Suppr超能文献

考量原住民姑息治疗模式:主流服务面临的挑战。

Considering Aboriginal palliative care models: the challenges for mainstream services.

作者信息

O'Brien Anthony P, Bloomer Melissa J, McGrath Pam, Clark Katherine, Martin Tony, Lock Mark, Pidcock Tina, van der Riet Pamela, O'Connor Margaret

机构信息

The University of Newcastle, Newcastle, New South Wales, Australia. tony.o'

出版信息

Rural Remote Health. 2013 Apr-Jun;13(2):2339. Epub 2013 May 8.

Abstract

This review discusses palliative care and end-of-life models of care for Aboriginal people in the Australian state New South Wales, and considers Aboriginal palliative care needs by reflecting on recent literature and lessons derived from Aboriginal consultation. Aboriginal people in Australia account for a very small proportion of the population, have poorer health outcomes and their culture demonstrates a clear resistance to accessing mainstream health services which are viewed as powerful, isolating and not relevant to their culture, way of life, family and belief systems. Aboriginal people regard their land as spiritual and their culture dictates that an Aboriginal person needs to know their origins, emphasising the value placed on kin and also demonstrating a strong desire to remain within their own country. Currently Aboriginal people tend to not access palliative care services in mainstream facilities; and there is very little data on Aboriginal admissions to palliative care centres. Over the last two decades only two models of palliative care focusing on and developed in Aboriginal communities have been implemented. The seminal contribution to Aboriginal Palliative Care was in the form of a resource kit developed to support palliative care providers to examine their practice for cultural appropriateness for Aboriginal and Torres Strait Islanders. The 'living model' coming from this project is adaptive and flexible, enabling implementation in different Aboriginal country as a participative process with community input. The Australian government's National Indigenous Palliative Care Needs Study similarly indicated that Australian empirical research on Aboriginal palliative care service provision is in its infancy, and comprehensive data on the rates of Aboriginal access to palliative care services did not exist. What literature does exist is drawn together in an argument for the development and need for culturally specific Aboriginal palliative care models, which are culturally appropriate, locally accessible and delivered in collaboration and partnership with Aboriginal controlled health services. This is essential because Aboriginal people are a minority cultural group who are disconnected from mainstream health service delivery, and have a sense of cultural isolation when accessing mainstream services. It is preferable that palliative care is delivered in a collaboration between Aboriginal Controlled Health Service and mainstream palliative care services to ensure a dignified end of life for the Aboriginal person. These collaborations and partnerships are fundamental to ensure that a critical mass of Aboriginal clinicians are trained and experienced in end of life care and palliation. Developing palliative care programs within Aboriginal communities and training Aboriginal Health Workers, promoted and developed in partnership with the Aboriginal community, are important strategies to enhance palliative care service provision. Further partnerships should be championed in this collaborative process, acknowledging a need for palliative care models that fit with Aboriginal peoples' community values, beliefs, cultural/ spiritual rituals, heritage and place.

摘要

本综述讨论了澳大利亚新南威尔士州原住民的姑息治疗和临终护理模式,并通过回顾近期文献以及原住民咨询中获得的经验教训,来考量原住民的姑息治疗需求。澳大利亚的原住民在总人口中占比极小,健康状况较差,而且他们的文化对获取主流医疗服务表现出明显的抵触情绪,因为这些服务被视为强大、孤立且与他们的文化、生活方式、家庭和信仰体系无关。原住民将他们的土地视为神圣之地,他们的文化规定原住民需要了解自己的起源,强调亲属关系的重要性,也表现出强烈的留在自己家乡的愿望。目前,原住民往往不使用主流机构的姑息治疗服务;关于原住民入住姑息治疗中心的数据也非常少。在过去二十年里,仅实施了两种在原住民社区中专注并发展起来的姑息治疗模式。对原住民姑息治疗的开创性贡献是以一套资源工具包的形式呈现的,该工具包旨在支持姑息治疗提供者审视其服务对原住民和托雷斯海峡岛民的文化适宜性。这个项目产生的“生活模式”具有适应性和灵活性,能够作为一个有社区参与的过程在不同的原住民地区实施。澳大利亚政府的《全国原住民姑息治疗需求研究》同样表明,澳大利亚关于原住民姑息治疗服务提供的实证研究尚处于起步阶段,不存在关于原住民获得姑息治疗服务比例的全面数据。现有的文献都集中在关于发展具有文化特异性的原住民姑息治疗模式的必要性的论证上,这些模式应在文化上适宜、在当地可及,并与原住民控制的医疗服务机构合作提供。这至关重要,因为原住民是一个与主流医疗服务脱节的少数文化群体,在使用主流服务时会有文化孤立感。最好由原住民控制的医疗服务机构与主流姑息治疗服务机构合作提供姑息治疗,以确保原住民有尊严地结束生命。这些合作关系对于确保有足够数量的原住民临床医生接受临终关怀和姑息治疗培训并积累经验至关重要。在原住民社区内制定姑息治疗项目并培训原住民健康工作者,与原住民社区合作推动和发展这些项目,是加强姑息治疗服务提供的重要策略。在这个合作过程中应倡导建立更多的伙伴关系,并认识到需要有符合原住民社区价值观、信仰、文化/精神仪式、传统和地域的姑息治疗模式。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验