Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,...Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.展开更多
BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To ...BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.展开更多
Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was b...Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was based on the data collected through semi-structured individual interviews.Seventeen nursing undergraduates in Macao,China who attended the simulation-centred program in hospice care participated in this qualitative from November to December 2020.This program included three parts:introduction to hospice care(2 h),management of terminal symptoms(10 h),and hospice situation simulations(6 h).The interview data were analyzed using qualitative content analysis.Results:This study revealed two themes and six sub-themes.Theme 1 was developing competencies in caring for dying patients and their families,which included four subcategories of sensitivity to patients’needs,knowledge of hospice care,skills of symptom control and comfort supply,and communication skills.Theme 2 was improving the ability to self-care and support colleagues,which included two subcategories of reflection on life and death and sharing and supporting among colleagues.Conclusion:This program improved the competency of nursing undergraduates in hospice care and participants’learning experience was good.展开更多
Objectives To investigate why patients with terminal illness and their families in Shanghai choose the hospice ward and their decision-making process.Methods This was a mixed-method study consisting of a cross-section...Objectives To investigate why patients with terminal illness and their families in Shanghai choose the hospice ward and their decision-making process.Methods This was a mixed-method study consisting of a cross-sectional survey and a descriptive qualitative study.Medical decision-makers for patients hospitalized in hospice wards were recruited between September 2019 and July 2021.A medical decision-maker is a family member who makes medical decisions for a patient.All 146 participants completed a self-developed 10-item questionnaire that included five items about their demographic characteristics and five items about the decision-making process.The semi-structured interviews were conducted with nine participants to understand the family’s decision-making process when they chose a hospice ward.The interviews were analyzed using qualitative content analysis.Results The mean age of the 146 participants was 57.6 years old.Of the decision-makers,56.85%were the patients’children.Family-dominated discussions involving other family members were the main decision-making mode(84.93%).Patient participation in the decision-making process was reported in 43.15%of families.The participation of doctors(17.81%)and nurses(2.05%)were reported in a small number of families.The most common reason for choosing the hospice ward was the inability to find any other hospital for the patients(82.19%).The most common ways to learn about the service were neighbors and friends(38.36%)and social media(28.77%).Two themes and six categories emerged from the interviews.The first theme was reasons for choosing hospice wards.The reasons included being unable to care for the patients at home,staying in a hospice ward could reduce the psychological stress for home care,being unable to be admitted into tertiary/secondary hospitals,and thinking a hospice ward was a suitable place for the family.The second theme was the decision process of choosing a hospice ward.This theme included the following two categories,i.e.,ways to learn about the hospice ward and family-discussion decision mode.Conclusion To most families having dying patients,a hospice ward is a reasonable and balanced choice after the families experience huge care stress and practical difficulties.The participation of patients should be encouraged in the family discussion so that their wishes can be known.More efforts will be needed to guide the families with dying patients to make reasonable medical choices.Social media can be a good way to improve public awareness of hospice services in the future.Meanwhile,healthcare providers should be more involved in the decision-making process.展开更多
In recent years, hospice care in Beijing has developed rapidly. In order to further promote the development of hospice care in Beijing, this paper first analyzes the current situation of hospice care in Beijing, and t...In recent years, hospice care in Beijing has developed rapidly. In order to further promote the development of hospice care in Beijing, this paper first analyzes the current situation of hospice care in Beijing, and then analyzes the existing problems of hospice care in Beijing, such as insufficient funds, lack of medical staff, no unified public information platform and low acceptance of hospice care. In view of the existing problems, the paper puts forward relevant policy suggestions for the development of hospice care in Beijing, such as increasing financial support, strengthening the propaganda and education of hospice care, strengthening the training of professional talents, improving the voluntary service system, formulating reasonable access standards, and building a unified public information platform, so as to further promote the effective, healthy and rapid development of hospice care in Beijing development.展开更多
