Hospice@Home Project for Oncology Patients

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Authors (including presenting author) :
Chan MFM (1), Shiu CKS (1), Lee CKC (1), Mung STH (1)
Affiliation :
(1) Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital
Introduction :
It is always a challenge for oncology patients whose self-care capacity decrease due to rapid deterioration or active anti-cancer treatment. Caring issue is a significant concern for the patients as well as their families, especially at the time receiving active anti-cancer treatment or at their end stage of life. Oncology patients aged below 60 are usually facing caring issue due to limited service available for cancer patients of young age. There are a range of community support services to the elderly persons living in the community provided by the Integrated Home Care Services (IHCS) under Social Welfare Department. However, majority of the services are targeted for elderly. Despite there are services for people with disability, long waiting time is revealed due to limited resource. Home Care Service for Persons with Severe Disabilities aims at providing a package of home-based support services to meet the personal care, nursing care and rehabilitation training needs of persons with intellectual or physical disabilities. In reality, cancer patients especially for those at advanced disease may not be benefited from the service. Since their health condition may be deteriorating at any time and thus cannot afford long waiting time for home support service. In view of the above difficulties, Hospice@Home Project for oncology young patients was launched in the Oncology Department at PYNEH for oncology patients whose have insufficient home care support and were keen to be cared at home at their terminal stage of illness. Under the Project, Health Care Worker of an NGO would pay home visit to the referred patient for providing home support service. The services include assisted bathing, feeding, personal care, position turning and psychosocial care. This Project is funded by Li Ka Shing Foundation. It is considered as a way-out to relieve the caring stress of oncology patients’ family, and to help the family in this transitional period and end stage of cancer journey. The outcome of the above-mentioned project is evaluated for future service planning.
Objectives :
It is to examine the effectiveness of Hospice@Home Project for Oncology Patients.
Methodology :
The two-year project was first launched in June 2017. Evaluation was performed in the December 2018. During the period, forty-seven patients under PYNEH oncology department applied for the service. In evaluation, Zarit Burden Interview was used to assess the carer’s stress before and after receiving the service. Additionally, feedback from patient’s relatives and staffs was collected for service review and future improvement.
Result & Outcome :
1) A compelling view of reducing caring stress was indicated. In general, the average stress score after receiving service was 34.9 out of 88, which implied a level of mild to moderate care stress. In some cases, carer stress score showed a significant decrease in post-test, e.g. from 46 to 29 (from moderate care stress to mild care stress) and from 70 to 58(from severe care stress to moderate care stress). Obviously, the carer stress was relieved with the Hospice@Home Project. 2) Service gaps of existing service for the young cancer patients was identified. 100% of the respondents showed satisfaction to this outreach home support service. Among the care services offered by the health care worker, respondents considered assisting personal care (65%), assisting bathing (58%) and supporting the psychosocial need of carer(45%) are very helpful to them. In conclusion, the above-captioned project is effective in relieving the caring stress of the family members of oncology patients. Timely home-based service with flexibility for oncology patients is recommended to fill up the existing service gap, especially for young patients aged below 60.

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