外科腸胃道手術病患之遠距照護

Abstract

本論文主要是研發遠距照護相關服務平台，提供外科腸胃道術後病患居家自我照顧，摘要說明如下： 腸胃道手術是治療腹部癌症最有效的方法。但是術後有些人容易產生併發症，例如: 老年人、多重慢性疾病和營養不良病患，當併發症發生時會造成住院天數延長、健保給付增加、或失能的情形。另一方面，台灣醫療面臨外科醫護人員短缺、健保支付制度改變及醫療資源分配不均等因素，造成病患和家屬無法安心出院居家療養。本研究結合台大醫院外科專業醫護團隊和台大醫院遠距照護中心，開發腸胃道術後遠距照護系統，其包含 (一)： 導入腸胃道術後照護系統於台大醫院遠距照護中心， (二)： 開發使用平板的遠距腸胃道術後照護系統，針對腸胃道術後病患的常見問題 （手術衛教、體重評估、腹內引流管追蹤和傷口感染），給予即時的居家照護幫助；選擇平板電腦應用在遠距照護的原因，在於使用介面較直覺，本身具有上網、照相及錄影功能，可以達到基本遠距照護系統需要的功能。 本論文評估遠距照護在外科腸胃道術後病患照顧的可行性和臨床價值，及研究加入遠距照護相較於傳統照護病患其術後營養狀態差異。

In this thesis, we develop a telecare system and tablet PC-based application services platform for patients undergoing gastrointestinal (GI) surgery. Telecare helps patients take care of themselves at home and have fast recovery. The GI surgery is the most effective method for treating patients with abdominal cancers. However, patients of old age or with major comorbidities, or malnutrition had higher proportions of post-operative complications, which resulted in long hospital stays, more medical costs, and mortality. On the other hand, the current medical dilemma in Taiwan includes lack of surgical professionals, frequent change of national health insurance payment, and unbalanced medical resources. Therefore, the patients’ family have no enough confidence to take care of the patients at home. To solve this dilemma, we develop a telecare information system special for gastrointestinal surgery which including a tablet PC-based application to be used in National Taiwan University (NTUH) telecare center. This telecare information system provides a real-time service of follow-up of body weight, intra-abdominal drains, symptoms, surgery education, and surgical wound care. This study enrolled subjects undergoing GI surgery to investigate the clinical feasibility and value of telecare for surgical cases.