出最適合的決策。
本輔助工具目前已完成內容可讀性測試、α測試,以及初步的非醫療人員使用者經驗調查,並綜合測試意見進行相關修訂。詳細內容請見附件。

參考文獻

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版本 2020