Objective:To summarize the research progress of music therapy in hospice care and to provide reference for further research.Methods:A wide range of literatures on music therapy and hospice care at home and abroad were...Objective:To summarize the research progress of music therapy in hospice care and to provide reference for further research.Methods:A wide range of literatures on music therapy and hospice care at home and abroad were searched and read,and the literature was integrated,judged,analyzed,and summarized.Results:The related research on music therapy in hospice care mainly focused on western developed countries such as Europe and the United States.China is still in the stage of theoretical exploration,lacking qualitative research based on case investigation and empirical research based on data statistics.Conclusions:Music therapy supports the management of symptoms in hospice care,which can meet the diverse needs of patients and their family members including physical,psychological,social,and spiritual.展开更多
Purpose:To explore the effect of storytelling on hospice care learning in the interest group.Methods:Storytelling was used among 7 master of science in nursing(MSN)students in the hospice care interest group.The effec...Purpose:To explore the effect of storytelling on hospice care learning in the interest group.Methods:Storytelling was used among 7 master of science in nursing(MSN)students in the hospice care interest group.The effect of storytelling was evaluated by the combination of students’reflect diary and the evaluation form.Results:Five themes were extracted from diary including:relieving the suffering of the patients,understanding and respecting patients’choice,communicating,team working,and family supporting.Among 5 items of the evaluation form,there were 4 items which were scored as either agree or strongly agree.Conclusions:Students reflected that the storytelling helped them recognize the importance of relieving the suffering,respecting and understanding,communicating,team working,and family supporting in the hospice care.展开更多
In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. ...In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. Because of this, in the clinical treatment of oncology patients, strengthening hospice care for family members, doing a good job of death education, assisting them to face and participate in the clinical treatment of oncology in a positive way, and avoiding excessive grief can simultaneously improve the quality of life of patients and their families.展开更多
To study the effect of hospice care for elderly patients with advanced tumor. Objective: this article mainly selects the psychological intervention for the patients in the end stage of the disease in the hospice care....To study the effect of hospice care for elderly patients with advanced tumor. Objective: this article mainly selects the psychological intervention for the patients in the end stage of the disease in the hospice care. Methods: the time selection range was mainly from November 2019 to November 2020. 106 elderly patients with end-stage diseases who received different interventions were analyzed. Results: there were differences in the three indexes (satisfaction score and SAS score) between the experimental group and the control group, and the results of the two groups were significant (P < 0.05). Conclusion: the application of psychological intervention in the end-stage management of diseases can further improve the compliance score and psychological status, ensure the further improvement of health status, and can be popularized.展开更多
Objective: to explore the value of hospice care and pain nursing in the intervention of patients with advanced gastric cancer. Methods: 51 cases of advanced gastric cancer patients in our hospital were randomly divide...Objective: to explore the value of hospice care and pain nursing in the intervention of patients with advanced gastric cancer. Methods: 51 cases of advanced gastric cancer patients in our hospital were randomly divided into 2 groups by computer, including 25 cases in group A and 26 cases in group B. The intervention of basic nursing and hospice care + pain nursing was given respectively. The nursing efficacy value of the two groups was compared and observed. Results: the psychological state score and pain score of group B after intervention were significantly lower than that of group A (P < 0.05), and the nursing satisfaction score and quality of life score of group B were significantly higher than that of group A. The difference of hospice care and pain nursing was statistically significant. Conclusion: hospice care + pain nursing has obvious nursing value in advanced gastric cancer. It can reduce the pain of patients to a certain extent and improve their psychological state and quality of life.展开更多
BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospi...BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospice care on depression,anxiety,and sleep disorders in patients with advanced cancer.METHODS This prospective study was conducted between July 2023 and June 2024.Patients with advanced cancer were selected and divided into observation and control groups(n=34 per group).The observation group received TCM hospice care,with a 4-week treatment cycle.The control group received routine hospice care.The Hamilton Depression Rating Scale,Hamilton Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index were used to assess depression,anxiety,and sleep quality changes,and Statistical Package for the Social Sciences 26.0 was used for data analysis.RESULTS No significant differences were found in age,sex,cancer type,disease course,or baseline mental symptom scores between the groups(P>0.05).After treatment,the observation group showed significantly greater improvements in depression,anxiety,and sleep quality(P<0.05).The depression,anxiety,and sleep scores in the observation group decreased to 7.21±2.48,6.12±2.39,and 4.53±1.89,respectively.In the control group,these scores decreased to 11.42±3.12,10.14±3.21,and 6.21±1.79.The observation group demonstrated superior efficacy(P<0.05).Depression,anxiety,and sleep quality were significantly positively correlated(P<0.05).Logistic regression analysis identified the TCM hospice care system as an independent factor improving patients'health.CONCLUSION The TCM hospice care system effectively improves depression,anxiety,and sleep disorders in patients with advanced cancer,offering comprehensive care suitable for clinical promotion and application.展开更多
NTRODUCTIONHospice care is a type of care and a philosophy of care that focuses on the palliation of a terminally ill or a seriously ill patient＆#39;s pain and symptoms,and attends to their emotional and spiritual ne...NTRODUCTIONHospice care is a type of care and a philosophy of care that focuses on the palliation of a terminally ill or a seriously ill patient＆#39;s pain and symptoms,and attends to their emotional and spiritual needs.[1] Taiwan scholar Xie Mei introduced the concept of hospice care to the mainland of China in 1982 and the practice of hospice care in the mainland of China began then.[2] Tianjin Medical University had set up the Institute of Hospice Care.[3] Major state-owned hospitals have established hospice wards.There are also some hospice agencies set up through private fund raising.However,after all these years of development,the supply of the hospice care service in our country is still much less than the demand,between which the gap is big.There are three main reasons causing the gap.The details are as follow.展开更多
Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to co...Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to 2011.Multivariable logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital mortality.Temporal trends in outcomes were characterized with use of joinpoint regression.Results:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic cancer.During their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice care.The rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of mortality.Conclusion:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such services.We recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.展开更多
Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses...Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.展开更多
A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following m...A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following medical treatment, breakthrough pain occurring 1–2 times a day was still distressing.Neuropathic pain in her right lower limb caused discomfort and irritability and decreased her quality of life. We had limited options to adjust her prescription drug regime, due to the side effect of these drugs.Although acupuncture therapy was only performed at her home once a week, the efficacy was outstanding. The patient did not report any further instances of breakthrough pain, and she did not require additional bolus morphine. She could comfortably live in her familiar surroundings with her family and did not require any emergency room visits or admission into the hospital during the last month of her life.She had excellent quality of life in the terminal period of her life, and could even participate in a family function during this time. The present case report suggests that acupuncture may have a role in treating neuropathic pain induced by bone metastasis in patients with advanced cancer across clinical and inhome settings.展开更多
Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-...Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.展开更多
