• Title/Summary/Keyword: 완화의료

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Advances of Hospice Palliative Care in Taiwan

  • Cheng, Shao-Yi;Chen, Ching-Yu;Chiu, Tai-Yuan
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.292-295
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    • 2016
  • Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

The Effects of Attitude to Death in the Hospice and Palliative Professionals on Their Terminal Care Stress (호스피스 완화의료 전문인력의 죽음에 대한 태도가 임종돌봄 스트레스에 미치는 영향)

  • Yang, Kyung Hee;Kwon, Seong Il
    • Journal of Hospice and Palliative Care
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    • v.18 no.4
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    • pp.285-293
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    • 2015
  • Purpose: This study was conducted to explore the effects of attitude to death in hospice and palliative professionals on their terminal care stress, and to analyze relationships among variables related to the two aforementioned parameters, such as depression and coping strategies. Methods: Participants were 131 hospice and palliative professionals from the cancer units of two tertiary hospitals and two general hospitals, two hospice facilities, two geriatric hospitals, and two convalescent hospitals in J province. Data were collected from April through June 2015 and analyzed using t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$ test), ANCOVA, and Pearson's correlation and a path analysis using the SPSS/WIN 21.0 and AMOS 18.0 programs. Results: The score for attitude to death was low (2.63), and that for depression was 0.45. Among all, 16.0% of the participants showed need for depression management. They scored 3.82 on terminal care stress. The subcategory with the highest mark was inner conflicts on limitation given availability of medical services (4.04). The score on coping strategy was low (3.13). They used passive coping strategies such as interpersonal avoidance (4.03), fulfilling basic needs (3.65) such as sleeping or eating. Attitudes to death had a direct negative effect on the terminal care stress level and indirectly affected through depression and fulfilling basic needs (CS2). Conclusion: It is necessary to provide hospice and palliative professionals with education on death and dying, as well as access to programs that provide emotional support and promote positive cognition of death and dying.

Initial Assessment and Care Planning in Palliative Hospice Care: Focus on Assessment Tools (호스피스 완화의료에서의 초기평가와 돌봄 계획의 수립: 평가도구를 중심으로)

  • Park, Eun Ju;Koh, Su Jin;Cheon, Jae Kyung
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.67-76
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    • 2019
  • For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

Case Study on the Use of Songwriting to Promote Self-Acceptance in Adolescents in Palliative Care (노래 만들기를 통한 완화의료 청소년의 자기수용 증진 사례 연구)

  • Youn, Ha Jeong
    • Journal of Music and Human Behavior
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    • v.19 no.2
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    • pp.55-80
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    • 2022
  • This study aimed to examine the effects of songwriting on the self-acceptance of adolescent in palliative care. Three participants were recruited from a university hospital in an urban area in South Korea. The songwriting intervention was conducted in six sessions, and each session was composed of an introduction, song writing and wrap-up. Participants were asked to complete the Unconditional Self-Acceptance Questionnaire (USAQ) before and after the intervention. Their verbal expressions and written song lyrics observed during the intervention were also measured. The results showed that the USAQ scores increased after the intervention, indicating the improvement in their acceptance of the self without judgement or high reactivity to feedback. In addition, the participants exhibited greater recognition of their emotions and acceptance of themselves as they are. They were also better able to discover internal resources and psychological competence. The participants reported that they could more freely express their emotions through song writing and that recording the songs they created was a means of communicating their feelings to others. Based on this study, it is expected that adolescents in palliative care will be able to experience self-acceptance through such brief song writing interventions.