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Ethical and Practical Issues with the Use of Antimicrobial Agents during the End of Life. 生命末期使用抗菌药物的伦理和实践问题。
Pub Date : 2024-09-01 DOI: 10.14475/jhpc.2024.27.3.99
Amlak Bantikassegn

The use of antimicrobials in patients receiving end-of-life (EOL) care, which is generally defined as supportive care provided to patients anticipated to live less than 1 year, has been actively debated in the realm of palliative care medicine due to the nebulous nature of the topic. In this article, we explore the use of antimicrobial use near EOL as it relates to both the ethical and practical issues that face physicians. We also discuss the reasons underlying the scarcity of prospective studies on this topic.

生命末期(EOL)护理一般是指为预计寿命不超过 1 年的患者提供的支持性护理,由于该主题的模糊性,姑息治疗医学界一直在积极讨论在接受生命末期护理的患者中使用抗菌药物的问题。在本文中,我们将探讨在临终前使用抗菌药物与医生面临的伦理和实际问题之间的关系。我们还讨论了有关该主题的前瞻性研究很少的原因。
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引用次数: 0
Early Hospice Consultation Team Engagement for Cancer Pain Relief: A Case Report. 安宁疗护咨询团队早期参与癌症疼痛缓解:病例报告
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.77
Jisoo Jeong

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

本病例报告探讨了与阿片类药物治疗癌痛相关的挑战和复杂性,强调了安宁疗护咨询团队早期参与和采用多学科护理方法的重要性。一名 56 岁的胰腺癌晚期患者经历了疼痛升级和不适当的阿片类药物处方,凸显了传统疼痛管理方法的缺陷。尽管主治医生进行了程序性干预并增加了阿片类药物的剂量,但患者的病情还是恶化了。随后,安宁疗护咨询团队的介入以及精神科的协作治疗使患者的病情得到了全面改善。该病例强调了在优化以患者为中心的姑息治疗过程中,早期安宁疗护参与、社会心理评估和协作方法的必要性。
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引用次数: 0
Knowledge and Perceptions of the End of Life among Tunisian Medical and Paramedical Staff. 突尼斯医务人员和辅助医务人员对生命终结的认识和看法。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.64
Nayssem Khessairi, Dhouha Bacha, Rania Aouadi, Rym Ennaifer, Ahlem Lahmar, Sana Ben Slama

Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care.

Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index.

Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers.

Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.

目的:生命末期(EOL)护理是个人生命中的一个脆弱时期。医疗保健专业人员(HPs)努力在保护人的生命与尊重病人意愿之间取得平衡。我们研究的目的是评估医护人员对临终关怀的认识和看法,并提出需要改进的地方,以提高护理质量:我们进行了一项单中心横断面研究,涉及一家大学医院中遇到临终关怀情况的医护人员。我们使用的问卷分为知识、实践、感知和培训四个部分。我们计算了回答正确率和集体能力指数:分析了 86 份问卷,其中 82.5%(71/86)由医务人员填写,17.5%(15/86)由医务辅助人员填写。71.8%(51/71)的受访者为实习生和住院医师。研究的重点是姑息治疗、临终医疗救助、积极治疗和安乐死,结果发现前三个方面的知识充足。被分配到重症监护室的受访者和拥有 8 年以上工作经验的受访者的正确答案率明显高于同类受访者。75%的受访者(65/86)表示,他们对临终关怀的掌握程度很低或根本没有掌握,主要原因是培训不足和没有培训人员:根据我们的研究结果(我们认为这在突尼斯尚属首次),我们可以得出结论,保健医生在临终关怀方面拥有可接受的知识水平。然而,他们需要更多的接触和培训,以发展这方面的专业知识。
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引用次数: 0
Inpatient Hospice Care in Korea during the COVID-19 Pandemic: A Preliminary Study. COVID-19 大流行期间韩国的住院病人临终关怀:初步研究。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.82
Youn Seon Choi, Sun Wook Hwang, In Cheol Hwang

Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs.

Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC.

Conclusion: Health policymakers should consider our findings when planning for future pandemics.

目的:本研究调查了韩国 2019 年冠状病毒病(COVID-19)大流行之前和期间住院临终关怀机构的生活质量(QoL)和护理质量(QoC):数据来自参与两项前瞻性队列研究的三家机构。测量的主要结果是晚期癌症患者及其家庭照顾者(FCs)的 QoL 以及家庭照顾者认为的 QoC:多变量回归分析表明,在 COVID-19 大流行期间,患者和家庭照顾者的 QoL 均优于大流行之前,而家庭照顾者报告的 QoC 更高:卫生决策者在规划未来的大流行时应考虑我们的研究结果。
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引用次数: 0
An Evolutionary Concept Analysis of Pediatric Hospice and Palliative Care. 儿科临终关怀与姑息治疗的演变概念分析。
Pub Date : 2024-06-01 DOI: 10.14475/jhpc.2024.27.2.51
Jung Hwa Lee, Soon Young Lee, Kyung Mi Cha

Purpose: This study aimed to clarify the concept of pediatric hospice and palliative care through conceptual analysis. It also sought to identify the differences between related concepts such as pediatric death care and pediatric spiritual care, in order to provide foundational data for the development of nursing theory and knowledge.

