Corrêa Santiago Rodríguez, Abel Julian
Medical Sciences University of São Paulo (USP), Project Estar ao Seu Lado-Cuidados Paliativos na Atenção Primária, Rio Grande, Brazil.
School of Interdisciplinary Studies, University of Glasgow, Scotland.
Curr Opin Support Palliat Care. 2018 Dec;12(4):504-509. doi: 10.1097/SPC.0000000000000394.
Despite the historical international development of palliative care over the last 50 years, provision of equity of care and access to appropriate medication remains a major problem in many countries across the world. Interest in the public health approach to end-of-life care has grown over the last 20 years. Models of palliative care, which are affordable and provide equity of care are changing through these new concepts. We describe an existing model of practice in a primary care setting in Rio Grande in Brazil, which could act as a template for redesign of palliative care services.
Traditional models of palliative care have focussed on the physical, social, psychological and spiritual domains. Abel and Kellehear have proposed a new model, uniting specialist and generalist palliative care with compassionate communities and the civic component encapsulated in the compassionate city charter. This model is more comprehensive, emphasizing both harm reduction and health and well being promotion, and is currently being rolled out within the Family Health Strategy in Rio Grande in Brazil.
An existing model of palliative care, which includes the public health approach in Rio Grande be used as a basis for more equitable palliative care in Brazil, to meet a large unmet need.
尽管过去50年姑息治疗在国际上取得了历史性发展，但在世界许多国家，提供公平的护理和获得适当药物仍然是一个主要问题。在过去20年里，人们对临终关怀的公共卫生方法的兴趣与日俱增。通过这些新概念，经济实惠且能提供公平护理的姑息治疗模式正在发生变化。我们描述了巴西里奥格兰德一个初级保健机构现有的实践模式，它可作为重新设计姑息治疗服务的模板。
传统的姑息治疗模式侧重于身体、社会、心理和精神领域。阿贝尔和凯勒黑尔提出了一种新模式，将专科和全科姑息治疗与富有同情心的社区以及体现在《富有同情心的城市宪章》中的公民要素结合起来。这种模式更全面，强调减少伤害以及促进健康和福祉，目前正在巴西里奥格兰德的家庭健康战略中推广。
巴西里奥格兰德现有的一种包括公共卫生方法的姑息治疗模式，应作为巴西更公平的姑息治疗的基础，以满足大量未得到满足的需求。
