scholarly journals Situation, possibilities and difficulties of the hospice and palliative care in Hungary

2014 ◽  
Vol 155 (38) ◽  
pp. 1504-1509 ◽  
Author(s):  
Katalin Hegedűs ◽  
Miklós Lukács ◽  
Judit Schaffer ◽  
Ágnes Csikós

Hospice-palliative care has existed in Hungary for more than 20 years but physicians know very little about it. The objective of the study is to give detailed practical information about the possibilities and the reasonability of hospice care and the process of how to have access to it. The authors review and analyze the database of the national Hospice-Palliative Association database to provide most recent national data on hospice-palliative care. In addition, legal, financial and educational issues are also discussed. At present there are 90 active hospice providers in Hungary, which provide service for more than 8000 terminally ill cancer patients. According to WHO recommendations there would be a need for much more service providers, institutional supply and more beds. There are also problems concerning the attitude and, therefore, patients are admitted into hospice care too late. Hospice care is often confused with chronic or nursing care due to lack of information. The situation may be improved with proper forms of education such as palliative licence and compulsory, 40-hour palliative training for residents. The authors conclude that a broad dissemination of data may help to overcome misbeliefs concerning hospice and raise awareness concerning death and dying. Orv. Hetil., 2014, 155(38), 1504–1509.

1996 ◽  
Vol 3 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Ronald S. Schonwetter

Background The concept of palliative care in oncology has not yet reached the forefront of American medicine, and hospice care may be underused. Methods Data on increasing needs for palliative care and the development of the hospice movement are compared with practice behavior patterns of physicians in regard to palliative care. Results Hospice/palliative care has grown from an alternative health care movement to an accepted part of the American health field. Limitations of hospice/palliative care include health professionals’ discomfort with care of the terminally ill as well as difficulties in predicting limited prognoses that may hinder access to such care. Conclusions Hospice/palliative care principles should be integrated into other elements of cancer control to ensure comprehensive care for all cancer patients.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S328-S328
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Jeannette Kates ◽  
Jingjing Shang ◽  
Angela M Gerolamo

Abstract Background Due to the emergence of COVID-19 and resulting pandemic, there is an increased demand for palliative care and hospice care services. However, the impact of COVID-19 on the hospice and palliative agencies is unknown. Methods An electronic survey was disseminated via the Hospice & Palliative Nurses Association newsletter, posted to the Sigma Theta Tau Hospice and Palliative Care Community Group discussion board and advertised through social media from May 7–28, 2020. Summary statistics were computed. Results We collected 36 surveys representing all U.S. regions. Most respondents (78%) reported that their agency has cared for confirmed COVID-19 patients. Only half of agencies had access to laboratory facilities for surveillance and detection of the presence of outbreaks in both patients and staff (58%) and the ability to test patients and providers for COVID-19 (55%). Due to COVID-19, participants stated that the agency added new protocols regarding aerosol-generating procedures policies (58%), use of surface barriers (61%) and PPE usage (e.g. donning and doffing) in patient homes (56%). The majority (76%) reported that their agency required field clinicians to call ahead to ascertain COVID-19 exposure/symptoms before a home visit. More than half (58%) reported that their agency lacked supplies, including N95 respirators (45%), cleaning/disinfectant product (23%), alcohol based sanitizer (18%), eye protection (18%), gowns (18%), and surgical masks (14%). Overall, participants shared that field clinicians had to reuse (76%), extend (73%) or ration (30%) PPE supplies. Respondents reported that their agency accessed supplemental PPE through state/local resources (67%), private/community donations (67%), and do-it-yourself efforts (55%). One third (31%) reported that their agency was experiencing staffing shortages due to COVID-19; of these, 60% reported that shortages were due to staff infected with/quarantined due to COVID-19. Conclusion Our findings suggest that COVID-19 has presented significant challenges for palliative care and hospice agencies as they provide care to patients and families at an unprecedented rate. Disclosures All Authors: No reported disclosures


Author(s):  
Li-Fang Chang ◽  
Li-Fen Wu ◽  
Chi-Kang Lin ◽  
Ching-Liang Ho ◽  
Yu-Chun Hung ◽  
...  