Methods: A conceptual analysis of pediatric hospice and palliative care was conducted using Rodgers' evolutionary method. Out of 5,013 papers identified, 28 were selected for detailed reading and analysis.

Results: Pediatric hospice and palliative care encompasses physical, psychological, social, mental, spiritual, and family care for children with acute and chronic diseases with uncertain prognoses ahead of death, as well as their families. Effective pediatric hospice and palliative care will require multidisciplinary team nursing, effective communication, and supportive policies.

Conclusion: The findings of this study suggest that providing pediatric hospice and palliative care will lead to improvements in pain relief for children and families, the efficiency of responses to death in children, and the quality of life for children and families. The significance of this study is that it clearly clarifies the concept by analyzing pediatric hospice and palliative care using an evolutionary method.

目的:本研究旨在通过概念分析澄清儿科临终关怀和姑息关怀的概念。研究还试图找出相关概念(如儿科死亡护理和儿科精神护理)之间的差异,从而为护理理论和知识的发展提供基础数据:方法:采用罗杰斯进化法对儿科临终关怀和姑息关怀进行了概念分析。在确定的 5013 篇论文中,选择了 28 篇进行详细阅读和分析:结果:儿科临终关怀和姑息治疗包括对患有急性和慢性疾病、死亡前预后不确定的儿童及其家人的身体、心理、社会、精神和家庭护理。有效的儿科临终关怀和姑息关怀需要多学科团队护理、有效沟通和支持性政策:本研究的结果表明,提供儿科临终关怀和姑息治疗将有助于减轻儿童和家属的疼痛,提高应对儿童死亡的效率,改善儿童和家属的生活质量。本研究的意义在于通过使用进化方法分析儿科临终关怀和姑息关怀,明确了这一概念。
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引用次数: 0
Attitudes toward Social Issues Related to Opioid Use among Palliative Care Physicians. 姑息治疗医生对阿片类药物使用相关社会问题的态度。
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.45
In Cheol Hwang, Seong Hoon Shin, Youn Seon Choi, Myung Ah Lee, DaeKyun Kim, Kyung Hee Lee

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use.

Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC).

Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education.

Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

目的:本研究调查了姑息关怀医生对阿片类药物使用相关社会问题的态度:方法:向韩国安宁缓和医疗协会(KSHPC)的 674 名会员医生发送电子邮件调查:对 66 名医生的数据进行了分析(回复率为 9.8%)。约 70% 的参与者表示,他们的处方模式不受与阿片类药物使用相关的社会问题的影响,90% 的参与者认为额外的规定应仅限于非癌症疼痛。在当前情况下,迫切需要对医生进行疼痛教育,并提高公众的认识。半数受访者认为 KSHPC 是负责提供疼痛教育的主要机构:姑息治疗医生的处方模式不受与阿片类药物使用相关的社会问题的影响,这些问题也不应影响癌症疼痛控制。
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引用次数: 0
Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients. 影响血液透析患者对预先医疗指示态度的因素。
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.11
Minhee Cho, Hyunjoo Na

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population.

Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis.

Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs.

Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

目的:预先指示(ADs)是一种法律文件,概述了个人对临终关怀的偏好或决定。在韩国,血液透析患者对预嘱的认识和了解不足。本研究探讨了这一患者群体对美好死亡的看法、对临终关怀的了解以及对临终关怀的态度之间的关系:这项横断面调查在 2021 年从一家二级医院招募了 119 名血液透析患者。参与者填写了一份自填问卷,并使用 t 检验、方差分析、皮尔逊相关系数、斯皮尔曼等级相关系数和多元回归分析对数据进行了分析:血液透析患者对美好死亡的认知平均分为 2.80 分(满分 4 分),其中临床症状被认为是最关键的因素。对自动症的了解和对自动症的态度的平均分分别为 5.69 分(满分 9 分)和 2.79 分(满分 4 分)。对美好死亡的看法与对注意力缺失症的态度之间存在正相关(r=0.34,PC结论:血液透析患者对美好死亡的积极认知与对反式脂肪肝的积极态度相关。需要开展教育计划来提高个人对美好死亡的理解,并鼓励制定临终关怀计划。
{"title":"Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients.","authors":"Minhee Cho, Hyunjoo Na","doi":"10.14475/jhpc.2024.27.1.11","DOIUrl":"10.14475/jhpc.2024.27.1.11","url":null,"abstract":"<p><strong>Purpose: </strong>Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population.</p><p><strong>Methods: </strong>This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis.</p><p><strong>Results: </strong>The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs.</p><p><strong>Conclusion: </strong>A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 1","pages":"11-20"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Experience of Nurses in a Consultative Hospice Palliative Care Service. 临终关怀姑息治疗咨询服务中护士的临床经验。
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.31
Sinyoung Kwon, Jinyee Byun