Introduction: Cognitive impairment is common in patients with cancer;however, studies examining the adaptation and validation of instruments for use in patients with cancer are scarce. Purpose: The purpose of this stu...Introduction: Cognitive impairment is common in patients with cancer;however, studies examining the adaptation and validation of instruments for use in patients with cancer are scarce. Purpose: The purpose of this study was to validate the Trail Making Test B (TMT-B) for use in patients with cancer. Methods: Ninety-four outpatients receiving palliative treatment and 39 healthy companions were assessed. Patients were tested with the TMT-B and answered questions regarding the presence and intensity of pain, fatigue, quality of sleep, anxiety, and depression, at two time points with a 7-day inter-assessment interval. Results: The instrument discriminated between patients, who were slower, and healthy companions with respect to the time required to complete the test, but not in terms of the number of errors. The test was stable for the healthy companions across the two assessments in terms of time to complete the TMT-B and the number of errors;for patients, the instrument was stable only for the number of errors. Performance on the TMT-B did not correlate with pain, fatigue, depression, anxiety, or sensation of rest. Conclusions: TMT-B cannot be considered fully validated. Further studies incorporating and comparing other instruments evaluating executive function and mental flexibility are needed.展开更多
Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burde...Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burden on patients and caregivers through effective medical symptom management,the provision of mental health support,and the development of health plans.This paper explores the current status and challenges regarding palliative care for patients with Parkinson's disease in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.We not only reviewed the systematic and effective therapy,but also concluded a new multidisciplinary cooperation model.TCM teams such as acupuncturists,TCM pharmacists and TCM physiotherapists should be key members of the new multidisciplinary team for the palliative care of Parkinson's disease.展开更多
The experiment will apply pain management to patients with advanced tumors, further improve the clinical effect of palliative care, and provide professional medical services for patients' pain relief. Methods: pat...The experiment will apply pain management to patients with advanced tumors, further improve the clinical effect of palliative care, and provide professional medical services for patients' pain relief. Methods: patients with advanced cancer admitted from February 2018 to February 2019 were selected as the research subjects, and a total of 80 patients met the inclusion criteria of the survey. They were divided into two groups by random drawing. The control group received conventional nursing measures (40 patients), and the observation group received pain management (41 patients), and the outcome of palliative care was analyzed. Results: in terms of nursing quality, the NRS pain score of observation group was (3.96 ± 1.24) points, and that of control group was (4.87 ± 1.63) points, the difference was statistically significant (P < 0.05). Meanwhile, in the survey of daily living ability, the scores of Barthel scale in the observation group and the control group were (80.55 ± 4.93) points and (69.35 ± 5.19) points, respectively. The difference was statistically significant. Finally, in the family satisfaction survey, the observation group was 95.0%, while the control group was 87.5%. The observation group more approved of the nursing plan. Conclusion: pain management is helpful to improve the pain of advanced tumor patients, improve the overall quality of palliative care, and further improve the quality of life. It has clinical promotion value.展开更多
Objectives:To investigate the focuses and trends of the studies on pediatric palliative care(PPC)and provide directions for future research.Methods:Relevant papers about PPC published from 2004 to 2018 were analyzed u...Objectives:To investigate the focuses and trends of the studies on pediatric palliative care(PPC)and provide directions for future research.Methods:Relevant papers about PPC published from 2004 to 2018 were analyzed using bibliometric analysis methods,including co-word analysis,biclustering analysis,and strategic diagram analysis.The included papers were divided into three groups based on the publication time,including 2004-2008,2009-2013,and 2014-2018.Results:A total of 1132 papers were published between 2004 and 2018,and there were 293 papers published between 2004 and 2008,396 between 2009 and 2013,and 443 between 2014 and 2018.There were 42 high-frequency MeSH terms/MeSH subheadings in papers published between 2004 and 2018,including 12 between 2004 and 2008,13 between 2009 and 2013,and 17 between 2014 and 2018.Conclusion:Studies on PPC were making progress,with the increasing number,expanding scope,and uneven global distribution.Integration palliative care into pediatrics,cancer treatments in pediatric oncology,education methods on PPC,and establishment of professional teams were the major themes during 2004e2008,then the themes changed into establishing interventions to enhance the quality of life of the patients and parents,building professional-family relationship,and investigating attitude of health personnel in PPC during 2009-2013 and subsequently turned into communication skills,end-oflife decision making,and guidelines making on PPC during 2014-2018.Underdeveloped and protential themes including effective approaches to deal with the ethical dilemmas,training programs on communication skills,family support and guideline making are worth studying in the future.展开更多
文摘Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.
