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
Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2016 Jul;115(7):490-500. doi: 10.1016/j.jfma.2015.12.009. Epub 2016 Jan 26.
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.
肾脏支持性护理（RSC）是一项专门针对急性、慢性肾衰竭及终末期肾病（ESRD）患者的护理计划，旨在最大程度缓解症状并优化患者生活质量。慢性肾脏病和ESRD患者预后的不确定性、台湾社会固有的社会文化问题以及结构化且实用的RSC路径的缺失，导致RSC未得到充分认识和利用。台湾患者很少将RSC信息作为标准化护理的一部分来接收，也不常被提供此选项。在国立台湾大学医院金山分院，我们在基于社区的姑息/临终关怀主要项目的支持下启动了一个RSC子项目。我们专注于了解需求并为合适的候选人提供RSC选择。设计并实施了一个三步四阶段方案，以识别合适的患者并提高RSC的适用性。我们利用家访和居家家庭会议作为一种方式，来了解患者的偏好，发现ESRD患者及其家人最看重的东西，并介绍RSC选项。在当前的综述中，我们描述了在台湾建立RSC项目的试点经验，并讨论其潜在优势。
