Page Nivedita, Naik Vinay, Singh Priya, Fernandes Prakash, Nirabhawane Vivek, Chaudhari Santosh
Cipla Palliative Care Centre, Pune, Maharashtra, India.
Cipla Foundation, Mumbai, Maharashtra, India.
Indian J Palliat Care. 2020 Jun;26(Suppl 1):S63-S69. doi: 10.4103/IJPC.IJPC_151_20. Epub 2020 Jun 30.
With the COVID-19 pandemic wreaking havoc globally, the extremely vulnerable subset of cancer palliative care patients has to go through the worst nightmare. Difficulty in accessing medical care in the event of increased symptom burden, obstacles in reaching hospitals at time of emergencies or end of life, limited access to medication, social distancing causing isolation, leading to psychosocial burden, lack of bereavement support, are few of the issues we identified. Palliative home care is an important tool to allay the anxieties and address the fears of cancer patients and caregivers, by ensuring continuity of care and providing the much needed handholding in these difficult times. This article aims to highlight the home-based care strategy and experience of the Cipla Palliative Care and Training Center during the COVID-19 lockdown.
We have utilized the data of documentation of the process of designing the protocol, the data entered by the team on unique data management software that is used at the palliative care center to record all palliative care interventions and reflections of the team on their experience of home visits during this period.
Continuity of care through home visits will ensure better management of patients in terms of physical symptoms, psychosocial support, allaying fears, and anxieties, as well as the ultimate goal of an improved quality of life. Physical symptoms (24%), morphine drop off (19%), psychosocial support (15%), end of life care (33%), and procedures (9%) were the major indications of visits.
The COVID-19 pandemic has increased the need for support, thus reiterating the importance of continuity of care. With abundant precautions and protocols in place, home care through visits is possible. With the lockdown and restrictions now entering their fourth phase, we need to be ready now more than ever to adapt to changing times and evolving definitions of the "New Normal."
随着新冠疫情在全球肆虐，癌症姑息治疗患者这一极为脆弱的群体不得不经历最可怕的噩梦。我们发现了一些问题，如症状负担加重时就医困难、紧急情况或生命终末期前往医院受阻、药物获取受限、社交距离导致隔离进而产生心理社会负担、缺乏丧亲支持等。姑息家庭护理是缓解癌症患者及其照护者焦虑、消除恐惧的重要手段，它能确保护理的连续性，并在这些困难时期提供急需的帮助。本文旨在突出西普拉姑息治疗与培训中心在新冠疫情封锁期间的居家护理策略与经验。
我们利用了设计方案过程中的记录数据、团队在姑息治疗中心用于记录所有姑息治疗干预措施的独特数据管理软件中输入的数据，以及团队对这一时期家访经历的反思。
通过家访实现护理连续性，将在身体症状管理、心理社会支持、减轻恐惧和焦虑以及提高生活质量这一最终目标方面确保对患者的更好管理。家访的主要指征包括身体症状（24%）、吗啡送药（19%）、心理社会支持（15%）、生命终末期护理（33%）和诊疗程序（9%）。
新冠疫情增加了对支持的需求，从而再次凸显了护理连续性的重要性。通过采取充分的预防措施和方案，家访式的居家护理是可行的。随着封锁和限制措施进入第四阶段，我们现在比以往任何时候都更需要做好准备，以适应不断变化的时代和“新常态”不断演变的定义。
