Pastrana Tania, Centeno Carlos, De Lima Liliana
1 Department of Palliative Medicine, RWTH Aachen University , Aachen, Germany .
J Palliat Med. 2015 May;18(5):429-37. doi: 10.1089/jpm.2014.0120. Epub 2015 Feb 6.
The development of palliative care (PC) in Latin America (LA) has been slow compared to other regions. A Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis may contribute to the identification of barriers and successful strategies.
The study's objective was to conduct a SWOT analysis of the development of PC in LA from the PC professional perspective.
Experts from 19 countries of the region were selected in collaboration with national associations. Specific questions were included in the Latin American Association for Palliative Care (ALCP) Atlas of Palliative Care cross-survey 2012. Content analysis was conducted categorizing responses in a SWOT framework. Descriptive and correlation analyses were performed.
A total of 577 statements were provided. Among the Strengths were integration into health systems and increasing number of professionals with PC training. Among weaknesses were lack of national PC programs, limited connection between policymakers and professionals, and barriers in the availability of opioids. Opportunities were increased awareness of policymakers and higher interest of students and professionals. Threats were competing funding for other services and medications, limited interest of the pharmaceutical industry in producing affordable opioid medications, and emphasis by the media on opioid diversion and abuse. Comments were categorized under (1) health policy, (2) education and research, (3) service provision, (4) opioid availability, and (5) advocacy. A moderately positive correlation was found (R=0.4 in both) between the ALCP development index and the number of positive/negative factors mentioned by country.
A SWOT framework is applicable in a situational analysis and helps to identify common aspects among the countries and key elements in the development of PC in Latin America.
与其他地区相比，拉丁美洲姑息治疗（PC）的发展较为缓慢。优势、劣势、机会和威胁（SWOT）分析可能有助于识别障碍和成功策略。
本研究的目的是从PC专业人员的角度对拉丁美洲PC的发展进行SWOT分析。
与各国协会合作，从该地区19个国家挑选专家。特定问题纳入了2012年拉丁美洲姑息治疗协会（ALCP）姑息治疗地图集交叉调查。进行内容分析，将回复分类到SWOT框架中。进行描述性和相关性分析。
共提供了577条陈述。优势包括融入卫生系统和接受PC培训的专业人员数量增加。劣势包括缺乏国家PC项目、政策制定者与专业人员之间联系有限以及阿片类药物供应方面的障碍。机会包括政策制定者意识提高以及学生和专业人员兴趣增加。威胁包括其他服务和药物的竞争性资金、制药行业生产负担得起的阿片类药物的兴趣有限以及媒体对阿片类药物转移和滥用的强调。评论分为（1）卫生政策，（2）教育与研究，（3）服务提供，（4）阿片类药物供应，以及（5）宣传。发现ALCP发展指数与各国提到的积极/消极因素数量之间存在中度正相关（两者R = 0.4）。
SWOT框架适用于情境分析，有助于识别各国之间的共同方面以及拉丁美洲PC发展的关键要素。
