台灣居家安寧療護面臨困境之探討

The concept of hospice care has developed alongside the recently increasing elderly population and the status of cancer as a leading cause of death in Taiwan. Subsequently, hospice care services have been extended from hospitals to homes and have begun to focus on providing medical services that cater to the physical, mental, and spiritual needs of patients in terminal stages. However, the usage rate of home hospice care has remained low in Taiwan; statistics have even indicated that most patients in terminal stages did not pass away at home although they had the intention to do so. Thus, this study examined the potential factors impeding the implementation of home hospice care from the perspectives of patients' families, healthcare personnel, and medical policies. The results suggest that, under the influence of concerns about insufficient hospice care resources and misconceptions and negative perceptions about and toward hospice care, patients and family members generally refuse the adoption of home hospice care. When providing hospice care services to patients, healthcare personnel tend to face the problems of insufficient clinical medical training, related psychological obstacle, and a lack of knowledge pertaining to serving near-death patients. Moreover, government policies, regulations, and budgets for relevant hospice care services can affect the promotion of hospice care services. In the end of the article, suggesting that in the future, the relevant strategies have to be set from clinical practice, education, technology integration, and policies to improve the accessibility of end-of-life care for terminal stage patients and their families, helping patients in terminal stages can pass away at home.