重症過渡期照護計畫，對加護病房病人及其家屬遷移之影響

The Impact of Critical Care Transition Programs (CCTPs) on Relocation Stress in Patients and Patient Families in the Intensive Care Unit

加護病房為危急重症單位，當脫離急性期即需轉銜至普通或慢性單位後續照護，從加護病房轉至普通病房意味從高強度護理環境轉銜至低強度護理環境，即將離開安全並往未知的環境遷移， 與加護病房非計畫重返與住院天數增加、不良事件以及與病人及家屬重症轉銜壓力症候群息息相關，對病人而言可能影響復原進展，對家庭而言運作也備受考驗，可併發病人或家屬對於疾病因應失調、不確定感或降低治療反應，甚至對醫護團隊之不信任感增加、幸福感與生活品質降低。近年來護理專業逐漸重視全人照護，重症團隊應積極教育培訓醫護人員，建立轉銜標準化評估工具，早期為即將轉銜出加護單位的個案量身訂作轉出計畫，了解家屬的處境經驗，評估病人或家屬需求，設定照護計畫目標，善用醫病共享決策以及跨專科支援，改善醫護團隊的溝通，如此才能更精準地面對轉銜準備，提升重症照護品質與成效。

The intensive care unit (ICU) is designed to care for patients with high disease severity who require critical care and close monitoring. Patients in the ICU may be transferred to the general ward for further treatment following recovery from the acute phase. Transferring from the ICU to the general ward after acute phase recovery is a stressful event that may stress both the patient and their family, potentially resulting in relocation stress syndrome (RSS). RSS has been found to be closely related to unplanned ICU readmissions, prolonged hospitalization, and adverse events, affecting recovery to health and family peace of mind. Furthermore, RSS may result in ineffective disease coping, feelings of uncertainty, and poor treatment response, leading to prolonged hospitalization, reduced trust in medical staff, and decreased happiness and quality of life. In recent years, the nursing profession has attached increasing importance to holistic health care. This has encouraged critical care teams to map out customized relocation plans for patients who are about to be transferred from the ICU that use standardized evaluation tools for transfers and elicit the situation and needs from patients or their family. Through the setting of care goals, shared decision making, and cross-unit support, enhanced communications among the medical team facilitate transition preparation and improve the quality and effect of intensive care.