Silbermann Michael, Fink Regina M, Min Sung-Joon, Mancuso Mary P, Brant Jeannine, Hajjar Ramzi, Al-Alfi Nesreen, Baider Lea, Turker Ibrahim, ElShamy Karima, Ghrayeb Ibtisam, Al-Jadiry Mazin, Khader Khaled, Kav Sultan, Charalambous Haris, Uslu Ruchan, Kebudi Rejin, Barsela Gil, Kuruku Nilgün, Mutafoglu Kamer, Ozalp-Senel Gulsin, Oberman Amitai, Kislev Livia, Khleif Mohammad, Keoppi Neophyta, Nestoros Sophia, Abdalla Rasha Fahmi, Rassouli Maryam, Morag Amira, Sabar Ron, Nimri Omar, Al-Qadire Mohammad, Al-Khalaileh Murad, Tayyem Mona, Doumit Myrna, Punjwani Rehana, Rasheed Osaid, Fallatah Fatimah, Can Gulbeyaz, Ahmed Jamila, Strode Debbie
1 Middle East Cancer Consortium, Technion-Israel Institute of Technology , Haifa, Israel .
J Palliat Med. 2015 Jan;18(1):18-25. doi: 10.1089/jpm.2014.0194.
Cancer incidence in Middle Eastern countries, most categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with cancer who present with advanced disease.
To determine knowledge, beliefs, barriers, and resources regarding palliative care services in Middle Eastern countries and use findings to inform future educational and training activities.
Descriptive survey.
SETTING/SUBJECTS: Fifteen Middle Eastern countries; convenience sample of 776 nurses (44.3%), physicians (38.3%) and psychosocial, academic, and other health care professionals (17.4%) employed in varied settings.
Palliative care needs assessment.
Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. The nonexistence of functioning home-based and hospice services leaves families/providers unable to honor patient wishes. Respondents were least satisfied with discussions around advance directives and wish to learn more about palliative care focusing on communication techniques. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly.
The majority of Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.
中东国家大多属于中低收入国家，预计未来10年癌症发病率将翻倍，增幅超过世界其他任何地区。虽然在癌症诊断/治疗方面已取得进展，但对于大多数患有晚期疾病的癌症患者而言，在改善姑息治疗方面仍有许多工作要做。
确定中东国家关于姑息治疗服务的知识、信念、障碍和资源，并利用研究结果为未来的教育和培训活动提供信息。
描述性调查。
地点/受试者：15个中东国家；从不同工作环境中抽取的776名护士（44.3%）、医生（38.3%）以及心理社会、学术和其他医疗保健专业人员（17.4%）组成的便利样本。
姑息治疗需求评估。
改善疼痛管理服务是关键促进因素。主要障碍包括缺乏指定的姑息治疗床位/服务、社区意识、工作人员培训、临终关怀服务的可及性以及人员/时间。缺乏有效的居家和临终关怀服务使得家庭/提供者无法满足患者的愿望。受访者对围绕预先指示的讨论最不满意，并希望更多地了解侧重于沟通技巧的姑息治疗。需要特别关注的人群包括：具有种族多样性、语言障碍和低识字率的患者；儿童和年轻人；以及老年人。
大多数中东癌症患者在偏远地区接受治疗；社区至关重要，必须纳入未来姑息治疗服务发展计划。促进医生和护士的姑息治疗教育和认证至关重要；必须维持居家和临终关怀服务。
