Establishment of a renal supportive care program: Experience from a rural community hospital in Taiwan

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• 作者：Chia-Ter Chao^a ; ^b ; ^j ; Hung-Bin Tsai^c ; ^j ; Chih-Yuan Shih^a ; Su-Hsuan Hsu^a ; Yu-Chien Hung^a ; Chun-Fu Lai^d ; Ruey-Hsiuang Ueng^e ; Ding-Cheng Chan^f ; ^g ; Juey-Jen Hwang^a ; ^h ; Sheng-Jean Huangⁱ ; ^{sjhuang1@ntu.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：chronic kidney disease ; end-stage renal disease ; hospice ; palliative care ; renal supportive care
• 刊名：Journal of the Formosan Medical Association
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：115
• 期：7
• 页码：490-500
• 全文大小：2275 K

文摘

Renal supportive care (RSC) denotes a care program dedicated for patients with acute, chronic renal failure, and end-stage renal disease (ESRD), aiming to offer maximal symptom relief and optimize patients' quality of life. The uncertainty of prognosis for patients with chronic kidney disease and ESRD, the sociocultural issues inherent to the Taiwanese society, and the void of structured and practical RSC pathway, contributes to the underrecognition and poor utilization of RSC. Taiwanese patients rarely receive information regarding RSC as part of a standardized care and are not commonly offered this option. In National Taiwan University Hospital Jinshan branch, we started a RSC subprogram, supported by the community-based palliative/hospice care main program. We focused on understanding the need and providing the choice of RSC to suitable candidates. A three-step and four-phase protocol was designed and implemented to identify appropriate patients and to enhance the applicability of the RSC. We harnessed family visit and home-based family meeting as a vehicle to understand the patients' preferences, to discover what ESRD patients and their family value most, and to introduce the option of RSC. In the current review, we described our pilot experience of establishing a RSC program in Taiwan, and discuss its potential advantage.