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

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 a...

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Bibliographic Details
Published in:Journal of the Formosan Medical Association 2016-07, Vol.115 (7), p.490-500
Main Authors: Chao, Chia-Ter, Tsai, Hung-Bin, Shih, Chih-Yuan, Hsu, Su-Hsuan, Hung, Yu-Chien, Lai, Chun-Fu, Ueng, Ruey-Hsiuang, Chan, Ding-Cheng, Hwang, Juey-Jen, Huang, Sheng-Jean
Format: Article
Language:English
Subjects:
Aged
chronic kidney disease
end-stage renal disease
hospice
Hospice Care - methods
Hospice Care - trends
Hospitals, Community
Humans
Internal Medicine
Kidney Failure, Chronic - therapy
palliative care
Palliative Care - methods
Palliative Care - trends
Quality of Life
Renal Dialysis
renal supportive care
Rural Population
Taiwan
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Summary: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.
ISSN:0929-6646
DOI:10.1016/j.jfma.2015.12.009