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墨西哥儿科姑息治疗提供面临的挑战:一项基于网络的横断面调查。

Challenges in the Provision of Pediatric Palliative Care in Mexico: A Cross-Sectional Web-Based Survey.

机构信息

RWTH Aachen University, Aachen, Germany.

Universidad de Guadalajara, Jalisco, Mexico.

出版信息

J Palliat Care. 2024 Jan;39(1):58-67. doi: 10.1177/08258597211062767. Epub 2021 Dec 13.

Abstract

An enormous need for pediatric palliative care (PPC) has been reported, especially in low- and middle-income countries (LMICs). However, the access to PPC is limited. This study identifies the current challenges in the provision of PPC and their severity from the perspective of healthcare professionals. We conducted a web-based descriptive cross-sectional survey among healthcare professionals treating children in need of palliative care in Mexico in 2019. We used convenience sampling and snowball sampling to acquire participants. Seventy healthcare professionals from Mexico participated. Participants were 64.3% female, on average 45.8 (SD = 10.9) years old, had an average of 15.84 (SD = 10.4) years of work experience and worked in 15 states. The three most severe barriers reported were: The barriers related to a lack of awareness and commitment, a lack of support, legal factors, and working conditions were rated highest. Participants considered increased awareness and better knowledge of PPC for all as the top priority, and particularly emphasized the need for better education and training of health professionals. We have identified several barriers to successful palliative care (PC) provision for children. Primarily, these are lack of awareness and commitment, especially of the health authorities and the medical professions, lack of personal and financial support, legal factors, and working conditions. The need to change and improve care exists at the policy level, the health professional level, and the public societal level.

摘要

大量需要儿科姑息治疗(PPC)的报道,尤其是在低收入和中等收入国家(LMICs)。然而,获得 PPC 的机会有限。本研究从医疗保健专业人员的角度确定了提供 PPC 目前面临的挑战及其严重程度。

我们在 2019 年对墨西哥需要姑息治疗的儿童进行了一项基于网络的描述性横断面调查。我们使用便利抽样和滚雪球抽样来获取参与者。来自墨西哥的 70 名医疗保健专业人员参与了这项研究。参与者中女性占 64.3%,平均年龄为 45.8 岁(标准差=10.9),平均工作经验为 15.84 年(标准差=10.4),工作于 15 个州。报告的三个最严重的障碍是:

与缺乏意识和承诺、缺乏支持、法律因素和工作条件相关的障碍被评为最高。参与者认为提高所有人对 PPC 的认识和更好的知识是当务之急,特别是强调需要更好地教育和培训卫生专业人员。

我们已经确定了成功为儿童提供姑息治疗(PC)的几个障碍。主要是缺乏意识和承诺,特别是卫生当局和医疗专业人员的意识和承诺,缺乏个人和财务支持,法律因素和工作条件。需要在政策层面、卫生专业人员层面和公众社会层面改变和改善护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0d0/10687805/0059f9105db3/10.1177_08258597211062767-fig1.jpg

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