Zapponi Sabina, Ascari Maria Chiara, Feracaku Erjona, Masin Silvia, Paglia Paola, Petroccione Roberta, Pinzaru Ana, Foà Chiara, Artioli Giovanna, Sarli Leopoldo
Università di Parma.
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Acta Biomed. 2018 Mar 26;89(4-S):45-54. doi: 10.23750/abm.v89i4-S.7198.
The 38/2010 law has expanded the provision of palliative care to patients with chronic-degenerative diseases. The ISTAT data show that 60% of the dying population is suffering from these diseases and could, according to the literature review, benefit particularly from such treatments. This study investigates the point of view of healthcare professionals, working in the context of dementia, regarding the knowledge and application of palliative care in the field of dementia. The focus is on the analysis of the resistance that may prevent the spread of palliative care, slowing the application of such care in different settings of terminality.
The method is a qualitative phenomenological approach. A grid of semi-structured interviews was created and was proposed to 33 health workers (18 women) who work in Health Centres or in the Alzheimer Nucleus of Northern Italy.
Most operators think they understand palliative care, they believe it to be useful and necessary, but often only connect it with terminal illness. Others have a broader vision based on a more abstract and theoretical level than on real practical knowledge. A majority of respondents think that the spread of palliative care is slow and difficult because of the prevalence of the biomedical model that holistically and prejudicially hinders the introduction of new models.
Appropriate training is the fundamental key to overcoming resistance. The professionals interviewed showed that they were aware of their lack of knowledge and declared that they had little competence in managing the complexity of long-term pathologies.
2010年第38号法律扩大了对慢性退行性疾病患者的姑息治疗范围。意大利国家统计局的数据显示,60%的临终人群患有这些疾病,根据文献综述,他们可能尤其能从这类治疗中受益。本研究调查了在痴呆症背景下工作的医护人员对痴呆症领域姑息治疗知识及应用的看法。重点在于分析可能阻碍姑息治疗推广、减缓其在不同临终环境中应用的阻力。
采用定性现象学方法。创建了一个半结构化访谈提纲,并向在意大利北部健康中心或阿尔茨海默病中心工作的33名医护人员(18名女性)提出。
大多数从业者认为他们理解姑息治疗,认为其有用且必要,但往往仅将其与晚期疾病联系起来。其他人有更宽泛的认识,基于更抽象的理论层面而非实际的实践知识。大多数受访者认为,由于生物医学模式的盛行从整体上和偏见上阻碍了新模式的引入,姑息治疗的推广缓慢且困难。
适当的培训是克服阻力的关键。接受访谈的专业人员表明,他们意识到自己知识的欠缺,并宣称自己在处理长期病症的复杂性方面能力不足。