Danjoux Nathalie, Hawryluck Laura, Lawless Bernard
Healthc Q. 2007;10(4):42-50. doi: 10.12927/hcq.2013.19313.
On January 31, 2007, Ontario's Critical Care Strategy hosted a workshop for healthcare providers examining cultural and religious perspectives on patient care in the intensive care unit (ICU). The workshop provided an opportunity for the Ministry of Health and Long-Term Care (MOHLTC) to engage service providers and discuss important issues regarding cultural and religious perspectives affecting critical care service delivery in Ontario. While a favourable response to the workshop was anticipated, the truly remarkable degree to which the more than 200 front-line healthcare providers, policy developers, religious and cultural leaders, researchers and academics who were in attendance embraced the need for this type of dialogue to take place suggests that discussion around this and other "difficult" issues related to care in a critical care setting is long overdue. Without exception, the depth of interest in being able to provide patient-centred care in its most holistic sense--that is, respecting all aspects of the patients' needs, including cultural and religious--is a top-of-mind issue for many people involved in the healthcare system, whether at the bedside or the planning table. This article provides an overview of that workshop, the reaction to it, and within that context, examines the need for a broad-based, non-judgmental and respectful approach to designing care delivery in the ICU. The article also addresses these complex and challenging issues while recognizing the constant financial and human resource constraints and the growing demand for care that is exerting tremendous pressure on Ontario's limited critical care resources. Finally, the article also explores the healthcare system's readiness and appetite for an informed, intelligent and respectful debate on the many issues that, while often difficult to address, are at the heart of ensuring excellence in critical care delivery.
2007年1月31日,安大略省重症护理战略为医疗保健提供者举办了一次研讨会,探讨重症监护病房(ICU)中患者护理的文化和宗教观点。这次研讨会为卫生与长期护理部(MOHLTC)提供了一个机会,使其能够与服务提供者进行交流,并讨论影响安大略省重症护理服务提供的文化和宗教观点方面的重要问题。虽然预计研讨会会得到积极回应,但出席的200多名一线医疗保健提供者、政策制定者、宗教和文化领袖、研究人员及学者对开展此类对话的需求的高度认同,表明围绕重症护理环境中此类及其他与护理相关的“棘手”问题进行讨论早就该进行了。毫无例外,对于能够从最全面的意义上提供以患者为中心的护理——即尊重患者需求的各个方面,包括文化和宗教方面——的浓厚兴趣,是许多参与医疗保健系统的人,无论是在床边还是在规划桌前,都首要考虑的问题。本文概述了那次研讨会及其反响,并在此背景下,探讨在ICU设计护理服务时采用一种基础广泛、不带评判且尊重他人的方法的必要性。本文还探讨了这些复杂且具有挑战性的问题,同时认识到持续存在的财务和人力资源限制,以及对护理需求的不断增长,这正对安大略省有限的重症护理资源造成巨大压力。最后,本文还探讨了医疗保健系统是否准备好并愿意就许多虽往往难以解决但却是确保卓越重症护理服务核心的问题进行明智、理性且尊重他人的辩论。