醫病共享決策輔助工具

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我/我的家人癌症末期進食減少時,需要打營養針嗎?

科別 家庭醫學科
主題類別 內分泌、營養與代謝
決策類型 治療
關鍵字 醫病共享決策、末期癌症、惡病質、靜脈輸液、安寧療護
適用病人條件 癌症末期病人出現進食減少或是消瘦等現象考慮使用營養針者。
可供選擇決策方案 注射水分或營養針,依病人意願進食
使用場所 病房
執行者 醫師、護理師、個案管理師
開發團隊、機構 臺北榮民總醫院安寧療護科A211大德病房
輔助工具研發過程說明

癌症病人隨疾病進展病況進入末期,無法再進行有效的抗癌治療,末期病人面臨身體上諸多症狀導致進食量減少、食慾不振,體重減輕、疲憊虛弱等,我們東方人文化民以食為天,常以詢問親人有沒有吃飽來表達我們的關心,此時病人或其家屬會詢問是否補充人工水分或營養針,但不同時期有不同的營養需求,故本決策輔助工具分析注射人工水分及營養帶來的益處及缺點、或依自己進食的意願進行補充營養等做討論,期望能讓病人及其家屬了解不同醫療選項後再透過與醫療人員充分討論溝通後,做出最佳決策。

參考文獻

Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., ... & Krznaric, Z. (2017). ESPEN guidelines on nutrition in cancer patients. Clinical nutrition, 36(1), 11-48.
Bouleuc, C., Anota, A., Cornet, C., Grodard, G., Thiery‐Vuillemin, A., Dubroeucq, O., ... & Favier, L. (2020). Impact on Health‐Related Quality of Life of Parenteral Nutrition for Patients with Advanced Cancer Cachexia: Results from a Randomized Controlled Trial. The Oncologist, 25(5), e843.
Bruera, E., Hui, D., Dalal, S., Torres-Vigil, I., Trumble, J., Roosth, J., ... & Allo, J. (2013). Parenteral hydration in patients with advanced cancer: a multicenter, double-blind, placebo-controlled randomized trial. Journal of clinical oncology, 31(1), 111.
Bruera, E., Sala, R., Rico, M. A., Moyano, J., Centeno, C., Willey, J., & Palmer, J. L. (2005). Effects of parenteral hydration in terminally ill cancer patients: a preliminary study. Journal of clinical oncology, 23(10), 2366-2371.
Cerchietti, L., Navigante, A., Sauri, A., & Palazzo, F. (2000). Hypodermoclysis for control of dehydration in terminal-stage cancer. International journal of palliative nursing, 6(8), 370-374.
Good, P., Richard, R., Syrmis, W., Jenkins‐Marsh, S., & Stephens, J. (2014). Medically assisted hydration for adult palliative care patients. Cochrane Database of Systematic Reviews, (4).
Good, P., Richard, R., Syrmis, W., Jenkins‐Marsh, S., & Stephens, J. (2014). Medically assisted nutrition for adult palliative care patients. Cochrane Database of Systematic Reviews, (4).
Good, P., Richard, R., Syrmis, W., Jenkins‐Marsh, S., & Stephens, J. (2014). Medically assisted hydration for adult palliative care patients. Cochrane Database of Systematic Reviews, (4).
Good, P., Richard, R., Syrmis, W., Jenkins‐Marsh, S., & Stephens, J. (2014). Medically assisted nutrition for adult palliative care patients. Cochrane Database of Systematic Reviews, (4).
Lichtman, S. (2005). Association Between Hydration Volume and Symptoms in Terminally Ill Cancer Patients with Abdominal Malignancies. Clinical Oncology Alert, 20(7), 54-56.
McCann, R. M., Hall, W. J., & Groth-Juncker, A. (1994). Comfort Care for Terminally III Patients: The Appropriate Use of Nutrition and Hydration. Jama, 272(16), 1263-1266.
Prado, C. M., Sawyer, M. B., Ghosh, S., Lieffers, J. R., Esfandiari, N., Antoun, S., & Baracos, V. E. (2013). Central tenet of cancer cachexia therapy: do patients with advanced cancer have exploitable anabolic potential?. The American journal of clinical nutrition, 98(4), 1012-1019.
Viola, R. A. (1997). Studying fluid status and the dying: The challenge of clinical research in palliative care. University of Ottawa (Canada).
Wailer, A., Hershkowitz, M., & Adunsky, A. (1994). The effect of intravenous fluid infusion on blood and urine parameters of hydration and on state of consciousness in terminal cancer patients. American Journal of Hospice and Palliative Medicine®, 11(6), 22-27.

版本 2020