Organizational issues and major problems of palliative care concerning treatment of end-stage renal disease in Polish residential hospices and hospital- -based palliative medicine wards

Pawłowski, L; Lichodziejewska-Niemierko, M; Krzyzaniak, N

Organizational issues and major problems of palliative care concerning treatment of end-stage renal disease in Polish residential hospices and hospital- -based palliative medicine wards

Pawłowski, L Lichodziejewska-Niemierko, M Krzyzaniak, N

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Publication Type:: Journal Article
Citation:: Medycyna Paliatywna w Praktyce, 2016, 10 (4), pp. 131 - 138
Issue Date:: 2016-01-01

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Field	Value	Language
dc.contributor.author	Pawłowski, L	en_US
dc.contributor.author	Lichodziejewska-Niemierko, M	en_US
dc.contributor.author	Krzyzaniak, N https://orcid.org/0000-0001-5668-7292	en_US
dc.date.issued	2016-01-01	en_US
dc.identifier.citation	Medycyna Paliatywna w Praktyce, 2016, 10 (4), pp. 131 - 138	en_US
dc.identifier.issn	1898-0678	en_US
dc.identifier.uri	http://hdl.handle.net/10453/126249
dc.description.abstract	Copyright © Via Medica. Background. Patients diagnosed with end-stage renal disease experience a significant level of symptom burden, including pain, nausea and vomiting, inability to urinate, fatigue etc. At this point in disease progression, it is important to establish what types and choices of therapy are most suitable for these patients, in particular, the value of continuing dialysis treatment. Material and methods. A self-administered questionnaire was distributed among Polish residential hospices and hospital based palliative medicine wards. All responses obtained underwent statistical analysis using Pearson's Chi Square test. Results. Permanent palliative care facilities, from which 73 out of 166 registered in Poland, took part in the survey. ESRD patients were identified to be cared by 81% of the aforementioned institutions. The most common treatment approach for these patients was highlighted as conservative treatment (68%), followed by hemodialysis (47%), whereas merely 11% provided peritoneal dialysis. Differences between facilities were identified relating to therapeutic recommendations for terminal ESRD patients with residential hospices more likely to recommend dialysis in conjunction with palliative care, whereas palliative wards advocated a withdrawal from dialysis followed by the initiation of palliative care. Conclusion. All surveyed facilities considered ESRD patients eligible for guaranteed hospice and palliative care services. However, certain changes are needed to improve care for ESRD patients, including: The development of collaborative partnerships between hospices, dialysis centers and nephrologists, development of guidelines for withdrawing dialysis and applying conservative treatment, introducing better renal-based training for medical personnel as well as the introduction of transparency within rules relating to the financing of these services.	en_US
dc.relation.ispartof	Medycyna Paliatywna w Praktyce	en_US
dc.title	Organizational issues and major problems of palliative care concerning treatment of end-stage renal disease in Polish residential hospices and hospital- -based palliative medicine wards	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	10	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	open_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	10	en_US

Abstract:

Copyright © Via Medica. Background. Patients diagnosed with end-stage renal disease experience a significant level of symptom burden, including pain, nausea and vomiting, inability to urinate, fatigue etc. At this point in disease progression, it is important to establish what types and choices of therapy are most suitable for these patients, in particular, the value of continuing dialysis treatment. Material and methods. A self-administered questionnaire was distributed among Polish residential hospices and hospital based palliative medicine wards. All responses obtained underwent statistical analysis using Pearson's Chi Square test. Results. Permanent palliative care facilities, from which 73 out of 166 registered in Poland, took part in the survey. ESRD patients were identified to be cared by 81% of the aforementioned institutions. The most common treatment approach for these patients was highlighted as conservative treatment (68%), followed by hemodialysis (47%), whereas merely 11% provided peritoneal dialysis. Differences between facilities were identified relating to therapeutic recommendations for terminal ESRD patients with residential hospices more likely to recommend dialysis in conjunction with palliative care, whereas palliative wards advocated a withdrawal from dialysis followed by the initiation of palliative care. Conclusion. All surveyed facilities considered ESRD patients eligible for guaranteed hospice and palliative care services. However, certain changes are needed to improve care for ESRD patients, including: The development of collaborative partnerships between hospices, dialysis centers and nephrologists, development of guidelines for withdrawing dialysis and applying conservative treatment, introducing better renal-based training for medical personnel as well as the introduction of transparency within rules relating to the financing of these services.

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http://hdl.handle.net/10453/126249