title: Establishment of a renal supportive care program: Experience from a rural community hospital in Taiwan.
abstract: 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.
authors.affiliation: 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.
authors.forename: Chia-Ter
authors.initials: CT
authors.lastname: Chao
authors.affiliation: Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hung-Bin
authors.initials: HB
authors.lastname: Tsai
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Shih
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
authors.forename: Su-Hsuan
authors.initials: SH
authors.lastname: Hsu
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
authors.forename: Yu-Chien
authors.initials: YC
authors.lastname: Hung
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
authors.affiliation: Department of Nursing, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
authors.forename: Ruey-Hsiuang
authors.initials: RH
authors.lastname: Ueng
authors.affiliation: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Chu-Tung Branch, Hsin-Chu County, Taiwan.
authors.forename: Ding-Cheng
authors.initials: DC
authors.lastname: Chan
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Taipei City Hospital, Taipei, Taiwan. Electronic address: sjhuang1@ntu.edu.tw.
authors.forename: Sheng-Jean
authors.initials: SJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D017051:Hospice Care / Q000379:methods* / Q000639:trends; D006764:Hospitals, Community; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010166:Palliative Care / Q000379:methods* / Q000639:trends; D011788:Quality of Life; D006435:Renal Dialysis; D012424:Rural Population; D013624:Taiwan
keywords: chronic kidney disease; end-stage renal disease; hospice; palliative care; renal supportive care