文摘BACKGROUND Hospice care plays an important role in improving the quality of life of advanced cancer patients,but controversy remains over whether age affects the attitudes of family members toward hospice care.AIM To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care.METHODS The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022.The participants were divided into youth(<40 years,n=65),middle-aged(40–60 years,n=59),and elderly(>60 years,n=51)groups.Researchers investigated and compared the degree of awareness regarding hospice care,attitudes,and whether the family members of patients would choose hospice care.RESULTS Among the family members of 175 patients,approximately 28%(49/175)were aware of hospice care.Awareness of hospice care,the proportion of hospice care acceptance and adaptation attitudes,and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups(P<0.05).No statistically significant difference was found in these three indicators between the middle-aged and elderly groups(P>0.05).Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment,whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns.CONCLUSION The family members of patients with advanced cancer had relatively low awareness of hospice care,while youth had a higher awareness of hospice care,acceptance,and adaptation attitudes,and were more willing to choose hospice care.
基金This research received the sponsor from the Academic Research Funding of Macao Polytechnic University(No.RP/ESS 02/2018).
文摘Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was based on the data collected through semi-structured individual interviews.Seventeen nursing undergraduates in Macao,China who attended the simulation-centred program in hospice care participated in this qualitative from November to December 2020.This program included three parts:introduction to hospice care(2 h),management of terminal symptoms(10 h),and hospice situation simulations(6 h).The interview data were analyzed using qualitative content analysis.Results:This study revealed two themes and six sub-themes.Theme 1 was developing competencies in caring for dying patients and their families,which included four subcategories of sensitivity to patients’needs,knowledge of hospice care,skills of symptom control and comfort supply,and communication skills.Theme 2 was improving the ability to self-care and support colleagues,which included two subcategories of reflection on life and death and sharing and supporting among colleagues.Conclusion:This program improved the competency of nursing undergraduates in hospice care and participants’learning experience was good.
文摘Objectives To investigate why patients with terminal illness and their families in Shanghai choose the hospice ward and their decision-making process.Methods This was a mixed-method study consisting of a cross-sectional survey and a descriptive qualitative study.Medical decision-makers for patients hospitalized in hospice wards were recruited between September 2019 and July 2021.A medical decision-maker is a family member who makes medical decisions for a patient.All 146 participants completed a self-developed 10-item questionnaire that included five items about their demographic characteristics and five items about the decision-making process.The semi-structured interviews were conducted with nine participants to understand the family’s decision-making process when they chose a hospice ward.The interviews were analyzed using qualitative content analysis.Results The mean age of the 146 participants was 57.6 years old.Of the decision-makers,56.85%were the patients’children.Family-dominated discussions involving other family members were the main decision-making mode(84.93%).Patient participation in the decision-making process was reported in 43.15%of families.The participation of doctors(17.81%)and nurses(2.05%)were reported in a small number of families.The most common reason for choosing the hospice ward was the inability to find any other hospital for the patients(82.19%).The most common ways to learn about the service were neighbors and friends(38.36%)and social media(28.77%).Two themes and six categories emerged from the interviews.The first theme was reasons for choosing hospice wards.The reasons included being unable to care for the patients at home,staying in a hospice ward could reduce the psychological stress for home care,being unable to be admitted into tertiary/secondary hospitals,and thinking a hospice ward was a suitable place for the family.The second theme was the decision process of choosing a hospice ward.This theme included the following two categories,i.e.,ways to learn about the hospice ward and family-discussion decision mode.Conclusion To most families having dying patients,a hospice ward is a reasonable and balanced choice after the families experience huge care stress and practical difficulties.The participation of patients should be encouraged in the family discussion so that their wishes can be known.More efforts will be needed to guide the families with dying patients to make reasonable medical choices.Social media can be a good way to improve public awareness of hospice services in the future.Meanwhile,healthcare providers should be more involved in the decision-making process.
文摘In recent years, hospice care in Beijing has developed rapidly. In order to further promote the development of hospice care in Beijing, this paper first analyzes the current situation of hospice care in Beijing, and then analyzes the existing problems of hospice care in Beijing, such as insufficient funds, lack of medical staff, no unified public information platform and low acceptance of hospice care. In view of the existing problems, the paper puts forward relevant policy suggestions for the development of hospice care in Beijing, such as increasing financial support, strengthening the propaganda and education of hospice care, strengthening the training of professional talents, improving the voluntary service system, formulating reasonable access standards, and building a unified public information platform, so as to further promote the effective, healthy and rapid development of hospice care in Beijing development.
