Paul Sally, Sallnow Libby
Strathcarron Hospice, Denny, Stirlingshire, UK.
BMJ Support Palliat Care. 2013 Jun;3(2):196-9. doi: 10.1136/bmjspcare-2012-000334. Epub 2013 Feb 23.
The public health approach to end-of-life care has gained recognition over the past decade regarding its contribution to palliative care services. Terms, such as health-promoting palliative care, and compassionate communities, have entered the discourse of palliative care and practice; examples exist in the UK and globally. This scoping study aimed to determine if such initiatives were priorities for hospices in the UK and, if so, provide baseline data on the types of initiatives undertaken.
An online survey was designed, piloted and emailed to 220 palliative care providers across the four UK countries. It included a total of six questions. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically.
There was a 66% response rate. Of those providers, 60% indicated that public health approaches to death, dying and loss were a current priority for their organisation. Respondents identified a range of work being undertaken currently in this area. The most successful were felt to be working with schools and working directly with local community groups. The findings demonstrate the relevance of a public health approach for palliative care services and how they are currently engaging with the communities they serve. Although the approach was endorsed by the majority of respondents, various challenges were highlighted. These related to the need to balance this against service provision, and the need for more training and resources to support these initiatives, at both national and community levels.
在过去十年中，临终关怀的公共卫生方法因其对姑息治疗服务的贡献而得到认可。诸如促进健康的姑息治疗和富有同情心的社区等术语已进入姑息治疗和实践的讨论范畴；在英国和全球都有相关实例。这项范围界定研究旨在确定此类举措是否是英国临终关怀机构的优先事项，如果是，则提供所开展举措类型的基线数据。
设计了一项在线调查，进行了试点，并通过电子邮件发送给英国四个地区的220家姑息治疗服务提供者。该调查总共包含六个问题。定量数据采用描述性统计进行分析。定性数据采用主题分析。
回复率为66%。在这些提供者中，60%表示公共卫生方法在死亡、临终和丧失方面的应用是其组织当前的优先事项。受访者指出了目前在该领域正在开展的一系列工作。最成功的工作被认为是与学校合作以及直接与当地社区团体合作。研究结果表明了公共卫生方法与姑息治疗服务的相关性，以及它们目前与所服务社区的互动方式。尽管大多数受访者认可这种方法，但也突出了各种挑战。这些挑战涉及需要在提供服务与该方法之间取得平衡，以及在国家和社区层面都需要更多培训和资源来支持这些举措。
