癌症住院病患對癌症個案管理師角色之認知與期望－－以南部某區域醫院為例

Cancer Patients' Perceptions and Expectations to the Role of Oncology Nurse Case Manager

癌症個案管理師為一新的進階護理角色，希望能基於以病人為中心的理念，了解癌症病人對個案管理師的想法，檢視工作流程，設計貼近癌症個案職務內容。本研究在調查南部某醫院之癌症住院病患對於癌症個管師角色認知與期望，並找出預測因子。用自擬式問卷經7位專家修正，以個案醫院癌症個管師收案之住院病患為研究對象進行立意取樣，預試問卷(N=24)於2009年11月20日與12月25日發放，內在一致性α=0.92；正式問卷於2010年l月27日至2月10日發放，有效問卷為103份，α=0.92。結果顯示癌症住院病患對癌症個管師角色之認知與期望程度總分平均數分別為14.13分與31.01分，期望程度顯著大於認知程度(p<.001)。不論背景，病患對癌症個管師的期望都高於認知。44.66%的病患希望於返家後進行電訪、希望以手冊方式獲得飲食方面的衛教資訊者佔56.31%，不需要出院準備服務與服務團體者佔83.50%與77.67%。年齡和曾因癌症治療的住院次數可以做為是否需要衛教預測因子，整體正確率可達80.6%。依調查結果，建議醫院的癌症個案管理師應提升癌症住院病患對癌症個案管理師角色之認知，並根據個案需求使癌症個案管理師於病患就醫過程中能真正發揮其角色功能。

This research article explores cancer patients' perceptions and expectations of the role of oncology nurse case manager. The purpose of this research is to explicate the job description of oncology nurse case manager based on cancer patients' expectations while facing cancer treatments. A self-administered questionnaire was designed for data collection. The survey questionnaire was reviewed and evaluated by seven experts before use. The purposeful sampling was used to select randomly the hospitalized cancer patients by the current case manager in a teaching hospital in southern Taiwan. The pre-test survey (N=24; Cronbach's α=0.93) was conducted from November 20 to 25, 2009. The formal survey was conducted from January 27 to February 10, 2010. The total number of returned valid survey questiolmaires was 103 (Cronbach's α=0.92). The expectation level was significantly much higher than the perceived level (p<.001). The average scores of perceived level and expectation level were 14.13 and 31.01 respectively. No matter what the patients' backgrounds are, their expectations were much higher than what they perceived. 44.66% of the surveyed patients hoped that the advanced oncology nurse case manager would do follow-up calls after they were discharged. 56.31% of the patients hoped to have an educational brochure for diet. 83.50% and 77.67% of the patients answered no need to the question of discharge preparation and service group, respectively. A patient's age and the number of hospitalization for cancer treatment can be used as the predictors for the need of health education. The accuracy rate of this research was 80.6%. In conclusion, the role of advanced oncology nurse case manager can be reinforced based on this research study.