安寧療護疼痛處置參考指引於癌末病患使用成效之調查

Advaced Cancer Patient's Pain Management Guideline in Hospice Care

本研究目的，希望能評值安寧療護疼痛處置參考指引於安寧病房與非安寧病房之使用與現況，探討安寧病房與非安寧病房醫護人員對於安寧療護疼痛處置參考指引之使用頻率與看法。以作為日後修訂疼痛處置參考指引之依據與參考。研究對象為曾有照顧癌症病患之醫師與護理人員。研究地點為已成立安寧病房之醫院，與未成立安寧病房之醫院。本研究共訪得139位醫護人員，研究結果顯示：(1)安寧病房與非安寧病醫護人員對於是否知道安寧療護疼痛處置參考指引的呈現差異。(2)曾參與安寧療護相關訓練課程者，對於指引手冊的評分高於未曾參與安寧療護相關訓練課程者。(3)醫護人員對安寧療護疼痛處置參考指引的滿意度平均為3.94(SD=.79)。(4)醫護人員對安寧療護疼痛處置參考指引的期待為縮小手冊的體積，以方便攜帶，以及定期修改內容，提供新知。本研究結果有助於政府以及安寧療護各領域專家了解安寧療護疼痛處置參考指引，目前於臨床使用現況，提供未來修訂安寧療護疼痛處置指引時之重要參考。

The Guideline for Pain Management for Hospice Care was developed by the National Department of Health in December, 2000. The purpose of this study was to explore the efficacy of the Guideline in Taiwan and to compare the satisfaction of the physicians and nurses working at hospice units and non-hospice units. One hundred and thirty-nine participants were recruited, including 112 nurses and 27 physicians. The results indicated that there was a significant difference between the people working at hospice and non-hospice units based on having known or read the Guideline ofPain Management. Second1y, it was found that those who had received hospice training program reported significantly higher levels of satisfaction for the Guideline of Pain Management than those who had not received hospice training program. Thirdly, the physicians and nurses reported the mean score of satisfaction in the Guideline of Pain Management was 3.94 (SD=.79). Finally, most of the physicians and nurses would like to modify the size of Guideline of Pain Management to a smaller size in order to keep it stand by. This study has provided important implications as to the multidisciplinary teams that take care for hospice patients for the government to understand how to best use the Guideline of Pain Management in clinical and offer important suggestions to further modify the Guideline.