末期病人的預後：醫療照護團隊需要再進修的課題

Prognosis for Terminally Ill Patients: Curriculum Needed for the Health Care Team

醫學有三項技能，診斷、治療及預後。診斷是將正確的病名及病因找出來，治療是在診斷後擬定治療方針，預後是預測末期疾病在自然過程中會產生各種結果的相對可能性。若有病人較準確的預後資訊，病人將可有較適宜的末期生涯規劃及對治療的考量，家屬則對未來事物有較適宜的規劃，醫護人員則可讓安寧療護發揮最大作用，能明智的使用醫療，及避免病人在臨終時的不必要治療。一位訓練優良的醫師應具備對疾病診斷、治療、及預後的能力。

Diagnosis, treatment, and prognosis have been recognized as the three major clinical skills in medicine. Diagnosis is finding the definite etiology of a disease, treatment is to make decision of strategy after diagnosis, and prognosis is the relative probabilities of the various outcomes of the nature history of a terminal disease. If the information about patient’s prognostication is more accurate, patient can benefit from appropriate planning about his (her) end-of-life, and appropriate decision making about his (her) treatment. Patient’s family can benefit from appropriate planning about his (her) daily work. Hospice physicians and coworkers may benefit from optimizing the use of hospice care, making judicious use of medical treatment, and avoiding futile treatment near the patient’s dying stage. A well-trained physicians needs to be proficient at diagnosis, treatment, and prognosis.