Hospice Care ; Hospices ; Humans ; Palliative Care ; Renal Dialysis

To let the general public,regardless of gender,age,career and education background,understand the core concept of hospice and palliative care,practice in their lives,and then spread to and serve as many people as possible,the hospice and palliative care team of Peking Union Medical College Hospital established the professional hospice and palliative care training platform for volunteers in 2021.This article reviews the training design,content,methods,and results of the platform.It is concluded that the platform has theory-based training design,logical and complete training content,suitable training method for volunteers,and satisfactory training results.The establishment of this hospice and palliative care training platform for volunteers has excellent feasibility.Efforts should be made to further explore the performance and long-term development strategy of the training platform.
Humans ; Hospices ; Palliative Care ; Hospice Care ; Volunteers/education*

Community-based home hospice care provided by community service centers and family physician teams aims to alleviate the suffering of terminally ill patients and help them to receive end-of-life care and pass away at home.The Puhuangyu Community Health Service Center established the home hospice care model of PUMCH-Puhuangyu Coordination at the end of 2019.The model has been practiced and improved to date.This paper introduces this model of home hospice care.
Humans ; Hospice Care ; Tertiary Care Centers ; Hospices ; Home Care Services ; Terminal Care

Objective To investigate the feasibility of home hospice care based on the practical experience in Puhuangyu community of Beijing.Methods We selected the patients assessed by hospice care team and receiving home hospice care from Puhuangyu Community Health Service Center of Beijing from January 1,2020 to December 31,2021.The clinical manifestations,hospice services received,and place of death of the patients were analyzed. Results A total of 24 patients were included in this study.They mainly suffered from malignant tumors(18 patients,75.0%),with pain as the most common symptom(12 patients,50.0%).The patients received a variety of hospice services through a combination of outpatient visits,home visits,and WeChat follow-up.The service time of each patient was(2.8±1.7) h each week on average and 57.9%(11/19) of the patients passed away at home. Conclusions The home hospice care in Puhuangyu community has a stable source of patients.The members of this hospice team can provide a variety of home hospice services.With this model,the wish to pass away at home can be achievable for most patients.Therefore,this model of community-based home hospice care is feasible.
Humans ; Hospice Care ; Hospices ; Beijing ; Home Care Services

Objective To share the outpatient clinic practice of hospice and palliative care at the Department of Geriatrics,Peking Union Medical College Hospital.Methods We conducted a retrospective analysis on the consecutive clinic data of doctor N in Geriatric Outpatient Clinic,Peking Union Medical College Hospital from January 1,2016 to December 31,2019.The patients aged 85 years and older,as well as those with end stage malignant tumor,non-tumor dysfunction due to chronic diseases or primary diseases without effective treatment were defined as patients with palliative care need.The basic information,symptoms,consultation purposes and treatments of these patients were collected.Results Among the 2502 visits during the study period,1388 patients with palliative care needs were admitted and recorded,with an average age of(69.7±13.5)years(8-105 years),among which 73.3% were patients over 60 years old and 712(51.3%)were males.Among these patients,63.4% visited specifically to seek for palliative care service and 87.2% of the visits were due to distress caused by advanced malignant tumors.Of the 221 patients with non-tumor diseases,frailty and neurodegenerative diseases were the leading life-threating cause.Of the 5483 symptoms recorded,pain(21.2%),anorexia(13.1%),fatigue(11.6%),constipation(6.9%),insomnia(4.6%),and abdominal distension(4.6%)were the six common symptoms.In the 2502 visits,26.2% of the patients had mutiple visits,and 50.3% of the patients with multiple visits had more than three visits;38.6% of patients visited the clinic themselves,and 65.7% of visits were attended by two or more family members(including the patients).The average duration of visit was(19.6±8.5)min(2-85 min),and 13.5%,53.0%,25.6% and 7.9% of the patients completed the consultation within 10,11-20,21-30 and over 30 min,respectively.Conclusion There is strong demand of palliative care in the outpatient clinic of Department of Geriatrics in Peking Union Medical College Hospital and it is feasible to provide palliative care service for patients with serious diseases in geriatric outpatient clinics.
Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Female ; Hospice Care ; Hospices ; Humans ; Male ; Middle Aged ; Palliative Care ; Retrospective Studies

Background and Objective: Palliative care is a human right. In the local setting, only a few data have been published regarding its practice among healthcare workers. This study aimed to determine the gaps and potential barriers in palliative care services among resident physicians. Methodology: A cross-sectional study design using a 27-item interview-based questionnaire was conducted from July to September 2019 among resident trainees in seven departments of four hospitals in Manila, Philippines. The data gathered were tallied using Microsoft Excel and analyzed using STATA Statistical Software with p-value of 0.05 as statistically significant. Results: A total of 200 physicians participated in the study. Majority of the respondents referred patients to palliative care services, primarily for symptom control and home care upon the diagnosis of a terminal illness. Sixty percent of respondents correctly identified patients eligible for hospice care. The 3 services rated as most important in palliative care were pain control, symptom control and psychological support. Most of the respondents perceived that palliative care is underutilized, and yet they felt that attending doctors know when referral to such is appropriate. The discrepancy is due to their lack of knowledge on the nature of its scope of care and eligibility criteria. The common barriers for referral to palliative care were “no time to refer secondary to rapid demise of the patient”, “difficulty in accurately predicting death”, and “lack of time to discuss issues of dying and hospice care”. These presumed barriers contradicted the respondents’ perceived practices in advance care planning, particularly on confirming the goals of treatment with the patient and family. Conclusion The prevailing illiteracy on palliative care that poorly translates to actualization is alarming as it deprives many patients of their right to a dignified and quality of life given their limited days. The inexcusable lack of awareness must be the impetus to a massive knowledge drive to impact clinical practice.
Hospices ; Physicians

