Institute of Community Health Care, School of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK.
Am J Hosp Palliat Care. 2021 Jul;38(7):861-868. doi: 10.1177/10499091211002797. Epub 2021 Apr 1.
Hospice and palliative care services provision for COVID-19 patients is crucial to improve their life quality. There is limited evidence on COVID-19 preparedness of such services in the Asia-Pacific region.
To evaluate the preparedness and capacity of hospice and palliative care services in the Asia-Pacific region to respond to the COVID-19 pandemic.
An online cross-sectional survey was developed based on methodology guidance. Asia-Pacific Hospice and Palliative Care Network subscribers (n = 1551) and organizational members (n = 185) were emailed. Descriptive analysis was undertaken.
Ninety-seven respondents completed the survey. Around half of services were hospital-based (n = 47, 48%), and public-funded (n = 46, 47%). Half of services reported to have confirmed cases (n = 47, 49%) and the majority of the confirmed cases were patients (n = 28, 61%). Staff perceived moderate risk of being infected by COVID-19 (median: 7/10). > 85% of respondents reported they had up-to-date contact list for staff and patients, one-third revealed challenges to keep record of relatives who visited the services (n = 30, 31%), and of patients visited in communities (n = 29, 30%). Majority of services (60%) obtained adequate resources for infection control except face mask. More than half had no guidance on Do Not Resuscitate orders (n = 59, 66%) or on bereavement care for family members (n = 44, 51%).
Recommendations to strengthen the preparedness of palliative care services include: 1) improving the access to face mask; 2) acquiring stress management protocols for staff when unavailable; 3) reinforcing the contact tracing system for relatives and visits in the community and 4) developing guidance on patient and family care during patient's dying trajectory.
为改善 COVID-19 患者的生活质量，为其提供临终关怀和姑息治疗服务至关重要。在亚太地区，临终关怀和姑息治疗服务在 COVID-19 方面的准备情况证据有限。
评估亚太地区临终关怀和姑息治疗服务应对 COVID-19 大流行的准备情况和能力。
根据方法学指南开发了在线横断面调查。向亚太姑息治疗网络订阅者（n = 1551）和组织成员（n = 185）发送电子邮件。进行描述性分析。
97 名受访者完成了调查。约一半的服务为医院基础服务（n = 47，48%）和公共资助服务（n = 46，47%）。一半的服务报告有确诊病例（n = 47，49%），大多数确诊病例为患者（n = 28，61%）。员工认为感染 COVID-19 的风险中等（中位数：7/10）。超过 85%的受访者表示，他们有最新的员工和患者联系名单，三分之一的受访者表示，在记录探访服务的亲属（n = 30，31%）和在社区中探访的患者（n = 29，30%）方面存在挑战。大多数服务（60%）获得了充足的感染控制资源，除了口罩。超过一半的服务没有关于不复苏命令（n = 59，66%）或关于丧亲家庭成员护理（n = 44，51%）的指导。
加强姑息治疗服务准备工作的建议包括：1）改善口罩的获取途径；2）在无法获取时为员工获得压力管理协议；3）加强社区内亲属和探访的接触追踪系统；4）制定患者临终关怀期间患者和家庭护理的指南。