基金This project was supported by Construction and Empirical Study of Competency Index System for Nurses Specializing in Hospice Care and Nursing(No.19PJ042).
文摘Objective:To summarize the research progress of music therapy in hospice care and to provide reference for further research.Methods:A wide range of literatures on music therapy and hospice care at home and abroad were searched and read,and the literature was integrated,judged,analyzed,and summarized.Results:The related research on music therapy in hospice care mainly focused on western developed countries such as Europe and the United States.China is still in the stage of theoretical exploration,lacking qualitative research based on case investigation and empirical research based on data statistics.Conclusions:Music therapy supports the management of symptoms in hospice care,which can meet the diverse needs of patients and their family members including physical,psychological,social,and spiritual.
文摘Purpose:To explore the effect of storytelling on hospice care learning in the interest group.Methods:Storytelling was used among 7 master of science in nursing(MSN)students in the hospice care interest group.The effect of storytelling was evaluated by the combination of students’reflect diary and the evaluation form.Results:Five themes were extracted from diary including:relieving the suffering of the patients,understanding and respecting patients’choice,communicating,team working,and family supporting.Among 5 items of the evaluation form,there were 4 items which were scored as either agree or strongly agree.Conclusions:Students reflected that the storytelling helped them recognize the importance of relieving the suffering,respecting and understanding,communicating,team working,and family supporting in the hospice care.
文摘In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. Because of this, in the clinical treatment of oncology patients, strengthening hospice care for family members, doing a good job of death education, assisting them to face and participate in the clinical treatment of oncology in a positive way, and avoiding excessive grief can simultaneously improve the quality of life of patients and their families.
文摘To study the effect of hospice care for elderly patients with advanced tumor. Objective: this article mainly selects the psychological intervention for the patients in the end stage of the disease in the hospice care. Methods: the time selection range was mainly from November 2019 to November 2020. 106 elderly patients with end-stage diseases who received different interventions were analyzed. Results: there were differences in the three indexes (satisfaction score and SAS score) between the experimental group and the control group, and the results of the two groups were significant (P < 0.05). Conclusion: the application of psychological intervention in the end-stage management of diseases can further improve the compliance score and psychological status, ensure the further improvement of health status, and can be popularized.
文摘Objective: to explore the value of hospice care and pain nursing in the intervention of patients with advanced gastric cancer. Methods: 51 cases of advanced gastric cancer patients in our hospital were randomly divided into 2 groups by computer, including 25 cases in group A and 26 cases in group B. The intervention of basic nursing and hospice care + pain nursing was given respectively. The nursing efficacy value of the two groups was compared and observed. Results: the psychological state score and pain score of group B after intervention were significantly lower than that of group A (P < 0.05), and the nursing satisfaction score and quality of life score of group B were significantly higher than that of group A. The difference of hospice care and pain nursing was statistically significant. Conclusion: hospice care + pain nursing has obvious nursing value in advanced gastric cancer. It can reduce the pain of patients to a certain extent and improve their psychological state and quality of life.
基金Supported by Joint Fund Project of Hunan University of Chinese Medicine,No.2024XYLH036National Advantageous Specialty of Traditional Chinese Medicine-Nursing(Guo Zhong Yao Yi Zheng Han[2024]No.90),No.czxm-yb-2024002Young Talent Program of Hunan Nursing Association.
