Takayanagi Hideo, Motokawa Nahomi, Takahashi Kenta, Hanawa Kazue, Kimura Tomoko
Dept. of Psychiatry, Sapporo Medical Center NTT EC.
Gan To Kagaku Ryoho. 2010 Dec;37 Suppl 2:227-8.
During a cancer therapy, a fine-tuned response is necessary for a patient to stay home with family for a longer period of time. Especially the patient is near the end of life. Based on the Basic Plan to Promote Cancer Control programs, our hospital established a cancer consulting support center and a palliative care team in June 2009, and staffed them with multidisciplinary personnel. With medical staffs involved as a team, we considered a shared decision making repeatedly in compliance with inpatient 's wishes for home care. One of the problems the author experienced frequently was that a patient would take a long time for a decision making due to the state of mental depression. Hence, we simply couldn't send him home, or we would fail to make a right timing for sending him home. Due to a patient's inability to make own decision, a home care period could not be shortened, so that a careful daily observation is desired to keep an eye for signs of depression and to provide appropriate responses.
在癌症治疗期间,为了让患者能更长时间地居家陪伴家人,需要有精准的应对措施。尤其是当患者接近生命末期时。基于《促进癌症控制项目基本计划》,我院于2009年6月设立了癌症咨询支持中心和姑息治疗团队,并配备了多学科人员。医疗团队成员共同参与,依据住院患者的居家护理意愿,反复进行共同决策。作者经常遇到的一个问题是,由于患者处于精神抑郁状态,做出决策需要很长时间。因此,我们根本无法送他回家,或者无法把握送他回家的正确时机。由于患者无法自行做决定,居家护理期无法缩短,所以需要进行仔细的日常观察,留意抑郁迹象并做出适当反应。