All About Nursing · Hospice & Palliative Care

Origins and a Bit of History of Hospice- Notable Influences on Hospice Development and Acceptance

Concept antedates 475 AD (早于公元475年)

  • The term hospes, a Latin word, from which the term hospice is derived, means to be both host and guest and implies interaction and mutual caring between the patient, family, and hospice staff. (Hospes 一詞是一個拉丁詞,安寧療護一詞由此而來,意味著患者,家人和安寧療護員工之間的互動和相互關懷。)
  • Self-sustained communities evolved after 335 AD where ill, weary, homeless, and dying persons received care. 在公元335年后, 发展起来,病人,疲惫,无家可归和垂死的人得到照顾.
  • During the early middle ages, the words hospice, hospital, and hostel were used interchangeably. 在中世纪早期,临终关怀,医院和旅馆这些词可以互换使用。
  • Also during the middle ages, hospitia or travelers’ rest at monasteries and convents provided food, shelter, as well as care for those sick or dying. 同样在中世纪,修道院和修道院的收容所或旅行者休息提供食物,住所以及照顾生病或垂死的人。
  • The care and support of the whole person (the body, soul, mind, and spirit) evolved in these early hospices. 對整個人(身體、靈魂、思想和精神)的關懷和支持,在這些早期的安寧療護中演化而來。

In the 1800s, hospice evolved to care for the sick and incurables. The first hospice were opened in Dublin (Our Lady’s Hospice) and in London (St. Joseph’s Hospice): 在1800年代,安寧療護發展到照顧病人和不治之症。第一家安寧療護中心在都柏林(Our Lady’s Hospice)和倫敦(St. Joseph’s Hospice)開設:

  • The word hospice became synonymous with care of the terminally ill late in the 1800s with the founding of Our Lady’s Hospice in Dublin by Sister Mary Aikenhead of the Irish Sisters of Charity, who was a colleague of Florence Nightingale. 19 世纪末,随着爱尔兰慈善修女会的 Mary Aikenhead 修女 Mary Aikenhead 在都柏林创立了圣母临终关怀,她是弗洛伦斯·南丁格尔的同事,安寧療護這個詞成為照顧绝症病患者的代名詞。
  • St. Joseph’s Hospice was established in 1900 in London, England. 圣若瑟临终关怀于1900年在英国伦敦成立。

Dame Cicely Saunders, MD, began refining the ideas and protocols that formed the cornerstone of modern hospice care in the 1950s and 1960s – The development of current concepts of palliative care is, in large part, through the work of Dame Cicely Saunders, including the use of scheduled oral opioids for pain management. 在1950年代和1960年代, 医学博士Dame Cicely Saunders开始完善现代临终关怀基石的想法和协议 – 在很大程度上是通过Dame Cicely Saunders的工作,構成现代姑息治疗概念的发展,包括使用预定的口服阿片类药物进行疼痛管理。Development of current concepts of palliative care are, in large part, through the work of Dame cicely Saunders at St. Christopher’s Hospice in London, including the use of scheduled oral opioids for pain management.

  • By the 1960s, Dame Cicely Saunders opened St. Christopher’s Hospice in suburban London, marking the beginning of the modern hospice movement. 在60年代, Dame Cicely Saunders 在伦敦郊区开设了圣克里斯托弗临终关怀中心,标志着现代临终关怀运动的开始。
  • Dame Cicely Saunders visited the United States in 1963 and spoke to medical and nursing students and interested others at Yale University. Dame Cicely Saunders 1963年访问美国,与耶鲁大学的医学和护理学生以及感兴趣的其他人进行了交谈。
  • Florence Wald, Dean of Yale School of Nursing, resigned to plan and found the Connecticut Hospice. 耶鲁大学护理学院院长弗洛伦斯·沃尔德(Florence Wald)辞职,成立了康涅狄格州临终关怀中心。

Elizabeth Kubler-Ross’s work in the 1960s demystified death and dying and opened the debate on care of the dying for healthcare professionals and the lay public; On Death and Dying was published in 1969, which lead to increased knowledge and research regarding grief, loss, and bereavement.

