家庭專科護理師（FNP）在全球推動在宅醫療的角色與挑戰：專業洞察

The Role and Challenges of Family Nurse Practitioners (FNPs) in Advancing Home Healthcare Globally: Professional Insights

全球人口老化是21世紀醫療體系面臨的重大挑戰之一（Hong et al., 2023; Sammy et al., 2019）。根據聯合國的統計，至2050年全球65歲以上的老年人口將達到21億，約佔總人口的20%（Trask, 2009; Unit-ed Nations Department of Economic and Social Affairs, 2018）。隨著人口老化，與高齡相關的慢性疾病如高血壓、糖尿病、心血管疾病和失智症的盛行率也迅速上升（Halonen et al., 2019）。這些疾病需要長期管理，而不僅僅是依賴急性醫療服務（Palladino et al., 2016）。因此，醫療體系必須正視高齡健康照護問題，並提供更多個別化和持續性的照護服務
隨著全球人口老化及慢性病個案數量的增加，醫療服務模式正發生重大變革（Estes et al., 2019）。傳統的醫療模式往往依賴於機構化的照護設施，如醫院和長期照護機構，然而，這種模式存在諸多不足，特別是在面對龐大的老年人口和慢性病個案時（Sendall et al., 2017）。首先，機構化照護的成本高昂，對許多國家而言是沉重的財政負擔（Moon & Choi, 2018）。其次，這種模式常常無法滿足個人化的健康需求，尤其是在慢性病管理方面（de Medeiros et al., 2020）。許多高齡者希望在家中接受醫療服務，這樣不僅更符合他們的生活方式，還能減少頻繁前往醫院帶來的不便。因此，居家醫療應運而生，成為一種更經濟且靈活的照護模式（Rimmele et al., 2021）。在這一轉變過程中，家庭專科護理師（Family Nurse Practitioner, FNP）作為核心角色，正在引領這場醫療革命（Della-fiore et al., 2022; Tsay et al., 2021）

 

With the accelerating global aging population, the importance of home healthcare services is be-coming more pronounced, and Family Nurse Practitioners (FNPs) play a pivotal role in this transfor-mation. Their expanded scope of practice allows them to provide personalized health assessments, diagnose diseases, prescribe medications, and manage chronic conditions, ultimately reducing hos-pital admissions and enhancing patients’ quality of life. Several countries, such as the United States, United Kingdom, Canada, and Australia, have integrated FNPs into their home healthcare systems. In these nations, FNPs deliver primary care in remote areas, leading to a significantly reducing medical expenses and hospitalization rates. Taiwan faces similar challenges due to rapid population aging. Although the potential for FNP development is substantial, issues such as restrictive scope of practice limitations and uneven distribution of medical resources remain. This article proposes strategies to advance the role of FNPs in Taiwan, including expanding their practice scope, fostering interdisci-plinary collaboration, and strengthening telemedicine technology. These measures aim to address the challenges of an aging society and improve the quality of home healthcare services.