Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
J Pain Symptom Manage. 2021 Feb;61(2):e13-e50. doi: 10.1016/j.jpainsymman.2020.10.025. Epub 2020 Nov 21.
Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes.
To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic.
A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted.
Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives' details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1-10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%).
Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
先前的公共卫生突发事件的证据表明，姑息治疗对于控制症状、制定预先护理计划和改善临终结局至关重要。
评估中东和北非地区姑息治疗服务应对 COVID-19 大流行的准备情况和能力。
进行了一项横断面在线调查，内容涉及世界卫生组织《国际卫生条例》。采用非概率抽样方法，并进行描述性分析。
对来自 12 个国家的 43 个服务机构的回复进行了分析。一半的受访者是医生（53%），服务主要以医院为基础（84%）。除一个服务机构外，所有服务机构都至少修改了一项程序以应对 COVID-19。三分之一的机构修改了（30%）不复苏政策，五分之一的机构（23%）则没有修改。虽然在入口处都提供了洗手设施（98%），但三分之一的机构对获取消毒剂产品（37%）、肥皂（35%）或自来水（33%）表示担忧。大多数机构都有能力使用技术提供远程护理（86%）和联系患者和员工名单（93%），尽管只有五分之二的机构有家属的详细信息（37%）。受访者报告称，工作人员对自身感染的焦虑程度很高（1-10 分制的中位数评分为 8 分），但只有一半的服务机构有应激管理程序（53%）。三分之二的机构计划支持对 COVID-19 患者进行分诊（60%）和共享协议（58%）。
参与的服务机构已为应对 COVID-19 做好准备，但由于缺乏员工支持和资源，其应对能力可能有限。我们提出了一些建议，以提高服务机构的准备情况并减轻不必要的痛苦。