Purpose: The purpose of this qualitative study was to employ Colaizzi's phenomenological research method to elucidate and understand the essence of practical experiences among consultative hospice palliative care nurses working in hospice institutions.

Methods: The participants in the study were 15 consultative hospice palliative care nurses with over 1 year of work experience in institutions located in S City, I City, and K Province in South Korea. Data were collected from 23 in-depth interviews and analyzed using Colaizzi's phenomenological qualitative method.

Results: The practical experiences of consultative hospice palliative nurses were categorized into five categories, 10 theme clusters, and 25 themes. The five categories included "being aware of patients' situations at the time of transition to hospice palliative care," "empathizing with patients and their families by putting oneself in the other's shoes," "providing patient and family-centered end-of-life care," "experiencing difficulties in practical tasks," and "striving to improve hospice service quality."

Conclusion: This study is significant in that it provides practical data for understanding the experiences of consultative hospice palliative care nurses caring for terminally ill patients. This could enhance our understanding of care solutions that effectively tackle the challenges consultative hospice palliative care nurses encounter while fulfilling their roles.

目的:本定性研究的目的是采用科莱兹的现象学研究方法来阐明和理解在临终关怀机构工作的临终关怀姑息治疗咨询护士的实践经验的本质:研究对象为韩国 S 市、I 市和 K 道的安宁疗护机构中工作 1 年以上的 15 名临终关怀姑息治疗咨询护士。研究人员通过 23 次深入访谈收集数据,并采用科莱兹的现象学定性方法对数据进行分析:结果:临终关怀姑息治疗咨询护士的实践经验被分为 5 个类别、10 个主题群和 25 个主题。这五个类别包括 "了解病人在转入安宁疗护姑息关怀时的情况"、"设身处地地同情病人及其家属"、"提供以病人和家属为中心的临终关怀"、"在实际工作中遇到困难 "和 "努力提高安宁疗护服务质量":这项研究的意义在于,它为了解临终关怀姑息关怀咨询护士护理临终患者的经验提供了实用数据。这可以加深我们对护理解决方案的理解,从而有效应对安宁疗护姑息关怀咨询护士在履行其职责时遇到的挑战。
{"title":"Clinical Experience of Nurses in a Consultative Hospice Palliative Care Service.","authors":"Sinyoung Kwon, Jinyee Byun","doi":"10.14475/jhpc.2024.27.1.31","DOIUrl":"10.14475/jhpc.2024.27.1.31","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this qualitative study was to employ Colaizzi's phenomenological research method to elucidate and understand the essence of practical experiences among consultative hospice palliative care nurses working in hospice institutions.</p><p><strong>Methods: </strong>The participants in the study were 15 consultative hospice palliative care nurses with over 1 year of work experience in institutions located in S City, I City, and K Province in South Korea. Data were collected from 23 in-depth interviews and analyzed using Colaizzi's phenomenological qualitative method.</p><p><strong>Results: </strong>The practical experiences of consultative hospice palliative nurses were categorized into five categories, 10 theme clusters, and 25 themes. The five categories included \"being aware of patients' situations at the time of transition to hospice palliative care,\" \"empathizing with patients and their families by putting oneself in the other's shoes,\" \"providing patient and family-centered end-of-life care,\" \"experiencing difficulties in practical tasks,\" and \"striving to improve hospice service quality.\"</p><p><strong>Conclusion: </strong>This study is significant in that it provides practical data for understanding the experiences of consultative hospice palliative care nurses caring for terminally ill patients. This could enhance our understanding of care solutions that effectively tackle the challenges consultative hospice palliative care nurses encounter while fulfilling their roles.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 1","pages":"31-44"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Palliative Care for Adult Patients Undergoing Hemodialysis in Asia: Challenges and Opportunities. 亚洲血液透析成人患者的姑息治疗:挑战与机遇。
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.1
Wei-Min Chu, Hung-Bin Tsai, Yu-Chi Chen, Kuan-Yu Hung, Shao-Yi Cheng, Cheng-Pei Lin

