疫情下人性化溝通的家庭會議

Humanizing Communication Approaches to Family Conferences in Times of Pandemic

家庭會議對醫療決策十分重要，特別在安寧緩和及加護病房照護等範疇，扮演重要的角色。健保署為鼓勵臨終安寧緩和，在2012年新增給付「緩和醫療家庭諮詢費」，並在2015年調整諮詢費及擴大給付範圍，使台灣民眾日益接受安寧緩和醫療的觀念。

不過，家庭會議面臨不少問題，當中醫師的溝通技巧對家庭會議成功與否，有著舉足輕重的影響，因此，一套有效的溝通模式必不可少。台大醫院致力將人性化溝通融入於家庭會議，例如，嘗試把VALUE及PLACE兩種溝通模式，應用在醫病共享決策(shared decision making,SDM)，成果顯示有助於在臨床實務實踐人性化溝通。未來，希望推動人性化醫病共享決策，成為醫療常規之一。

 

Family conferences facilitate medical decision making, especially in the fields of palliative care and intensive care. Taiwan’s National Health Insurance started covering family conferences for palliative medicine in 2012 and has increased the coverage and budgets since 2015 with the goal of promoting general acceptance of palliative medicine in Taiwan.

However, there are many difficulties in holding family conferences whose success relies to a great extent on physicians’ communication skills. However, better clinical outcomes of and patient satisfaction with shared decision-making can be achieved by humanizing communication with more empathetic approaches like VALUE (Value, Acknowledge, Listen, Understand, and Elicit) and PLACE (Prepare, Listen, Agree, Connect, and Explore). This is of particular significance during times of pandemic. It is our hope that, in the future, shared decision-making with the help of humanized communication approaches is advocated to be the standard medical practice in different fields, not restricted to palliative care.