Disability Studies, University of Manitoba, Winnipeg, Canada.
Palliat Support Care. 2012 Mar;10(1):37-42. doi: 10.1017/S1478951511000563.
The purpose of this article is to identify how inclusive and accessible palliative care can be achieved for all, including those labelled as vulnerable populations.
Drawing on a review of existing literature as well the research of the Vulnerable Persons and End-of-Life New Emerging Team (VP-NET), this article reflects on what changes can be made within palliative care to make it more inclusive.
Experiences of marginalization often result, intentionally or unintentionally, in differential treatment in healthcare. This increased vulnerability may result from attitudes of healthcare providers or from barriers as a result of "normal" care practices and policies that may exclude or stigmatize certain populations. This may include identifying when palliative care is necessary, who receives palliative care and where, and what is necessary to complement palliative care.
Inclusive and accessible palliative care can become possible through building on the existing strengths in palliative care, as well as addressing existing barriers. This may include treating the whole person and that person's support team, including paid support workers, as part of the unit of care. It involves ensuring physically accessible hospice and palliative care locations, as well as thinking creatively about how to include those excluded in traditional locations. Inclusive palliative care also ensures coordination with other care services. Addressing the barriers to access, and inclusion of those who have been excluded within existing palliative care services, will ensure better palliative and end-of-life care for everyone.
本文旨在确定如何为所有人提供包容性和可及性的姑息治疗,包括那些被标记为弱势群体的人。
本文借鉴了现有文献综述以及弱势群体和临终新兴团队(VP-NET)的研究,反思了在姑息治疗中可以做出哪些改变,使其更具包容性。
边缘化的经历往往会导致医疗保健中的差异化待遇,无论是有意还是无意的。这种脆弱性的增加可能是由于医疗保健提供者的态度,也可能是由于“正常”护理实践和政策造成的障碍,这些障碍可能会排斥或污名化某些人群。这可能包括确定何时需要姑息治疗、谁接受姑息治疗以及在何处接受治疗,以及需要什么来补充姑息治疗。
通过利用姑息治疗的现有优势,并解决现有的障碍,包容性和可及性的姑息治疗是可能的。这可能包括将整个人以及那个人的支持团队,包括付费支持人员,作为护理单元的一部分来治疗。它涉及确保临终关怀和姑息治疗场所的物理可达性,以及创造性地思考如何将那些在传统场所被排斥的人纳入进来。包容性的姑息治疗还确保了与其他护理服务的协调。解决获得姑息治疗的障碍,并将那些在现有姑息治疗服务中被排斥的人纳入进来,将确保每个人都能得到更好的姑息治疗和临终关怀。