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

这篇文章强调了为接受血液透析的非癌症患者提供综合姑息关怀的重要性,重点关注台湾、日本、韩国和中国等亚洲国家的老龄化人口。随着全球人口结构向老龄化社会转变以及医疗保健的不断发展,需要姑息治疗的血液透析患者人数明显增加。这就需要立即转变模式,将姑息关怀纳入其中,解决这些患者及其家属所面临的复杂的生理、社会心理和精神挑战。许多挑战阻碍了姑息关怀的有效提供,包括预后困难、转诊延迟、文化误解、临床医生缺乏信心以及医护人员之间合作不足。文章提出了潜在的解决方案,如对临床医生进行有针对性的培训、使用远程医疗促进共同决策、引入有时间限制的透析试验等,以克服这些障碍。将姑息关怀纳入常规肾病治疗并促进医护人员之间透明的沟通是提高血液透析患者生活质量和临终关怀的关键策略。通过采用创新策略和促进合作,医疗服务提供者可以提供更加以患者为中心的整体护理,以满足正在接受血液透析的老龄化人群中重症患者的复杂需求。
{"title":"Palliative Care for Adult Patients Undergoing Hemodialysis in Asia: Challenges and Opportunities.","authors":"Wei-Min Chu, Hung-Bin Tsai, Yu-Chi Chen, Kuan-Yu Hung, Shao-Yi Cheng, Cheng-Pei Lin","doi":"10.14475/jhpc.2024.27.1.1","DOIUrl":"10.14475/jhpc.2024.27.1.1","url":null,"abstract":"<p><p>This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
End-of-Life Planning and the Influence of Socioeconomic Status among Black Americans: A Systematic Review. 美国黑人的临终规划和社会经济地位的影响:系统回顾
Pub Date : 2024-03-01 DOI: 10.14475/jhpc.2024.27.1.21
Chesney Ward, Katherine Montgomery

Purpose: The purpose of this systematic review is to explore end-of-life (EOL) care planning and the impact of socioeconomic status (SES) among people who identify as Black or African American.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were used to guide and inform this systematic review process. The following academic electronic databases with publications that reflected the interdisciplinary fields related to the research objective were searched APA PsycINFO, CINHAL, PubMed, Scopus, and Social Work Abstracts.

Results: After the authors conducted the search, 14 articles (from 13 studies) ultimately met the criteria for inclusion. The results substantiated significant concerns highlighted in previous literature regarding SES and its relation to EOL planning, but also revealed an absence of original work and interventions to increase engagement in EOL planning among Black and African American populations.

Conclusion: Black individuals deserve an equitable EOL experience. Researchers, practitioners, and policymakers need to move towards advocacy and action to meet this important need.

目的:本系统综述旨在探讨生命末期(EOL)护理规划以及社会经济地位(SES)对黑人或非裔美国人的影响:方法:本系统性综述采用了系统性综述和荟萃分析首选报告项目(PRISMA)作为指导和信息来源。检索了以下学术电子数据库中与研究目标相关的跨学科领域的出版物 APA PsycINFO、CINHAL、PubMed、Scopus 和 Social Work Abstracts:作者进行搜索后,最终有 14 篇文章(来自 13 项研究)符合纳入标准。研究结果证实了以往文献中强调的有关社会经济地位及其与临终规划关系的重要问题,但也显示出缺乏原创性工作和干预措施来提高黑人和非裔美国人对临终规划的参与度:黑人理应获得公平的临终关怀。研究人员、从业人员和政策制定者需要进行宣传并采取行动来满足这一重要需求。
{"title":"End-of-Life Planning and the Influence of Socioeconomic Status among Black Americans: A Systematic Review.","authors":"Chesney Ward, Katherine Montgomery","doi":"10.14475/jhpc.2024.27.1.21","DOIUrl":"10.14475/jhpc.2024.27.1.21","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review is to explore end-of-life (EOL) care planning and the impact of socioeconomic status (SES) among people who identify as Black or African American.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were used to guide and inform this systematic review process. The following academic electronic databases with publications that reflected the interdisciplinary fields related to the research objective were searched APA PsycINFO, CINHAL, PubMed, Scopus, and Social Work Abstracts.</p><p><strong>Results: </strong>After the authors conducted the search, 14 articles (from 13 studies) ultimately met the criteria for inclusion. The results substantiated significant concerns highlighted in previous literature regarding SES and its relation to EOL planning, but also revealed an absence of original work and interventions to increase engagement in EOL planning among Black and African American populations.</p><p><strong>Conclusion: </strong>Black individuals deserve an equitable EOL experience. Researchers, practitioners, and policymakers need to move towards advocacy and action to meet this important need.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 1","pages":"21-30"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of hospice and palliative care
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