儿童安宁疗护研习会

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1、兒童安寧療護研習會時間：94年11月15-16日地點：馬偕醫院淡水分院主辨單位：財團法人中華民國安寧照顧基金會、財團法人安寧療護教育資訊服務中心、台灣安寧緩和醫學學會、台灣安寧緩和護理學會、台灣兒科醫學會、馬偕紀念醫院、國立成功大學醫學院附設醫院參加人：吳玉媛、蔡美惠主講人：RichardD.W.HainSeniorLecturerinPaediatricPalliativeMedicineDepartmentofChildHealth,WalesCollegeofMedicineCardiffUniversity,Cardiff,Wales,UnitedKingdomHonoraryMe

2、dicalOfficerTyHafanChildren’sHospice譯者簡介：林翔宇馬偕醫院小兒科醫師林炫沛馬偕醫院小兒科醫師一、內容簡介2004年衛生署死因資料顯示，台灣每年有數千名末期兒童，需要提供兒童全人醫療照顧，特邀請英國兒童癌症治療和安寧療護專家Dr.Hain來台，藉著他的經驗和專業知識，講授兒童癌末的臨床處置、社會心理暨靈性照顧等議題，以提供更優質的服務。二、英國兒童安寧療護模式介紹Introduction：Palliativecareandpalliativemedicine：WhatistheidealtypeandHowshoulditbedelivered？＊Who

3、needsit？＊Whatdotheyneed？＊Whoprovidesit？＊Wherearethey？Mythno.1！”Palliativecareismainlyaboutchildrenwithcancer”Whatdoesthistellus？Twogroupsofneeds：*Generictoallgroups--Physicalsymptomcontrol--Respite--Coordinationofcommunityservices--Emotional/psychological/spiritual/support*SpecifictosomegroupsMyth

4、no.2！“Doctorshavelittleornoroletoplayinthepalliativephase”Whatdoesthistellus？*Needsmorethanoneprofessionanddiscipline*Cannotbelimitedtooneinstitution--School--Hospital--Hospice--HomeMythno.3！“Allpalliativecareisdoneinchildren’shospices”Summary*ChildwithLLCisusuallyathomeoratschool.*Deathisusuallya

5、thomeorathospital;hospiceadmissionsareprimarilyforrespite.*Choiceofplaceofdeathisimportant.*Goodpalliativecareneedsmedicalaswellasnursing[andother]support.Weneedtodevelopamodelofpalliativecarethatallows：*Caretofollowchild,wherevertheyare*Goodaccesstospecialistmedicalandnursingexpertiseinpalliative

6、care*Choiceforfamilyandchildofinpatientoroutpatient-basedmanagement.Thisrequiresamodelthatis:Community-based,reachingintohospitalorHospitalorhospicebased,reachingouttohomeandschoolorApragmaticmixofthetwo！二、何謂兒童安寧療護（包括倫理議題）Whatispalliativecareinchildren？“…anactiveandtotalapproachtothecareofchildren

7、,embracingphysical,emotional,socialandspiritualelements”（RoyalCollegeofPaediatricsandChildHealth,1997）Total---threedomains（physical,psychosocialandexistential）Itisimportanttorememberthatallsymptomshaveaspectsinal