Nervi Flavio, Guerrero Mario, Reyes Maria Margarita, Nervi Bruno, Cura Alejandra, Chávez Myriam, Derio Lea
Division of Medicine and Department of Gastroenterology, Pontificia Universidad Católica de Chil, and the Fundación Pro Dignitate Hominis, Clínica Familia para Cuidados Paliativos, Santiago, Chile.
J Pain Palliat Care Pharmacother. 2003;17(3-4):13-22.
As in other developed and developing countries, the most common chronic disorders affecting the Chilean population are cardiovascular disease, cancer, cirrhosis, diabetes, chronic obstructive pulmo- nary disease and external injuries. Availability of oncology services is not extensive and there are no academic programs to adequately train practitioners in either palliative medicine or comprehensive palliative care for allied health professionals including nurses, psychologists and chaplains. Major efforts have been made to incorporate palliative care as an important health care focus in the last decade and in the development of effective policies for opioid availability. Chile now meets 84% of the 17 criteria outlined by the World Health Organization and the International Narcotics Control Board for opioid availability. Postgraduate medical education in symptom control, clinical use of opioids and end-of-life care remains relatively poor as judged by the results of a questionnaire administered to 158 resident physicians at the Pontificia Universidad Católica de Chile. Improvements in symptom control and the development of palliative care in Chile will depend on the effective assessment of symptom control effectiveness and improved education and training of health professionals in clinical pharmacology, symptom control, clinical ethics, and end-of-life care.
与其他发达国家和发展中国家一样，影响智利人口的最常见慢性疾病是心血管疾病、癌症、肝硬化、糖尿病、慢性阻塞性肺病和外伤。肿瘤学服务的可及性并不广泛，也没有学术项目来充分培训包括护士、心理学家和牧师在内的辅助医疗专业人员在姑息医学或综合姑息治疗方面的从业者。在过去十年里，智利做出了重大努力，将姑息治疗作为重要的医疗保健重点，并制定了有效的阿片类药物供应政策。智利现在符合世界卫生组织和国际麻醉品管制局列出的17项阿片类药物供应标准中的84%。根据对智利天主教大学158名住院医师进行的问卷调查结果判断，研究生医学教育在症状控制、阿片类药物的临床使用和临终关怀方面仍然相对较差。智利症状控制的改善和姑息治疗的发展将取决于对症状控制效果的有效评估，以及对卫生专业人员在临床药理学、症状控制、临床伦理和临终关怀方面的教育和培训的改进。