文摘BACKGROUND The hospice care system of traditional Chinese medicine(TCM)provides a reference for relieving depression,anxiety,and sleep disorders in patients with advanced cancer.AIM To explore the effects of TCM hospice care on depression,anxiety,and sleep disorders in patients with advanced cancer.METHODS This prospective study was conducted between July 2023 and June 2024.Patients with advanced cancer were selected and divided into observation and control groups(n=34 per group).The observation group received TCM hospice care,with a 4-week treatment cycle.The control group received routine hospice care.The Hamilton Depression Rating Scale,Hamilton Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index were used to assess depression,anxiety,and sleep quality changes,and Statistical Package for the Social Sciences 26.0 was used for data analysis.RESULTS No significant differences were found in age,sex,cancer type,disease course,or baseline mental symptom scores between the groups(P>0.05).After treatment,the observation group showed significantly greater improvements in depression,anxiety,and sleep quality(P<0.05).The depression,anxiety,and sleep scores in the observation group decreased to 7.21±2.48,6.12±2.39,and 4.53±1.89,respectively.In the control group,these scores decreased to 11.42±3.12,10.14±3.21,and 6.21±1.79.The observation group demonstrated superior efficacy(P<0.05).Depression,anxiety,and sleep quality were significantly positively correlated(P<0.05).Logistic regression analysis identified the TCM hospice care system as an independent factor improving patients'health.CONCLUSION The TCM hospice care system effectively improves depression,anxiety,and sleep disorders in patients with advanced cancer,offering comprehensive care suitable for clinical promotion and application.
文摘NTRODUCTIONHospice care is a type of care and a philosophy of care that focuses on the palliation of a terminally ill or a seriously ill patient＆#39;s pain and symptoms,and attends to their emotional and spiritual needs.[1] Taiwan scholar Xie Mei introduced the concept of hospice care to the mainland of China in 1982 and the practice of hospice care in the mainland of China began then.[2] Tianjin Medical University had set up the Institute of Hospice Care.[3] Major state-owned hospitals have established hospice wards.There are also some hospice agencies set up through private fund raising.However,after all these years of development,the supply of the hospice care service in our country is still much less than the demand,between which the gap is big.There are three main reasons causing the gap.The details are as follow.
文摘Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to 2011.Multivariable logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital mortality.Temporal trends in outcomes were characterized with use of joinpoint regression.Results:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic cancer.During their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice care.The rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of mortality.Conclusion:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such services.We recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.
基金supported by the“Climbing Plan”for Outstanding Young Teachers at Shanghai University of Medicine&Health Sciences(A3-0200-21-311008)Ministry of Education of Humanities and Social Science Project(23YJC630002).
文摘Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.
文摘A 66-year-old female patient was diagnosed with hepatocellular carcinoma accompanied by neuropathic pain induced by a metastatic tumor that compromised root and spinal canal. Although her pain was relieved following medical treatment, breakthrough pain occurring 1–2 times a day was still distressing.Neuropathic pain in her right lower limb caused discomfort and irritability and decreased her quality of life. We had limited options to adjust her prescription drug regime, due to the side effect of these drugs.Although acupuncture therapy was only performed at her home once a week, the efficacy was outstanding. The patient did not report any further instances of breakthrough pain, and she did not require additional bolus morphine. She could comfortably live in her familiar surroundings with her family and did not require any emergency room visits or admission into the hospital during the last month of her life.She had excellent quality of life in the terminal period of her life, and could even participate in a family function during this time. The present case report suggests that acupuncture may have a role in treating neuropathic pain induced by bone metastasis in patients with advanced cancer across clinical and inhome settings.
文摘Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.
