數位療法的兩難與共融──護理照護與照護倫理的視角

The Paradox and Integration of Digital Therapeutics: The Perspectives of Nursing Care and Care Ethics

數位療法（digital therapeutics，DTx）是基於臨床實證以軟體驅動、具治療目的介入的產品，目前在全球快速發展，現有多數探討DTx之相關研究忽視護理視角，使DTx之理論架構止步於醫療介入而非照護關係上。本文以護理照護與照護倫理為核心視角，透過文獻探討綜整五項DTx兩難困境：照護關係vs.數位中介、臨床判斷vs.演算法決策、照護倫理vs.數據合規、工作減負vs.數位行政增量、專業自主vs.演算法治理；並據此提出涵蓋DTx全生命週期之護理參與四階段框架—設計、實施、評估、倫理治理。將共融定義提升至雙層複合概念，強調護理角色於DTx導入臨床場域之重要性及其核心地位。最後，從實務、教育、研究、政策四層面提出相關建議以實現以科技賦能專業、以人性遞送照護之願景。

Digital therapeutics (DTx) are evidence-based, software-driven interventions that are expanding rapidly worldwide. However, current research has largely marginalized the nursing perspective, restricting the theoretical framework of DTx to clinical interventions rather than the fundamental caring relationship. This literature review, grounded in the core tenets of nursing care and ethics, was developed to synthesize five paradoxes inherent to DTx. These include: relational caring versus digital mediation; clinical judgment versus algorithmic decision-making; care ethics versus data compliance; workload relief versus digital administrative burden; and professional autonomy versus algorithmic governance. To address these tensions, a comprehensive four-stage nursing engagement framework is proposed that spans the entire DTx lifecycle of design, implementation, evaluation, and ethical governance. Furthermore,“integration”is reconceptualized as a dual-layered construct, highlighting the indispensable role of nurses in the clinical deployment of DTx. Finally, strategic recommendations are provided covering the dimensions of practice, education, research, and policy with the goal of actualizing a future of technology-empowered professionalism and humanistic care.