Lin Cheng-Pei, Boufkhed Sabah, Pai Asha Albuquerque, Namisango Eve, Luyirika Emmanuel, Sleeman Katherine E, Costantini Massimo, Peruselli Carlo, Higginson Irene J, Ekstrand Maria L, Harding Richard, Salins Naveen, Bhatnagar Sushma
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
School of Nursing, Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan.
Indian J Palliat Care. 2021 Jan-Mar;27(1):152-171. doi: 10.4103/ijpc.ijpc_429_20. Epub 2021 Feb 17.
COVID-19 has been causing a high burden of suffering for patients and families. There is limited evidence on the preparedness of Indian palliative care services for the pandemic.
This study aimed to assess the preparedness and capacity of Indian palliative care services in response to the COVID-19 pandemic.
A cross-sectional online survey was developed based on prior evidence and international health regulations. It was emailed to the Indian Palliative Care Association members and investigators' professional networks in India. One participant per palliative care service was requested. Descriptive analysis was used.
Representatives of 78 palliative care services completed the survey. Three in four services had COVID-19 case definition and adapted their protocols for infection control (75%). About half of the services (55%) reported concerns about achieving appropriate hand hygiene in the community. More than half of the services (59%) had capacity to train nonspecialists for symptom control and psychological support. About half of the services reported that they had plans to redeploy staff (56%) and resources (53%) in the case of outbreaks. Two-fifths of the services used paper records to store an updated contact list of staff (40%) and did not have designated focal contacts for information update (40%). Staff anxiety related to personal infection risk and family care was relatively high (median score = 7 on a 1-10 scale).
We recommend the following resource allocation to enable palliative care services to support the Indian health system in delivering essential care in this and future pandemics: (1) infection control, especially in the community; (2) training using existing clinical protocols to strengthen palliative care across the health system; and (3) redeployment plans.
新型冠状病毒肺炎给患者及其家庭带来了沉重的痛苦负担。关于印度姑息治疗服务机构应对这一疫情的准备情况，证据有限。
本研究旨在评估印度姑息治疗服务机构应对新型冠状病毒肺炎疫情的准备情况和能力。
基于先前的证据和国际卫生条例开展了一项横断面在线调查。调查通过电子邮件发送给印度姑息治疗协会成员以及印度研究人员的专业网络。要求每个姑息治疗服务机构推选一名参与者。采用描述性分析方法。
78家姑息治疗服务机构的代表完成了调查。四分之三的机构制定了新型冠状病毒肺炎病例定义，并调整了感染控制方案（75%）。约半数机构（55%）报告称担心在社区中难以实现适当的手部卫生。超过半数的机构（59%）有能力培训非专科人员进行症状控制和心理支持。约半数机构报告称，他们制定了在疫情爆发时重新调配工作人员（56%）和资源（53%）的计划。五分之二的机构使用纸质记录来存储工作人员的最新联系方式清单（40%），并且没有指定负责信息更新的联络人（40%）。工作人员对个人感染风险和家庭护理的焦虑程度相对较高（在1至10分的量表上，中位数为7分）。
我们建议进行以下资源分配，以使姑息治疗服务机构能够支持印度卫生系统在此次及未来疫情中提供基本护理：（1）感染控制，尤其是在社区；（2）利用现有临床方案进行培训，以加强整个卫生系统的姑息治疗；（3）重新调配计划。
