Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey.
Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey.
J Cancer Policy. 2022 Dec;34:100361. doi: 10.1016/j.jcpo.2022.100361. Epub 2022 Sep 7.
In 2014, the World Health Assembly called for improved access to palliative care (PC) as a core component of healthcare systems. Still, in 2019 the development of PC activism in Turkey was patchy in scope, care provision is isolated and services are limited in relation to population size. This workshop was aimed to increase understanding of the PC approach in cancer and to discuss holistic strategies for implementing PC for cancer in Turkey.
The workshop hosted in February 2020 at Ankara was attended by 80 healthcare professionals, bureaucrats, and international PC experts. Panel discussions were held to determine the current status, shortcomings and specify solutions for future PC in cancer in Turkey.
Positive developments in PC after 2010 were acknowledged. Yet PC services are insufficient and mostly unavailable in the less developed regions. PC centers embedded in oncology hospitals were run by oncologists and follows classical cancer treatment protocol. It has emerged that the future need for specialized pc will be greater than anticipated. The latest regulations and the National Pallia-Turk project will provide a framework to develop nationwide PC activism. The barriers are; limited training, lack of integration into cancer care, public ignorance, and legislative issues to Do-Not-Resuscitate (DNR) orders. The contextual suggestions are; all healthcare workers must acquire a minimum knowledge and skills of PC. Home-based PC should be timely and responsive, coordination among patient's care stakeholders, Hospital-based PC for intensive symptom control or reduce caregiver burden. simultaneous cancer and PC to avoid late referral, legal arrangements for advance directives and DNR orders, and public awareness via mass media initiatives.
The workshop recommendation substantially contributes to the existence of PC policy and guidelines; will be useful for the development of comprehensive PC activism to address the future need of PC in Turkey.
2014 年，世界卫生大会呼吁改善姑息治疗（PC）的可及性，将其作为医疗体系的核心组成部分。然而，2019 年，土耳其的 PC 行动主义发展参差不齐，护理服务孤立，与人口规模相比服务有限。本次研讨会旨在提高对癌症 PC 方法的理解，并讨论在土耳其实施癌症整体 PC 策略。
2020 年 2 月在安卡拉举办的研讨会邀请了 80 名医疗保健专业人员、官僚和国际 PC 专家参加。小组讨论确定了土耳其目前癌症 PC 的现状、不足，并为未来的 PC 确定解决方案。
肯定了 2010 年后 PC 的积极发展。然而，PC 服务不足，在欠发达地区基本无法提供。嵌入肿瘤医院的 PC 中心由肿瘤学家管理，并遵循经典的癌症治疗方案。已经出现的是，未来对专业 PC 的需求将超过预期。最新的法规和国家 Pallia-Turk 项目将为发展全国性的 PC 行动主义提供框架。障碍包括：培训有限、缺乏与癌症护理的整合、公众无知以及与 DNR 命令相关的立法问题。具体建议包括：所有医疗保健工作者都必须掌握 PC 的基本知识和技能。家庭 PC 应及时响应，协调患者护理利益相关者，医院 PC 用于强化症状控制或减轻照顾者负担。同时进行癌症和 PC 治疗，以避免晚期转诊，为提前指示和 DNR 命令做好法律安排，通过大众媒体倡议提高公众意识。
研讨会的建议极大地促进了 PC 政策和指南的存在；将有助于制定全面的 PC 行动主义，以满足土耳其未来对 PC 的需求。
