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关爱与冲突——武装部队中的姑息治疗:护理人员面临的挑战

Caring and Conflict-Palliative Care in the Armed Forces: The Challenges for Caregivers.

作者信息

Butola Savita, Bhatnagar Sushma, Rawlinson Fiona

机构信息

Border Security Force, Gwalior, Madhya Pradesh, India.

Department of Oncoanaesthesia and Palliative Medicine, Dr. B.R.A IRCH, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Palliat Care. 2021 Jul-Sep;27(3):405-418. doi: 10.25259/IJPC_393_20. Epub 2021 Oct 27.

Abstract

OBJECTIVES

In India, Palliative care remains inaccessible, especially in remote areas. This study aimed at exploring the experience of caregivers related to arranging palliative care at home, for personnel and family members of an armed force.

MATERIALS AND METHODS

Qualitative study based on thematic analysis of semi-structured interviews with adult caregivers - either serving personnel or their dependent family members.

RESULTS

Lack of palliative care in rural areas makes arranging home care challenging for Indian caregivers, especially in armed forces. The families stay alone and personnel cannot be there to look after loved ones. Constraints of leave, financial and legal problems, frequent movement and social isolation disrupt care as well as family and community support systems, leading to psycho-social problems and stress for the serving personnel as well as families. Educating staff, integrating palliative care into existing medical services, coordinating with other agencies to increase awareness and provide care at home, access to opioids, timely leave, reimbursement of expenses, increased family accommodation, guidance about benefits, and considerate implementation of transfer policy can help mitigate some of their problems.

CONCLUSION

These caregivers face physical exhaustion, psycho-social, financial, legal, and spiritual issues- some common to all rural Indians and others unique to the armed forces. Understanding their experiences will help the providers find solutions, especially in relation to the unique needs of the men in uniform.

摘要

目标

在印度,姑息治疗仍然难以获得,尤其是在偏远地区。本研究旨在探索武装部队人员及其家庭成员的照顾者在家中安排姑息治疗的经历。

材料与方法

基于对成年照顾者(在职人员或其受抚养家庭成员)进行半结构化访谈的主题分析的定性研究。

结果

农村地区缺乏姑息治疗,这使得印度照顾者,尤其是武装部队中的照顾者,在家中安排护理具有挑战性。家人独自生活,而军人无法在身边照顾亲人。休假限制、财务和法律问题、频繁调动以及社会孤立破坏了护理以及家庭和社区支持系统,给在职人员及其家庭带来心理社会问题和压力。对工作人员进行教育、将姑息治疗纳入现有医疗服务、与其他机构协调以提高认识并提供居家护理、获取阿片类药物、及时休假、费用报销、增加家属住房、提供福利指导以及妥善实施调动政策,有助于缓解他们的一些问题。

结论

这些照顾者面临身体疲惫、心理社会、财务、法律和精神问题——其中一些是所有印度农村居民共有的,另一些则是武装部队特有的。了解他们的经历将有助于提供者找到解决方案,特别是针对军人的独特需求。

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