This study aimed to explore the effectiveness of an inpatient hospice palliative care unit (PCU) and palliative consultation service (PCS) on comprehensive quality of life outcome (CoQoLo) among terminally ill cancer patients. This was a prospective longitudinal study. Terminally ill cancer patients who met the inclusion criteria and received PCU or PCS in a northern Taiwanese medical center were recruited. The CoQoLo Inventory was used to measure CoQoLo level pre- and seven days following hospice care between August 2018 and October 2019. A total of 90 patients completed the study. No significant differences were found in CoQoLo levels between the PCU and PCS groups pre- and seven days following care. However, the CoQoLo level of patients significantly improved seven days following care in both PCU and PCS groups, compared with pre-hospice care. Patients’ age, religious belief, marital status, closeness with family, palliative prognostic index (PPI), and symptom severity were significant concerning CoQoLo levels after adjusting for patients’ baseline characteristics. PCU and PCS showed no difference in CoQoLo levels, but both of them can improve CoQoLo among terminally ill cancer patients. These patients could receive PCU or PCS to achieve a good CoQoLo at the end-of-life stage.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bożena Baczewska ◽  
Bogusław Block ◽  
Beata Kropornicka ◽  
Antoni Niedzielski ◽  
Maria Malm ◽  
...  

Introduction. The objective of the presented research is to characterize hope in the situational dimension, i.e., health, in the patients with cancer in the terminal phase of the disease, being treated in hospices and palliative care centers. Hope is very important for all the patients, especially for patients with cancer in various phases of the disease. Giving up on oncologic therapy and causal treatment is often associated with a transition into palliative care. When death and a loss of values become a threat, the individual has got hope to rely on. Material and Methods. The study relies on the Test to Measure Hope in the Health Context (NCN-36) by B.L. Block. 246 patients in the terminal phase of cancer participated in the study. Results. The internal structure of hope of recovery in the patients’ group was varied. The patients showed low levels of hope of recovery since they do not believe in the effectiveness of treatment. They were also not convinced of the effectiveness of modifications in dieting, lifestyle, or the use of nonconventional medicine. They trusted the doctor in charge and were moderately satisfied with the therapy in use. The intensity of hope of recovery was on the low level in the patients in the terminal phase of cancer. Age, sex, place of living, and marital status had a significant influence on the level of hope of recovery. Variables such as living on one’s own or living with one’s family, socioeconomic status, education, or profession did not affect the level of hope of recovery. Conclusions. The presented results allowed as to conclude that the assessment of hope in terminally ill cancer patients can be considered as one of the important tools enabling the personalization and the improvement of palliative care.


2013 ◽  
Vol 67 (1-2) ◽  
pp. 193-200 ◽  
Author(s):  
Sonia Quinones-Gonzalez

The Hispanic and Latino populations have increased nationwide. Hispanics are now the largest minority group in the United States. This increase in population will have an impact on all service areas, including hospice and palliative care. The goal as service providers is to remove barriers to care in order to increase opportunities for all the people residing in the communities. This project addresses the impact of the Hispanic and Latino populations in Pasco County, Florida, and the need to develop Latino outreach programs that will inform, educate, and provide culturally sensitive services which will decrease the barriers of communication and accessibility for Hispanics and Latinos who are in need of hospice and palliative care. The new outreach program, named Nuestro, which means “ours” in Spanish, is designed with this purpose in mind. The project's goal was to increase service by 200%; the outcome after 2 years was an increase of services by 900%.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S199-S199
Author(s):  
George Demiris ◽  
Karen Hirschman

Abstract In order to better support older adults with life-limiting illness and their families, many initiatives utilize information technology and other innovative platforms to increase access to supportive services and bridge geographic distance. Such technologies cover a broad range of systems ranging from smart phone applications to wearables and traditional telehealth platforms. There is a growing evidence base for such interventions but technical, clinical and ethical challenges remain when utilizing technology in the context of hospice and palliative care especially for older adults, including the concerns for caregiver burden, privacy, security, confidentiality, obtrusiveness and accessibility. In this symposium we provide an overview of innovative tools available for interventions in palliative and hospice care designed for patients and/or family caregivers in urban and rural settings. We provide lessons learned from three NIH funded studies testing different technology-based interventions in various settings including home hospice and outpatient palliative care. Discussion will follow focused on the clinical, ethical and practical challenges of innovation and the unique considerations for technology-mediated intervention design in a variety of palliative and hospice care settings. This symposium aims to provide: 1. an overview of existing technology-based interventions for older adults and their families in palliative care and hospice 2. evidence-based recommendations resulting from clinical trials in urban and rural settings for the design and implementation of innovative tools in hospice and palliative care 3. a discussion of challenges and opportunities for the use of technology to support older adults and their families


2016 ◽  
Vol 22 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Jennifer L. Ashley ◽  
Tracy K. Fasolino

