Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom.
Section of Public Health, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
J Pain Symptom Manage. 2018 Sep;56(3):363-370. doi: 10.1016/j.jpainsymman.2018.06.009. Epub 2018 Jun 25.
The World Health Assembly Palliative Care Resolution in 2014 and the inclusion of palliative care within the sustainable development goals raised optimism that palliative care would no longer be a peripheral aspect of global health. However, no funding, accountability measures, or indicators for palliative care development accompanied these policy developments. This risks health actors continuing to prioritize the attainment of better known target-driven aspects of health care.
To explore the attitudes of international palliative care experts regarding how the future development of palliative care can be accelerated.
About 16 international palliative care experts were interviewed for their epistemic expertise. Participants were interviewed face to face or via Skype. Interviews were recorded, transcribed nonverbatim, and analyzed using a thematic approach (NVivo).
Participants strongly supported the rollout of national palliative care policies around the world for two reasons: to ensure palliative care attracts national funding streams and to attract global funding for palliative care. The absence of a global indicator for palliative care development was considered a severe impediment to the inclusion of palliative care within global efforts toward universal health care. Advocacy partnerships, using human rights approaches with economic frames, were considered the most effective methods of influencing policymakers.
Palliative care represents a value proposition that is not currently being maximized by advocacy. Advocates should consider palliative care developmentally, focusing on key asks for development and consider how palliative care can contribute to other international development priorities, in particular poverty reduction.
2014 年世界卫生大会姑息治疗决议和将姑息治疗纳入可持续发展目标，使人们乐观地认为姑息治疗将不再是全球卫生的一个边缘方面。然而，这些政策发展并没有伴随着姑息治疗发展的资金、问责措施或指标。这使得卫生行为者继续优先考虑实现更知名的以目标为导向的医疗保健方面。
探讨国际姑息治疗专家对加速姑息治疗未来发展的态度。
对约 16 名国际姑息治疗专家进行了访谈，以了解他们的专业知识。参与者接受了面对面或通过 Skype 的访谈。访谈进行了录音，非逐字转录，并使用主题方法（NVivo）进行了分析。
参与者强烈支持在全球范围内推出国家姑息治疗政策，原因有二：一是确保姑息治疗吸引国家资金流，二是吸引全球资金用于姑息治疗。姑息治疗发展缺乏全球指标被认为是将姑息治疗纳入全球实现全民健康保健工作的严重障碍。利用人权方法和经济框架建立倡导伙伴关系被认为是影响决策者的最有效方法。
姑息治疗代表了一种目前尚未通过倡导得到最大程度利用的价值主张。倡导者应该从发展的角度考虑姑息治疗，关注发展的关键要求，并考虑姑息治疗如何为其他国际发展优先事项做出贡献，特别是减贫。
