Palliative Medicine Consultant, Te Omanga Hospice, Lower Hutt, New Zealand; PhD candidate, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Honorary Professor, Department of General Practice and Primary Care, The University of Auckland, Auckland, New Zealand.
N Z Med J. 2022 Dec 2;135(1566):36-48. doi: 10.26635/6965.5883.
Community specialist palliative care (SPC) in Aotearoa New Zealand is provided by independent hospices. Substantial increase in demand for palliative care is projected in the next 20 years. We aimed to describe the current landscape of SPC services across Aotearoa whilst incorporating an equity lens.
A descriptive cross-sectional survey was undertaken to describe aspects of hospice service and populations served. Survey links were emailed to clinical, or service leads of hospices identified via Hospice New Zealand Website.
All eligible hospices (n=32) completed the online survey. All hospices provided care at home, with 94% (n=30) also providing care for patients in aged residential care facilities. All 32 hospices provided symptom management, family and carer support and bereavement care. Six hospices (19%) did not provide afterhours cover. Fifteen (47%) hospices did not have Māori cultural position and median full time equivalent across all hospices for such position was one day per week. Only nine (28%) hospices provided palliative medicine specialist training.
Areas of inconsistency were highlighted including afterhours access and cultural support for Māori. The capacity of the present system to address current and future shortages of palliative medicine specialist is questioned.
在新西兰奥特亚罗瓦，社区专科姑息治疗（SPC）由独立的临终关怀机构提供。预计在未来 20 年内，对姑息治疗的需求将大幅增加。我们旨在描述奥特亚罗瓦 SPC 服务的现状，同时纳入公平视角。
采用描述性横断面调查，描述临终关怀服务和服务人群的各个方面。通过新西兰临终关怀网站确定的临床或服务负责人，向临终关怀机构发送在线调查链接。
所有符合条件的临终关怀机构（n=32）都完成了在线调查。所有临终关怀机构都提供居家护理，其中 94%（n=30）还为居住在养老院的患者提供护理。所有 32 家临终关怀机构都提供症状管理、家庭和护理人员支持以及丧亲关怀。有 6 家（19%）临终关怀机构没有提供 24 小时服务。有 15 家（47%）临终关怀机构没有毛利文化岗位，所有临终关怀机构中此类岗位的全职等效人员每周工作一天。只有 9 家（28%）临终关怀机构提供姑息治疗专科培训。
突出显示了不一致的领域，包括 24 小时服务的获取和对毛利人的文化支持。目前的系统在解决姑息治疗专科医生目前和未来短缺的能力受到质疑。
