Development and Future Problems of the Home Palliative Care Team : "The Okayama Model"

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  • 在宅緩和ケアチームの組織化と課題 : 岡山モデルによる一事例から
  • ザイタク カンワ ケアチーム ノ ソシキカ ト カダイ オカヤマ モデル ニ ヨル イチジレイ カラ

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Abstract

The purpose of this study was to clarify the factors necessary for the primary care team (medical practitioner, visiting nurse, and pharmacist in private practice) to cooperate smoothly with the palliative care expert team (physician, nurse, and MSW specialized in palliative care). These two teams were constructed in order to promote home palliative care for cancer patients who hope to meet their end in their own homes. The objects of analysis included audio cassette tapes recorded in the case study meetings (learning meetings) by the medical providers who participated in home palliative care, as well as medical records and nursing records. The tapes were transcribed, and Watson's theory was used for a comprehensive analysis. As a result, three factors necessary to promote smooth cooperation in home palliative care were extracted: 1) sufficient preparation before starting, 2) understanding of the caring methods and the drugs specific to home palliative care, and 3) clarification of the roles and responsibilities of both teams. The following issues need to be addressed in the future: outcome assessments for patients or bereaved family members, an appropriate role and occupational type of coordinator (leader), and an expanded team including other professionals.

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