The first hospital palliative care service at the Royal Victoria Hospital, Montreal, Canada, was started by Balfour Mount, MD and opened in 1975; first use of the term palliative care to refer to a program of care for terminally ill persons and their families; this became the first hospice palliative care program in North America. 第一家医院的姑息治疗服务在加拿大蒙特利尔皇家维多利亚医院由马里兰州贝尔福芒特 MD Balfour Mount发起,于1975年开业; 首次使用姑息治疗一词来参考护理绝症患者及其家人的护理计划;這成為北美第一個安寧療護緩和療護計劃。

In the United States, hospice programs began in the 1970s and Medicare funding was secured in 1982 (providing reimbursement of costs through insurance but requiring relinquishment of curative treatments). 在美國,安寧療護計劃始於1970年代,醫療保險資金於1982年獲得(通過保險報銷費用,但要求放棄治療性治療)。

  • The first hospice in the United States was the Connecticut Hospice, incorporated in 1971. They began seeing home care patients in 1974, and opened a 44-bed inpatient facility in 1979. 美国第一家临终关怀医院是康涅狄格州临终关怀医院,成立于1971年。他们于1974年开始看望家庭护理患者,并于1979年开设了一家拥有44张床位的住院设施。
  • In 1983, the Tax Equity Fiscal Responsibility Act created the Medicare Hospice Benefit and defined hospice care in the United States as legitimate medical care but with a 1986 sunset provision. 1983年,《稅務公平財政責任法》創建了Medicare安寧療護福利,並將美國的安寧療護定義為合法的醫療保健.
  • In 1986, the Medicare Hospice Benefit is made permanent by Congress and hospices are given a 10% increase in reimbursement rates. States are given the option of including hospice in their medicaid programs. Hospice care is now available to terminally ill nursing home residents. 在1986年,醫療保險安寧療護福利被國會永久化,安寧療護的報銷率增加了10%。各州可以选择将临终关怀纳入其医疗补助计划。临终关怀护理现在可供绝症疗养院居民使用。

In 1988, the European Association for Palliative Care (EAPC) was formed, and in the mid 1990s, the International Association of Hospice and Palliative Care (IAHPC) was established in the United States. 在1988年,欧洲姑息治疗协会(EAPC)成立,而在1990年代中期,国际临终关怀和姑息治疗协会(IAHPC)在美国成立。

In 1993, hospice is included as a nationally guaranteed benefit under President Clinton’s health care reform proposal. Hospice is now an accepted part of the healthcare continuum. 在1993年,根据克林顿总统的医疗保健改革提案,临终关怀被列为国家保障福利。安寧療護成为醫療保健連續體中被接受的一部分。

In 1995, the physician-assisted suicide movement results of the Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatment (SUPPORT) study, showing high incidence of uncontrolled pain (from 74% to 95%) in very ill and dying adults in site of planned interventions from nurses, encouraged physicians to attend to pain control. 在1995年, 医生协助自杀运动的研究结果,以了解对治疗结果和风险的偏好研究显示, 在重病和垂死的成年人中, 不受控制疼痛的发生率是74% 到 95%.

In 1996, major grant-makers began to fund research, program initiatives, public forums, and conferences to transform the culture of dying and improve care at the end of life. 在1996年,主要的资助机构开始资助研究以改变死亡文化并改善临终关怀。

In 1997, the Institute of Medicine (IOM) published the report Approaching Death: Improving Care at the End of Life, citing inadequacies in end of life care, and goals to improve that care; and the National Hospice Organization (NHO) published A Pathway for Patients and Families Facing Terminal Illness. 在1997年, 医学研究所(IOM)发表了报告《接近死亡:改善临终关怀》;国家临终关怀组织(NHO)出版了《面对绝症的患者和家庭的途径》。

In 2000, the National Hospice and Palliative Care Organization (NHPCO) developed Hospice Standards of Practice for Hospice Programs. 在2000年,國家安寧療護和緩和療護組織(NHPCO)制定了安寧療護計劃的安寧療護實踐標準。


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