BACKGROUND: We evaluated the timing and route of arrival of patients with cancer referred to a hospital near their residence for end-of-life care.METHODS: The medical records of patients with cancer receiving palliative systemic treatment at other hospitals who were transferred to our hospital for terminal care were reviewed retrospectively.RESULTS: Records of 60 patients (mean age, 57.4 years) were reviewed. The median survival after transfer was 40 days; 56.3% and 43.3% of the patients were referred to the outpatient and emergency departments of our hospital, respectively. Only 45% of the patients were enrolled in the hospice palliative care system. The most common reason for not enrolling was rejection of the patients or their families for hospice palliative care.CONCLUSION: For end-of-life care, the time from the referral to death was short, and many patients were transferred to the emergency department of our hospital.
Emergency Service, Hospital ; Hospices ; Humans ; Medical Records ; Outpatients ; Palliative Care ; Referral and Consultation ; Retrospective Studies ; Terminal Care

BACKGROUND: Terminally ill cancer patients suffer from refractory symptoms, and the last option of treatment is to consider sedatives. However, due to concerns that sedation may shorten survival time, some people prefer not to take sedatives. The purpose of this study was to investigate the effects of sedative administration on survival time among terminally ill cancer patients.METHODS: Two hundreds and thirty-seven patients who were hospitalized to the hospice care unit of public hospitals in Seoul from January, 2015 to March, 2016 were analyzed retrospectively. The univariate and multivariate Cox's proportional hazard regression model was used to determine independent factors related to survival time.RESULTS: The usage of sedation was necessary because the incidence of insomnia was 61.4% in the lorazepam only group, and the incidence of delirium was highest in the haloperidol group and the haloperidol with lorazepam group. Interestingly, multivariate analysis showed that male (HR, 1.766; P < 0.001), decreased consciousness (HR, 1.803; P=0.003), anorexia (HR, 1.506; P=0.012), resting dyspnea (HR, 1.757; P < 0.001), elevated serum bilirubin (HR, 1.657; P=0.001), and the haloperidol with lorazepam group (HR, 0.535, P < 0.001) were each significantly associated with survival time. Furthermore, patients in the haloperidol with lorazepam group survived longer than patients with no such medications.CONCLUSION: There is no evidence that treatment with sedative medication shortens the survival time of patients with terminally ill cancer with refractory symptoms.
Anorexia ; Bilirubin ; Consciousness ; Delirium ; Dyspnea ; Haloperidol ; Hospice Care ; Hospices ; Hospitals, Public ; Humans ; Hypnotics and Sedatives ; Incidence ; Lorazepam ; Male ; Multivariate Analysis ; Palliative Care ; Retrospective Studies ; Seoul ; Sleep Initiation and Maintenance Disorders ; Terminally Ill

BACKGROUND: In this study, consultations with children of young patients with cancer were evaluated by dividing the child's age into infancy, childhood, and adolescence to ensure the necessity and importance of appropriate intervention, coordination, and communication.METHODS: From June 2017 to February 2019, medical records and consultation records were reviewed by selecting suitable cases among patients hospitalized in hospice palliative care unit at a Pusan national university Yangsan hospital. The consultation was conducted on several occasions by nurses, doctors and social workers from the time the patient was hospitalized to the day before death.RESULTS: The cases of consultation were as follows: female patient with stomach cancer with a child in infancy, patient with gastric cancer with a child in childhood, and male patient with rectal cancer with a child in adolescence.CONCLUSION: It is ideal for parents to initiate communication with their children on their terminal status, so multidisciplinary teams must first support the motivation. In consultations with children, we should first explain the information about the cancer status of the parents, followed by the future clinical course, estimated life expectancy, and changes related to terminal status. Additionally, we must attempt to manage the psychological and emotional concerns of children. This study may support the creation of an atmosphere for in-depth research on family interviews of young patients with cancer in Korea. We think that this will contribute as basic data for some guidelines for communication based on the age of children in consultations with patients with terminal cancer.
Adolescent ; Atmosphere ; Busan ; Child ; Female ; Gyeongsangnam-do ; Hospice Care ; Hospices ; Humans ; Korea ; Life Expectancy ; Male ; Medical Records ; Motivation ; Palliative Care ; Parents ; Rectal Neoplasms ; Referral and Consultation ; Social Work ; Social Workers ; Stomach Neoplasms ; Young Adult

PURPOSE: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. METHODS: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. RESULTS: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). CONCLUSION: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.
Adult ; Child ; Diagnosis ; Education ; Gyeonggi-do ; Hospices ; Humans ; Incheon ; Palliative Care ; Republic of Korea ; Seoul ; Specialization ; Terminal Care