Hospice and palliative care aim to improve the quality of life for patients and families impacted by chronic, serious, and life-threatening illnesses. Patients and families benefit from earlier integration of palliative care and seamless transitions to hospice care. Nurses are an integral part of the care team, and their understanding of these services is critical. However, many nurses do not receive formal education in hospice and palliative care. This leads to lack of skills that nurses need to provide and discuss hospice and palliative care across care settings. Nurses in an acute care setting of a large health system were invited to participate in a survey, Attitudes Towards Care at the End-of-Life. The results of this survey revealed that nurses believe that patients and families need to be communicated with honestly regarding their disease, but nurses lack the knowledge of how to facilitate these discussions. Another key finding is that nurses feel less confident with non-pharmacologic interventions to relieve patients’ suffering. Education is urgently needed in these areas.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20749-e20749
Author(s):  
E. Swietlik ◽  
A. Doboszynska

e20749 Beginning of the hospice care in Poland is associated with democratic opposition in the eighties of the XX century and social movement Solidarity. In 1978, C. Saunders visited Gdansk, Warsaw, and Krakow, supporting an organization of palliative care in Poland. Polish hospice care, similarly to other countries,originated from the necessity of special care of terminally ill cancer patients. Palliative care societies, initially informal, then registered formally, emerged in Poland in 1981. Hospices, both institutional and house hospice care, came into being in all larger cities in Poland to the nineties of the XX century. In 1991, National Forum of the Hospice Movement was founded. This Forum, gathering the majority of hospices, is actually transformed into the association of societies: Forum of the Polish Hospices. In the nineties of the XX century, professional palliative care developed. Since 1998, specialization in the palliative care for both physicians and nurses is available. From the very beginning, hospice care based on the volunteers gathered at the Roman Catholic parish and several priests first organized palliative care. In 1991, The Sejm (lower chamber of the Polish Parliament) passed the law Health care institutions, enabling various societies and associations to establish health care institutions, whereas the law The Social Insurance Act (1997) gives an opportunity to get financial means for hospice care from the State. Actually, there are hospices acting on voluntary service (the number of such hospices decreases), partial voluntary service and also paid employees, and institutions which activities are based on full-time employment and financed by the National Health Fund. About 130 non-profit societies and hospice foundations both secular andchurch exist in Poland. Non-public health care institutions founded 99 hospices. About 70 hospices (both public and private) are stationary. No significant financial relationships to disclose.


2016 ◽  
Vol 34 (3_suppl) ◽  
pp. e265-e265
Author(s):  
Janusz Wojtacki ◽  
Agnieszka Paczkowska ◽  
Mikolaj Majkowicz ◽  
Anna Cieśnik ◽  
Natalia Gurgul ◽  
...  

e265 Background: Voluntary activities are essential in many different aspects of hospice and palliative care. The interest in becoming a volunteer lowers in many communities. Better knowledge of volunteers’ characteristics and wider understanding of their motivations seem to be crucial for more sufficient volunteers’ recruitment and retain. Methods: Self-reported demographic details and data on motives for hospice / palliative care volunteering were collected from initial questionnaire forms fulfilled by all consecutive participants of the teaching course for medical voluntary cancer patients caregivers (16 editions; April-2006-November-2014; no data for 2009) at Rev. Eugeniusz Dutkiewicz Hospice SAC, Gdańsk, Poland. Results: all 562 records were analyzed: 1) mean volunteers age was 35,73+14,69 years and significant trend (p < 0.001) for increasing age was observed (e.g.: mean age values + SD were: 2007: 28.41+11.82; 2011: 37.19+14.93; 2014: 41.31+12.16); 2) the vast majority of volunteers were females (82.03%), who already completed education; 3) 67 of study participants declared professional connections with medicine (19.47%), 42 (12.21%) - pedagogy or 38 (11.05%) – psychology; 4) 241 (42.88%) volunteers declared full current professional activity, 174 (30.96%) were unemployed, 50 (8.89%) - retired; 5) participants mostly reported motives for volunteering which might be categorized as altruistic (67.08%: “I want to help others”) – the percentage increased significantly during the study period (p < 0.012); 6) the next two most frequently indicated motives represented category of personal gain (29.36%: “I want to improve my skills”; 26.87%: “volunteering is the way of my personal development” – not significant trend for time). Conclusions: 1) Results showed that some demographic features as well motives for hospice / palliative care volunteering changed over the time in our community - it warrants some individualization in recruitment process recognition for volunteers coordinators; 2) the study will continue to identify the volunteers’ subgroup with the greatest probability to retain at service for longer period of time.


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