基金the Graduate Program in Adult Health Nursing at the University of Sao Paulo’s School of Nursingthe Agency for the Support and Development of Graduate Education(Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior,CAPES)for financing this study
文摘Introduction: Cognitive impairment is common in patients with cancer;however, studies examining the adaptation and validation of instruments for use in patients with cancer are scarce. Purpose: The purpose of this study was to validate the Trail Making Test B (TMT-B) for use in patients with cancer. Methods: Ninety-four outpatients receiving palliative treatment and 39 healthy companions were assessed. Patients were tested with the TMT-B and answered questions regarding the presence and intensity of pain, fatigue, quality of sleep, anxiety, and depression, at two time points with a 7-day inter-assessment interval. Results: The instrument discriminated between patients, who were slower, and healthy companions with respect to the time required to complete the test, but not in terms of the number of errors. The test was stable for the healthy companions across the two assessments in terms of time to complete the TMT-B and the number of errors;for patients, the instrument was stable only for the number of errors. Performance on the TMT-B did not correlate with pain, fatigue, depression, anxiety, or sensation of rest. Conclusions: TMT-B cannot be considered fully validated. Further studies incorporating and comparing other instruments evaluating executive function and mental flexibility are needed.
基金funded by Youth Science Foundation Project of National Natural Science Foundation(CN)(81603565)the Graduate Research and Innovation Projects of Tianjin(CN)(2020YJSS179)the Graduate Research and Innovation Projects of Tianjin University of Traditional Chinese Medicine(CN)(YJSKC-20201030).
文摘Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burden on patients and caregivers through effective medical symptom management,the provision of mental health support,and the development of health plans.This paper explores the current status and challenges regarding palliative care for patients with Parkinson's disease in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.We not only reviewed the systematic and effective therapy,but also concluded a new multidisciplinary cooperation model.TCM teams such as acupuncturists,TCM pharmacists and TCM physiotherapists should be key members of the new multidisciplinary team for the palliative care of Parkinson's disease.
文摘The experiment will apply pain management to patients with advanced tumors, further improve the clinical effect of palliative care, and provide professional medical services for patients' pain relief. Methods: patients with advanced cancer admitted from February 2018 to February 2019 were selected as the research subjects, and a total of 80 patients met the inclusion criteria of the survey. They were divided into two groups by random drawing. The control group received conventional nursing measures (40 patients), and the observation group received pain management (41 patients), and the outcome of palliative care was analyzed. Results: in terms of nursing quality, the NRS pain score of observation group was (3.96 ± 1.24) points, and that of control group was (4.87 ± 1.63) points, the difference was statistically significant (P < 0.05). Meanwhile, in the survey of daily living ability, the scores of Barthel scale in the observation group and the control group were (80.55 ± 4.93) points and (69.35 ± 5.19) points, respectively. The difference was statistically significant. Finally, in the family satisfaction survey, the observation group was 95.0%, while the control group was 87.5%. The observation group more approved of the nursing plan. Conclusion: pain management is helpful to improve the pain of advanced tumor patients, improve the overall quality of palliative care, and further improve the quality of life. It has clinical promotion value.
文摘Objectives:To investigate the focuses and trends of the studies on pediatric palliative care(PPC)and provide directions for future research.Methods:Relevant papers about PPC published from 2004 to 2018 were analyzed using bibliometric analysis methods,including co-word analysis,biclustering analysis,and strategic diagram analysis.The included papers were divided into three groups based on the publication time,including 2004-2008,2009-2013,and 2014-2018.Results:A total of 1132 papers were published between 2004 and 2018,and there were 293 papers published between 2004 and 2008,396 between 2009 and 2013,and 443 between 2014 and 2018.There were 42 high-frequency MeSH terms/MeSH subheadings in papers published between 2004 and 2018,including 12 between 2004 and 2008,13 between 2009 and 2013,and 17 between 2014 and 2018.Conclusion:Studies on PPC were making progress,with the increasing number,expanding scope,and uneven global distribution.Integration palliative care into pediatrics,cancer treatments in pediatric oncology,education methods on PPC,and establishment of professional teams were the major themes during 2004e2008,then the themes changed into establishing interventions to enhance the quality of life of the patients and parents,building professional-family relationship,and investigating attitude of health personnel in PPC during 2009-2013 and subsequently turned into communication skills,end-oflife decision making,and guidelines making on PPC during 2014-2018.Underdeveloped and protential themes including effective approaches to deal with the ethical dilemmas,training programs on communication skills,family support and guideline making are worth studying in the future.
