提升口腔癌顯微重建病人術後溝通滿意度之改善專案

Enhancing the Communication Satisfaction after the Microsurgical Reconstruction in Patients with Oral Cancers

口腔癌病人常因術後顏面構造改變及氣管造口、氣管內管留置，導致無法以言語與家屬及醫療人員溝通表達其需求，容易延誤處置時機及降低對溝通照護之滿意度。本專案旨在提升口腔癌顯微重建病人術後溝通之滿意度，專案期間自2012年6月1日至2012年12月31日，經現況分析發現：口腔癌顯微重建病人對術後溝通滿意度低，僅2.45分、病人與護理人員術後溝通時間平均長達15分鐘、缺乏口腔癌顯微重建術後病人個別性之溝通工具。擬定之解決方案包括：修訂口腔癌顯微重建病人術後使用之溝通輔具、設計製作心情手札本、訂定術前溝通衛教計畫。經介入措施實施後，病人對護理人員術後溝通滿意度提升至4.65分，病人與護理人員溝通時間平均縮短為8分鐘，而透過完善的術前溝通計畫及運用住院心情手札本可激勵病人勇敢面對疾病與治療，病人的滿意度高達95%。顯示專案成果可促進口腔癌顯微重建病人與臨床護理人員間的有效性溝通，期望藉由此專案改善口腔癌顯微重建病人溝通不良，能及時滿足其需求，增加與他人互動機會，俾提升病人生活品質與整體醫療照護品質。

Postoperative facial disfigurement, and tracheostomy tube or endotracheal tube insertion in patients with oral cancers can result in difficulties in communicating with family members and medical staff and in expressing needs verbally, causing delay in care and low satisfaction toward communication and care. The aim of this project (from 1 June 2012 to 31 December 2012) was to promote the satisfaction toward communication in patients with oral cancers after microsurgical reconstruction. The preimplementation study showed that satisfaction toward communication satisfaction was as low as 2.45 and the average time needed for explicit communication between patients and nursing staff was 15 minutes, and the supportive communication tools was not available. The proposed solutions included revision of the communication aids, design and production of the mood notebooks, and provision of preoperative communication and health education. After interventions, the postoperative communication satisfaction increased to 4.65 and the average time for communication between patients and nursing staff was shortened to 8 minutes. The use of comprehensive communication plans preoperatively and the mood notebooks during hospitalization may motivate patients to face the diseases and treatment bravely and improve the patients’ satisfaction up to 95%. This project can facilitate the clinical effectiveness of communication between the patients and nursing staff. With proposed solution this project, we expected that we could improve the communication satisfaction, meet the patients’ needs in time, and increase the opportunities for interaction with caregivers, and ultimately promote the quality of life of patients and the overall quality of care.