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美華醫療團隊中國行
李國良醫師 Gary Lee, M.D.
您會如何回答這個問題：哪個國家 65 歲以上的人口比例較高，美國或中國？目前，兩個國家約有 18-20% 的人口在 60-65 歲以上，但由於預期壽命延長和一胎政策的影響，中國人口正快速老化。到 2050 年，中國 40% 的人口將在 60 歲以上。此外，中國的癌症發生率一直在上升。預計 2022 年將新增近 500 萬癌症病例。
針對這些變化，中國政府積極推動緩和療護和安寧療護的發展。政府政策明確指出需要建立安寧療護基礎設施、改善醫療人員培訓並擴大公共教育。
How would you answer this question: which country has a higher proportion of people over 65, the United States or China? Currently, about 18-20% of the population of both countries is over 60-65 years old, but China’s population is aging rapidly due to longer life expectancy and the effects of its one-child policy. By 2050, 40% of people in China will be 60 years old or older.
In addition, the incidence of cancer has been increasing in China. Almost 5 million new cancer cases were estimated to have occurred in 2022.
針對這些變化，中國政府積極推動緩和療護和安寧療護的發展。政府政策明確指出需要建立安寧療護基礎設施、改善醫療人員培訓並擴大公共教育。
How would you answer this question: which country has a higher proportion of people over 65, the United States or China? Currently, about 18-20% of the population of both countries is over 60-65 years old, but China’s population is aging rapidly due to longer life expectancy and the effects of its one-child policy. By 2050, 40% of people in China will be 60 years old or older.
In addition, the incidence of cancer has been increasing in China. Almost 5 million new cancer cases were estimated to have occurred in 2022.
世界健康基金會Project HOPE 是一家總部位於美國的非政府組織，自 1983 年以來一直在中國開展工作，幫助中國實現醫療服務現代化。 9 月 18 日至 28 日，我作為美華慈心關懷聯盟醫事講師志工團隊的一員，受 Project HOPE 邀請在中國教授生命末期療護並參觀提供緩和療護和安寧療護服務的機構。志工團隊包括來自 Kaiser Santa Clara 的 Esther Luo 醫生、Sandy Chen Stokes 護理師、來自加州大學戴維斯分校的註冊護士 Nancy Chiang、物理治療師 Janet Lee 和我 (Gary Lee, 一位安寧療護/緩和療護醫生)。
訪問期間，我們五人都積極參與了三個專業培訓課程的教學：第七期湖北省武漢護理師緩和療護教育師資(TOT) 培訓班和第一期武漢醫師培訓班；以及北京第一屆腫瘤科護理師緩和療護教育師資 (TOT) 培訓。在武漢，我們參觀了武漢大學護理學院, 湖北省腫瘤醫院，與安寧療護團隊積極的討論病例，並參觀了他們的緩和療護診所。在北京，我們參觀了北京大學腫瘤醫院, 首鋼醫院和北京清華長庚醫院的住院安寧療護病房。泰康人壽保險公司也接待我們，該公司建立了退休社區並提供生命末期服務，包括安寧療護、殯葬服務和紀念公園。
中國在生命末期療護方面正迅速發展，但它是一個幅員遼闊、多元化的國家。雖然大城市和三級醫院提供一流的教育和服務，但仍非常需要衛生專業教育、培訓和服務擴展。能夠為中國緩和療護的發展盡綿薄之力，我感到非常榮幸。
In response to these changes, the Chinese government has been actively promoting the development of hospice and palliative care. Government policy has explicitly stated the need to create the infrastructure for hospice care, improve health provider training, and expand public education.
Project HOPE is a US-based NGO that has worked in China since 1983, helping to modernize the country’s health services. From September 18-28, I was a member of a team of CACCC volunteers that was invited by Project HOPE in China to teach end-of-life care and to visit facilities providing hospice and palliative care services. The team included Dr. Esther Luo from Kaiser Santa Clara, Sandy Chen Stokes, RN, Nancy Chiang, RN, from UC Davis, Janet Lee, physical therapist, and myself, a palliative care/hospice physician.
All five of us were active in teaching portions of three professional training courses during the visit: the 7th Hubei Palliative Care Training of Trainers (TOT) course for nurses and the 1st training course for physicians in Wuhan; and the 1st Palliative Care TOT Training for Oncology Nurses in Beijing. In Wuhan, we visited the Wuhan University School of Nursing, Hubei Cancer Hospital, where we participated in a lively case discussion with the hospice team and received a tour of their palliative care clinic. In Beijing, we toured the inpatient hospice wards at Beijing Cancer Hospital, Beijing Shougang Hospital, and Beijing Tsinghua Changgung Hospital. We also were hosted by Taikang Life Insurance Co., which has built retirement communities and provides end-of-life services including hospice care, funeral services, and memorial parks.
China is advancing rapidly in end-of-life care, but it is a large and diverse country. While top-notch education and services are available in large cities and tertiary care hospitals, there continues to be a great need for health professional education, training, and service expansion. It was a privilege to be able to contribute in a small way to the development of palliative care in China.
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