Demmer Craig
Department of Health Sciences, Lehman College, City University of New York, Bronx, NY, USA.
Am J Hosp Palliat Care. 2007 Feb-Mar;24(1):7-12. doi: 10.1177/1049909106295288.
As a result of limited access to antiretroviral treatment, many South Africans die yearly of AIDS. It is important that the end-of-life needs of these people be met. This article examines the major challenges involved in providing quality end-of-life care to people with AIDS in South Africa. Published reports are reviewed, as is the author's experience living and working in KwaZulu-Natal, South Africa. The issues discussed include the nature of the South African health care system, with emphasis on the scarcity of palliative care resources for AIDS patients, ineffective control of pain, models of care such as the integrated community-based home care model that relies heavily on community caregivers to meet the needs of people dying of AIDS, the living conditions of AIDS patients and their families, and AIDS-related stigma. Broad recommendations are presented for improving palliative care services for people with AIDS in the South African context.
由于获得抗逆转录病毒治疗的机会有限，许多南非人每年死于艾滋病。满足这些人的临终需求非常重要。本文探讨了在南非为艾滋病患者提供高质量临终关怀所涉及的主要挑战。回顾了已发表的报告以及作者在南非夸祖鲁 - 纳塔尔省生活和工作的经历。讨论的问题包括南非医疗保健系统的性质，重点是艾滋病患者姑息治疗资源的稀缺、疼痛控制无效、诸如严重依赖社区护理人员来满足艾滋病临终患者需求的基于社区的综合家庭护理模式等护理模式、艾滋病患者及其家庭的生活条件以及与艾滋病相关的耻辱感。针对在南非背景下改善艾滋病患者的姑息治疗服务提出了广泛的建议。
