上海市癌症患者连续性照护现况调查

目的了解上海市癌症患者连续性照护现况,为构建上海市癌症患者连续性照护模式提供参考。方法选取上海市6所三级医院、2所二级医院、3所社区卫生服务中心和1所区疾病预防控制中心进行实地询问调查。结果有2所医院对出院后的患者进行主动病情跟踪,1所医院通过患者自评量表的方式进行症状管理;分别有2所通过网络、1所医院通过联谊会进行健康教育活动;1所医院与社区卫生服务中心建立了合作关系。各机构均建立了机构内的患者档案,3所医院加入了医院间的信息共享平台。结论医疗机构对患者的服务呈现出连续性照护的雏形,存在医院对出院后患者提供的服务不完善、社区服务与医院服务不协调和机构之间缺乏互动等问题。建议增强医院对出院患者的服务,衔接好医院社区对患者的照护服务,建立医院社区间的互动平台,以完善癌症患者的连续性照护机制和提高照护质量。

Cross-sectional study on successive care of cancer patients in Shanghai

Objective To explore successive care of cancer patients in Shanghai,to provide a reference for constructing cancer patients successional care mode in Shanghai.Methods Six first-class hospitals,two second-level hospitals,three community health service centers and one county CDC were selected and involved in the field investigation.Results Two hospitals provided active follow-up service for discharged patients;one hospital implemented symptom management through a patient self-rating scale;2 hospitals regularly carried out health education activities through network and one hospital through a fellowship system;one hospital had established a coo-peration relationship with community health center.All professional institutes had built up patient profile system;three hospitals had joined the Medical Alliance Project of Shanghai.Conclusion Every institute has formulated its preliminary successive care mode.But problems such as incomplete services for discharged patients,lacking of service coordination between community service and hospital service,and agencies interaction insufficiency remain to be solved.According to these problems,we suggest future enhancement of service provided to discharged patients,bridging the gap between community service and hospital service,and construction of hospital-community interactive platform.Consequently,we can perfect successive caring system and improve the quality of caring.