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8 Cooperation with other medical disciplines
1) Attitudes
a) Be aware of the limitation of one's own skill and expertise, and accept different ideas to improve a patient's QOL
b) Bear in mind that a patient's conditions may require a consultation with others medical disciplines
c) Cooperate with other medical disciplines according to patient's conditions
d) Respect each other's specialty
e) Try to get the most out of available other medical disciplines
f) Hold always palliative care standpoint when cooperating with other medical disciplines
2) Skills
a) Cooperate with other medical disciplines
b) Seek for the second opinion
3) Knowledge
a) Describe various specialties relating to palliative care: oncology, dental surgery, rehabilitation, complementary therapy, etc.
b) Describe symptoms requiring multidisciplinary approach: lymphedema, bedsore, difficult pains, etc.
9 Caring a family
1) Attitudes
a) Understand that a patient's death is the most tragic event for his or her family
b) Respect each family's way of life
c) Take care to each family members
d) Consider children's care
e) Consider elderly parents' care
f) Consider a patient's and his or her family's physical, mental, and financial burden
g) Consider a family's care after a patient's death
2) Skills
a) Describe a patient's and his or her family's structure and the background in a medical record
b) Explain a patient's dying process to the family on a suitable occasion
c) Recognize and deal with changing roles in a family as a team
d) Deal with each family members' or their shared value system as a team
e) Assess a bereaved family's physical and mental change
f) Provide medical care for the bereaved family considering the loss experience
3) Knowledge
a) Describe value systems variety within a family
b) Describe a family's physical, mental, and financial burden
c) Describe interaction among family members that affect the patient physically and mentally
d) Describe grieving in bereavement
e) Describe importance of children's grief care
f) Describe anticipatory grieving
g) Describe family concepts' variety
h) Describe a family life's change or continuity before and after a patient's death
i) Describe a support team's role and function on family care
j) Describe community's role and function on family care: church, temple, friends, self-help group, bereaved family group, etc.
10 Spirituality
1) Attitudes
a) Recognize that everyone has a spiritual dimension
b) Describe the meaning and reason of one's own existence
c) Respect a patient's and his or her family's spirituality
d) Respect team member's spirituality
e) Try to involve spiritual care
f) Respect a patient's religion
2) Skill
a) Listen actively to a patient and his or her family
b) Describe a patient's and family's way of life, beliefs, creed, and religious experience and their narrating attitude
c) Assess a patient's and family's spirituality according to the above description
d) Listen actively to the other team members
e) Provide spiritual care as a team
3) Knowledge
a) Describe what spirituality is
b) Describe the difference between spirituality and religion
c) Describe the cultural and religious aspect of death
d) Describe sexuality importance in human life
e) Describe that we could not resolve the other's distress
11 Home care
1) Attitudes
a) Recognize that medical care is a part of a patient's and family's life
b) Respect the place where a patient would like to be
c) Respect a patient's view of life and death
d) Consider the interaction between a patient and his or her family
e) Consider the burden of a patient's family
f) Bring out a patient's, his or her family's and a community's latent potency
g) Recognize the limitation of one's own skill and limitation, and respect bother discipline's roles and functions
h) Respect a patient's and his or her family's decision on treatment
2) Skills
a) Use resources available in the daily life
b) Educate a patient and his or her family about an adequate care
c) Cooperate with a home care team as one of the members
d) Withdraw an active treatment if it is not appropriate: fluid infusion, vasopressor, antibiotics, blood transfusion etc.
3) Knowledge
a) Describe the healthcare system on home care
b) Describe resources for home care available in the nursing care insurance: home help, home nursing, home refurbishment, welfare lending equipment, day treatment, short stay, etc.
c) Describe resources for home care available under the medical care insurance: doctor's home visit, home nursing, home dentistry, home diet therapy, home oxygen therapy, home rehabilitation, home pharmacy consultation, etc.
d) Describe resources for home care available under the health care system for the elderly
e) Describe care manager's role and function
f) Describe a community's culture and habits which may have influence palliative care
g) Describe doctor's and the other professionals' roles and functions
h) Describe a home care team's dynamism
i) Describe medical interventions' demerits
12 Complementary therapies
1) Attitude
a) Recognize modern medical limitations
b) Understand patient's feeling seeking for complementary therapies
2) Skill
a) Advise a patient on complementary therapies from his or her point of view
b) Evaluate complementary therapies' evidence
3) Knowledge
a) Describe complementary therapy's definition
b) Describe current complementary therapy's situation used in palliative care
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