Hadian Marziyeh, Jabbari Alireza, Mazaheri Elaheh
Department of Health Care Management, Health Management and Economics Research Center, Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Educ Health Promot. 2020 Oct 30;9:276. doi: 10.4103/jehp.jehp_107_20. eCollection 2020.
Palliative care has been proposed as a multidisciplinary method for providing patients with care. The present study proposes to discuss the necessary principles required for any country to successfully implement a palliative medicine program. The present study was a systematic review conducted in January 2019, and the articles related to palliative care requirements on the databases of Web of Science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, and Google Scholar from January 1, 2009, to January 20, 2019, were searched. Strategy for searching and selecting the articles was Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. The findings showed that the World Health Organization has introduced for main phases for increasing these types of services including: defining and developing a national policy, training and educating healthcare employees and general public, as well as pain relief. In general, two scenarios are described in the development of palliative medicine: bottom-up and top-down approaches. In conclusion, although there seem to be progressing activities regarding the issue of making palliative medicine accessible, there are still many obstacles including lack of adequate knowledge and political support, social and cultural problems, inadequate training and education of physicians and nurses, fixed and biased attitude in medical professions, and low priority of palliative medicine among policymakers. Therefore, it could be said that implementing palliative medicine programs requires an overall change in culture, public and individual education, political support, and appropriate policies.
姑息治疗已被提议作为一种为患者提供护理的多学科方法。本研究旨在讨论任何国家成功实施姑息医学项目所需的必要原则。本研究是一项于2019年1月进行的系统综述，检索了2009年1月1日至2019年1月20日期间在科学网、PubMed、Scopus、科学Direct、Ovid、ProQuest、Wiley和谷歌学术数据库中与姑息治疗要求相关的文章。检索和选择文章的策略是系统评价和Meta分析的首选报告项目指南。研究结果表明，世界卫生组织推出了增加这类服务的四个主要阶段，包括：界定和制定国家政策、培训和教育医护人员及公众，以及缓解疼痛。一般来说，姑息医学的发展描述了两种情况：自下而上和自上而下的方法。总之，尽管在使姑息医学可及方面似乎有进展，但仍有许多障碍，包括缺乏足够的知识和政治支持、社会和文化问题、医生和护士培训和教育不足、医学专业的固定和偏见态度，以及姑息医学在政策制定者中的低优先级。因此，可以说实施姑息医学项目需要文化、公众和个人教育、政治支持以及适当政策的全面变革。
