Stjernswärd Jan, Foley Kathleen M, Ferris Frank D
Cancer Control and Palliative Care, World Health Organization, New York, NY, USA.
J Pain Symptom Manage. 2007 May;33(5):486-93. doi: 10.1016/j.jpainsymman.2007.02.016.
The quality of life of at least 100 million people would have improved--if today's knowledge of palliative care was accessible to everyone. A Public Health Strategy (PHS) offers the best approach for translating new knowledge and skills into evidence-based, cost-effective interventions that can reach everyone in the population. For PHSs to be effective, they must be incorporated by governments into all levels of their health care systems and owned by the community. This strategy will be most effective if it involves the society through collective and social action. The World Health Organization (WHO) pioneered a PHS for integrating palliative care into a country's health care system. It included advice and guidelines to governments on priorities and how to implement both national palliative care programs and national cancer control programs where palliative care will be one of the four key pillars of comprehensive cancer control. The WHO PHS addresses 1) appropriate policies; 2) adequate drug availability; 3) education of policy makers, health care workers, and the public; and 4) implementation of palliative care services at all levels throughout the society. This approach has demonstrated that it provides an effective strategy for integrating/establishing palliative care into a country.
如果如今的姑息治疗知识能为每个人所用，那么至少1亿人的生活质量将会得到改善。公共卫生战略（PHS）为将新知识和技能转化为基于证据且具有成本效益的干预措施提供了最佳途径，这些干预措施能够惠及全体民众。要使公共卫生战略发挥作用，政府必须将其纳入医疗体系的各个层面，并使其为社区所拥有。如果该战略通过集体和社会行动让全社会参与进来，将会最为有效。世界卫生组织（WHO）率先提出了一项将姑息治疗纳入国家医疗体系的公共卫生战略。它为各国政府提供了关于优先事项以及如何实施国家姑息治疗项目和国家癌症控制项目的建议和指导方针，在国家癌症控制项目中，姑息治疗将成为综合癌症控制的四大关键支柱之一。世界卫生组织的公共卫生战略涵盖以下四个方面：1）制定适当政策；2）确保充足的药物供应；3）对政策制定者、医护人员和公众进行教育；4）在全社会各级实施姑息治疗服务。这种方法已证明，它为将姑息治疗纳入/建立到一个国家的医疗体系中提供了有效的策略。
