應用個案管理照護模式於化學治療肺癌病人之成效

Efficacy of Case Management Care Model for Lung Cancer Patients Under Chemotherapy

本研究目的為探討應用個案管理照護模式對化學治療肺癌病人之成效。採類實驗研究方法，研究對象為台灣北區某醫學中心接受化學治療住院之肺癌病人，隨機分為實驗組和對照組，實驗組採個案管理照護模式，對照組維持原有之照護模式，兩組各收案100人，比較不同照護方式成效之差異。使用研究工具為照護成效量表，包括病人基本資料、照護成效及病人滿意度量表。研究結果發現兩組病人之平均住院天數(t= 6.22, p < .001)、住院醫療費用(t= 4.49, p < .001)、實驗組與對照組之非計畫性十四天再住院率分別為7％與17％、三天內再入急診率為0％與1％，以上四項均是實驗組比對照組低。而病人對照護滿意度則實驗組高於對照組(t= 5.79, p < .001)均達統計上顯著差異。個案管理照護模式對於化學治療肺癌病人之照護有正向成效，並提昇病人對照護滿意度及節省醫療成本，個案管理照護模式值得積極推廣及建立。

The purpose of this study was to investigate the efficacy of applying case management care model on lung cancer patients under chemotherapy. The study was a quasi-experimental design. Subjects were recruited from a chemotherapy unit at a medical center in northern Taiwan. Subjects were randomly assigned into experimental or control groups with each group 100 subjects. Subjects in the experimental group were provided with the case management care model, and control subjects received standard care. Assessment tools used in this study included questionnaire collecting patients’basic demographic data, nursing care scale and patients’ satisfaction scale. The study results showed that there were significant differences between two groups in hospitalization length of stay, medical cost, non-planned rehospitalization within 14 days, and re-entry emergency within 3 days after discharge (0% vs 1%). Patients’ satisfaction level was also different between groups. In conclusion, case management care model had positive effects on patient care. It significantly improved patients’ satisfaction level and reduced medical costs. We suggested that the case management care model can be promoted and implemented for caring lung cancer patients.