What can family physicians contribute in palliative home care in Taiwan?

Peng, Jen‐Kuei; Hu, Wen‐Yu; Hung, Shou-Hung; Yao, Chien‐An; Chen, Ching-Yu; Chiu, Tai‐Yuan

doi:10.1093/fampra/cmp023

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…Involving family physicians for caring patients at home, in liaison with the palliative home care team, can be helpful in establishing an ethical care model in terminal cancer patients. [ 25 ] OOH is an integral part of our care process; provided in liaison with the LGP. In our study, 421 (83.20%) patients had access to the LGP.…”

Section: Discussionmentioning

confidence: 99%

Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study

Dhiliwal¹,

Muckaden²

2015

Indian J Palliat Care

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Background:Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission.Materials and Methods:Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS) and other parameters.Results:Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms (P < 0.005). 83.2% patients received out of hours care (OOH) through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes.Conclusion:Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

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Section: Discussionmentioning

confidence: 99%

Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study

Dhiliwal¹,

Muckaden²

2015

Indian J Palliat Care

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“…Usually the FPs tend to "limit their services to and referral and were less likely to see patients and prescribe medicine, to provide phone follow-ups, to provide home visits or to offer bereavement care for the family" (28). Interestingly, a prior Taiwan study revealed low willingness of FPs to provide palliative home care (29).…”

Section: Discussionmentioning

confidence: 99%

Narrative review of home care for palliative patients in general practice

Despotova-Toleva

Toleva-Nowak

2021

Ann Palliat Med

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The need of palliative care is constantly growing worldwide and the spectrum of patients and diseases, leading to the need of palliative care is very broad (1). According to recently published data in the "Letter for National Palliative Care Advocates to send to government lead on Universal Health coverage, and UN negotiations" (2) by 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious health-related suffering, and 83% of these deaths will occur in low-income and middleincome countries.Due to the phenomenon of the so-called "silver tsunami" (the increasing number of elderly, and those of them with severe, incurable, life-limiting and life-threatening diseases) the problem escalates dramatically. Thus, significant and urgent changes should be made in some basic documents, including "Suggested language changes to zero draft 'Political Declaration of the High-level Meeting on

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“… 19 Home visits to cancer patients by general practitioners also allow for the choice of a home death. 20 This is an important step to respect the autonomy of those who desire to spend their last days at home.…”

Section: Discussionmentioning

confidence: 99%

The Changes of Ethical Dilemmas in Palliative Care A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan

Chih

et al. 2016

Medicine

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The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan.The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998.This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the “frequency” and “difficulty” of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The “ethical dilemma” scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average “ethical dilemma” score in each domain.All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average “ethical dilemma” score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average “ethical dilemma” score in communication. Nurses reported higher “ethical dilemma” scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average “ethical dilemma” score in resource allocation after adjustment for other relating factors.Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the palliative care system is in its early stages of development.

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What can family physicians contribute in palliative home care in Taiwan?

Abstract: Through palliative home care with the participation of family physicians, patients' preference could be a significant determinant of home death. Our finding can be helpful to the establishment of an ethical care model for terminal cancer patients.

Cited by 9 publications

References 26 publications

Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study

Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study

Narrative review of home care for palliative patients in general practice

The Changes of Ethical Dilemmas in Palliative Care A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan

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