在美華人生命末期療護推廣運動陳明慧-CACCC.docVIP

Building a community in which Chinese Americans are able to face end of life with dignity, respect and meaning 在美華人生命末期療護推廣運動 Chinese American End-of-Life Care Movement 陳明慧護理師 美華慈心關懷聯盟 創辦人及執行長 Sandy Chen Stokes, RN, PHN, MSN Founder Executive Director, Chinese American Coalition for Compassionate Care Abstract Chinese Americans continue to have the lowest rates of hospice use of any group in the U.S. In focus groups, Chinese Americans reported they would have made different decisions if they had had more complete information at the time of a loved one’s death. They also reported poor communication between patients and non-Chinese health providers due to linguistic and cultural differences; in particular, the health provider’s lack of cultural competence often resulted in a lack of trust. Problems also existed with Chinese doctors, whose authority patients and families were reluctant to question. The Chinese American Coalition for Compassionate Care (CACCC) was formed in December 2005 to address the lack of linguistically and culturally appropriate end-of-life education and training available to the Chinese community and those who serve it. This article provides a brief history of the hospice movement in the U.S., a sample of CACCC accomplishments to date, and a projection of future CACCC projects. The CACCC, the only organization in the U.S. devoted to end-of-life concerns in the Chinese American community, serves as a model for other efforts throughout the nation to promote diversity and cultural sensitivity in end-of-life care. 美國生命末期療護 美國的安寧療護運動於1970年代中由義工開始帶動成長的，全美大約有二百多家安寧療護是完全由捐款及義工來提供服務的。根據美國國家安寧緩和療護機構 (National Hospice and Palliative Care Organization - NHPCO) 於2000年的統計顯示﹕全美接受安寧療護服務的病人中，每五位就有四位是65歲以上的長者。超過三分之一的病人是85歲以上的老人。在安寧療護運動剛起步的70年代，大多數的安寧療護病人都是癌症患者。而目前，全美癌症患者只佔所有安寧療護病人的41%。其他四個常見的病症依次是心臟病、非特定性的衰竭 (debility unspecified)、肺病及失智症。在國家安寧緩和療護機構於2000年的統計中顯示，全美有六十萬人接受了安寧療護服務。雖然當時全美有88% 的