PALLIATIVE CARE IN
ISLAMIC HOSPITALS
ERNA ROCHMAWATIPALLIATIVE CARE
(WHO, 2003)“Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment
of pain and other problems, physical, psychological and spiritual.”
DISTRIBUSI KEBUTUHAN PALLIATIVE CARE BERDASARKAN AREA (Global Atlas of Palliative Care At the End of Life, 2014)
DISTRIBUSI KEBUTUHAN PERAWATAN PALIATIF
BERDASARKAN PENYAKIT
(Global Atlas of Palliative Care at the End of Life, 2014)
PERKEMBANGAN PALLIATIVE CARE DI NEGARA MAYORITAS BERPENDUDUK MUSLIM
(Aljawi & Harford 2012, Lynch et al 2013)
SYMPTOMS PREVALENCE: PHYSICAL AND PSYCHOLOGICAL
SPIRITUAL SYMPTOMS
• anger at God
• feelings of isolation from God, community or others • loss of faith and despair
• difficulties in accepting the disease and difficulties in being available for others
• (Puchalski et al 2009, Byrne 2002, Effendy et al 2014)
• Gomez-Castillo et al. (2015) highlighted that spiritual distress led to a lower quality of life and higher rates of morbidity
TYPE OF PALLIATIVE CARE
(Hospice Foundation Irlandia)
PALLIATIVE CARE APPROACH
Merupakan bagian yang penting dan terintegrasi di semua praktek klinik yang harus berlandaskan pada pengetahuan dan prinsip praktek perawatan paliatif.
•Quality of life
•A whole person approach
•Care for both the dying person and those that matter to the person
•Patient autonomy and choice
JOURNEY IN PALLIATIVE CARE
(Rochmawati, Wiechula & Cameron 2016)
PALLIATIVE CARE NURSING
(Bashaireh )
Doing for
Preserving integrity
empowering
Finding meaning
VALUING
connecting
CHALLENGES
•Often being referred in the late stage
•Lack of integration with other mainstream health care services
•Stand alone unit
•Many needs of the patients
COMPLEXITY OF CARE
•Many symptoms occurred
•Previous family problems
•Aggressive interventions
RECOGNISING THE UNIQUENESS OF THE
PATIENTS
•Cultural background
•Person centred care
•Personal history
CARE TO MAINTAIN DIGNITY
(CHOCHINOV, 2002)
•Patient’s autonomy
•Patient’s functional capacity
•Patient’s cognitive state
•Patient’s continuity of self
FAMILY CAREGIVER
•Sangat penting
•Indonesia àstrong family ties àkeluarga inti, extended family
•Role: physical care, spiritual care, managing aspect of patient’s care
•BURDENàphysical & psychological exhaustions, financial
END OF LIFE CARE
•End of life care discussions
END OF LIFE DISCUSSION
•Influenced by country and culture
àMostly indirect particularly with the patients
àMore detailed and direct with the patient’s relatives
•EOL discussions generally commenced when the patient’s condition deteriorated
EOL DISCUSSIONS
•Providing honest information about the patient’s condition
•Asking the relatives to fulfill the patient’s wishes (if any) and to provide spiritual support
•Encouragement of spiritual practices (reciting Qur’an, kalimat thoyibah)
•Asking the patient to seek and provide forgiveness àforgiving relates to quality of life
•Asking the relatives about dying and death preparations (place of funeral,
GOOD DEATH
•Western perspectives
•Islamic perspectives
WESTERN PERSPECTIVES
(Gustafson 2007, Davies 2006)•Free from avoidable sufferings
•Preferences for a specific dying process
•Pain-free status
•Religiosity/spirituality
•Emotional well-being
•Life completion
•Treatment preferences
•Dignity
•Family
•Quality of life
•Relationship with the health care providers
ISLAMIC PERSPECTIVES
(Tayeb et al 2010)
•Religious faith and beliefs
•Self esteem and body image
•Concern about family security
GOOD DEATH IN ISLAMIC PERSPECTIVES
(Tayeb et al 2010)
Religious faith and belief Self esteem and body image Concern about family security
• Ada yang membimbing untuk membaca syahadat
• Ada yang membacakan Al-Qur’an disamping pasien
• Menghadap kilbat
• Meninggal di tempat dan waktu yang baik
• Mencegah bau, deformitas setelah meninggal
• Menjaga jasad tetap utuh
• Menjaga kebersihan jasad
• Ekonomi
•Importance of respecting human dignity and privacy
•Valuing emotional and spiritual support
•Importance of access to emotional and spiritual support
GOOD DEATH IN ISLAMIC PERSPECTIVES
(Tayeb et al 2010)
FREE RESOURCES
•www.thewhpca.org/resources/global-atlas-on-end-of-life-care
•www.caresearch.com.au
SUMBER PUSTAKA
•www.thewhpca.org/resources/global-atlas-on-end-of-life-care •
http://cdn.intechopen.com/pdfs/27618/InTech-Palliative_care_in_the_muslim_majority_countries_the_need_for_more_and_better_ca re.pdf
•http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886872/
• http://www.dailymail.co.uk/health/article-3517258/What-makes-good-death-want-die-Study-reveals-11-important-factors-dying-well.html
