Integration of palliative care with other medical specialties - opinions of nephrologists
Monika Lichodziejewska-Niemierko
Advances in Palliative Medicine 2008;7(3):137-142.
open access
Vol 7, No 3 (2008)
Original articles
Published online: 2008-10-10
Abstract
The palliative and hospice care in Poland is offered mostly to patients with cancer in its terminal stages.
According to the modern definition of palliative care, it should include patients with other chronic and
advanced diseases. The goal of the study was to evaluate the knowledge and awareness in Polish nephrology
specialists, concerning the problems of palliative care in patients with chronic renal failure. Anonymous
surveys were carried out among 59 nephrologists (30 men and 29 women, with an average age of 42). Sixty
percent of the respondents claimed that the quality of life is the criteria for effective treatment, while only
25% put biochemical parameters in the first position. Almost 80% of the respondents believe that dialysis
patients do not receive proper psychological care and almost 90% state the same in relation to social care.
Similar answers are given in relation to satisfying the spiritual needs and family support. More than 66% of
nephrologists believe that doctors and nephrology nurses should be involved in the palliative care. More than
half of nephrologists were forced to make the decision to abandon the dialysis therapy in patients with
chronic haemodialysis and most of them think that there should be clear rules of conduct for such situations.
More than 96% of the respondents believe that palliative care can be applied in nephrology, albeit 40% of
nephrologists objected to putting palliative care training in the nephrology specialisation programme. After
a presentation aimed at introducing the aspects of palliative care in nephrology, the percentage of specialists
with a critical attitude was reduced to 16%.
Palliative hospice care is not offered to chronic renal failure patients, although they would most probably
benefit from it. Nephrologists acknowledge the necessity of training in the aspects concerning such care, as
well as defining the ethical and legal guidelines concerning the withdrawal of dialysis therapy.
Abstract
The palliative and hospice care in Poland is offered mostly to patients with cancer in its terminal stages.
According to the modern definition of palliative care, it should include patients with other chronic and
advanced diseases. The goal of the study was to evaluate the knowledge and awareness in Polish nephrology
specialists, concerning the problems of palliative care in patients with chronic renal failure. Anonymous
surveys were carried out among 59 nephrologists (30 men and 29 women, with an average age of 42). Sixty
percent of the respondents claimed that the quality of life is the criteria for effective treatment, while only
25% put biochemical parameters in the first position. Almost 80% of the respondents believe that dialysis
patients do not receive proper psychological care and almost 90% state the same in relation to social care.
Similar answers are given in relation to satisfying the spiritual needs and family support. More than 66% of
nephrologists believe that doctors and nephrology nurses should be involved in the palliative care. More than
half of nephrologists were forced to make the decision to abandon the dialysis therapy in patients with
chronic haemodialysis and most of them think that there should be clear rules of conduct for such situations.
More than 96% of the respondents believe that palliative care can be applied in nephrology, albeit 40% of
nephrologists objected to putting palliative care training in the nephrology specialisation programme. After
a presentation aimed at introducing the aspects of palliative care in nephrology, the percentage of specialists
with a critical attitude was reduced to 16%.
Palliative hospice care is not offered to chronic renal failure patients, although they would most probably
benefit from it. Nephrologists acknowledge the necessity of training in the aspects concerning such care, as
well as defining the ethical and legal guidelines concerning the withdrawal of dialysis therapy.