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

Leszek Pawłowski*, Monika Lichodziejewska-Niemierko, Natalia Krzyzaniak

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalMedycyna Paliatywna w Praktyce
Volume10
Issue number4
Publication statusPublished - 1 Jan 2016
Externally publishedYes

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Hospices
Palliative Care
Chronic Kidney Failure
Dialysis
Therapeutics
Hospice Care
Peritoneal Dialysis
Poland
Chi-Square Distribution
Nausea
Vomiting
Fatigue
Renal Dialysis
Disease Progression
Palliative Medicine
Patient Care
Guidelines
Kidney
Pain

Cite this

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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",
abstract = "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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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, Leszek; Lichodziejewska-Niemierko, Monika; Krzyzaniak, Natalia.

In: Medycyna Paliatywna w Praktyce, Vol. 10, No. 4, 01.01.2016, p. 131-138.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - 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

AU - Pawłowski, Leszek

AU - Lichodziejewska-Niemierko, Monika

AU - Krzyzaniak, Natalia

PY - 2016/1/1

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