约旦河西岸被占领巴勒斯坦领土上的先进癌症护理服务获取情况。
Access to advanced cancer care services in the West Bank-occupied Palestinian territory.
作者信息
Mitwalli Suzan, Hammoudeh Weeam, Giacaman Rita, Harding Richard
机构信息
Institute of Community and Public Health, Birzeit University, West Bank, Palestine.
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, London, United Kingdom.
出版信息
Front Oncol. 2023 Mar 16;13:1120783. doi: 10.3389/fonc.2023.1120783. eCollection 2023.
INTRODUCTION
Universal Health Coverage (UHC) identifies the provision of palliative care for people with advanced disease as an essential health service. Palliative care is also stipulated as a human right under existing covenants. Oncology services provided by the Palestinian Authority under Israeli military occupation are limited to surgery and chemotherapy treatment. Our study aimed to describe the experiences of patients with advanced-stage cancer in the West Bank in accessing oncology services and meeting their health care needs.
METHODOLOGY
We conducted a qualitative study among adult patients diagnosed with advanced lung, colon, or breast cancer in three Palestinian governmental hospitals, and with oncologists. Thematic analysis was conducted on the verbatim interview transcripts.
RESULTS
The sample consisted of 22 Palestinian patients (10 men and 12 women) and 3 practicing oncologists. The findings reveal that cancer care is fragmented, with limited access to the services needed. Patients face referral delays in accessing treatment which worsen their health condition in some cases. Some patients reported difficulties in getting Israeli permits to access radiotherapy treatment in East-Jerusalem, and others experienced interruptions of their chemotherapy treatment sessions due to the unavailability of chemotherapy medications caused by Israeli-side delays. Other reported problems were related to the Palestinian health system and service delivery and quality, including fragmentation of services, infrastructure issues, and unavailability of medications. Advanced diagnostic services and palliative care are almost absent at Palestinian governmental hospitals, and patients need to seek these services in the private sector.
CONCLUSION
The data demonstrate specific access restrictions to cancer care in the West Bank due to Israeli military occupation of Palestinian land. This affects all stages of the care pathway, from restricted diagnosis services, to limited treatment and then poor availability of palliative care. Cancer patients will continue to suffer if the root causes of these structural constraints are not addressed.
引言
全民健康覆盖（UHC）将为晚期疾病患者提供姑息治疗确定为一项基本卫生服务。根据现有公约，姑息治疗也被规定为一项人权。在以色列军事占领下，巴勒斯坦权力机构提供的肿瘤服务仅限于手术和化疗治疗。我们的研究旨在描述约旦河西岸晚期癌症患者在获得肿瘤服务和满足其医疗需求方面的经历。
方法
我们在三家巴勒斯坦政府医院对被诊断患有晚期肺癌、结肠癌或乳腺癌的成年患者以及肿瘤学家进行了一项定性研究。对逐字记录的访谈文本进行了主题分析。
结果
样本包括22名巴勒斯坦患者（10名男性和12名女性）和3名执业肿瘤学家。研究结果表明，癌症护理是分散的，获得所需服务的机会有限。患者在获得治疗方面面临转诊延迟，这在某些情况下会使他们的健康状况恶化。一些患者报告说，在获得以色列许可前往东耶路撒冷接受放射治疗方面存在困难，还有一些患者由于以色列方面的延误导致化疗药物无法供应而经历化疗疗程中断。其他报告的问题与巴勒斯坦卫生系统、服务提供和质量有关，包括服务分散、基础设施问题和药物供应不足。巴勒斯坦政府医院几乎没有先进的诊断服务和姑息治疗，患者需要在私营部门寻求这些服务。
结论
数据表明，由于以色列对巴勒斯坦土地的军事占领，约旦河西岸在癌症护理方面存在特定的获取限制。这影响了护理路径的各个阶段，从有限的诊断服务到有限的治疗，再到姑息治疗的可及性差。如果这些结构性限制的根本原因得不到解决，癌症患者将继续受苦。
Zotero 插件