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国家缓和医疗战略在受冲突影响国家的实施:约旦示范项目。

National Palliative Care Strategy in a Conflict Affected Country: A Jordanian Demonstration Project.

机构信息

Department of Palliative Care (O.S.), King Hussein Cancer Center, Amman, Jordan; Center for Palliative and Cancer Care in Conflict (O.S., G.A., A.M.), King Hussein Cancer Center, Amman, Jordan; College of Medicine, Faculty of medicine (O.S.), The University of Jordan, Amman, Jordan.

Center for Palliative and Cancer Care in Conflict (O.S., G.A., A.M.), King Hussein Cancer Center, Amman, Jordan.

出版信息

J Pain Symptom Manage. 2024 May;67(5):e473-e485. doi: 10.1016/j.jpainsymman.2023.12.018. Epub 2023 Dec 28.

Abstract

CONTEXT

Palliative care (PC) integration is vital, as endorsed by the World Health Organization. Yet, Jordan, a Middle Eastern country with limited resources, faces ongoing challenges despite efforts to improve palliative and home care. Establishing a national PC strategic framework, with government and stakeholder consensus, is essential for ensuring universal access to high-quality palliative care. However, processes for achieving this, particularly in the Middle East, are underreported.

OBJECTIVES

This study delineates the process of developing Jordan's National Palliative and Home Care Strategic Framework, reflecting on its five-year impact. Additionally, it identifies barriers to PC progress in Jordan and offers recommendations to stakeholders.

METHODS

We conducted a rapid review and analyzed reports, minutes, meetings, and publications. The sequential framework development involved content and situational analysis, expert review, transparent expert consultation, multistage consensus procedures, and high-level advocacy meetings.

RESULTS

The National Palliative and Home Care Strategic Framework encompasses six domains: 1) policy, 2) finance, 3) service delivery, 4) opioid access, 5) capacity building, and 6) information, research, monitoring, and evaluation. Government endorsement in April 2018 ignited national engagement, driving policy, service delivery, workforce development, education, training, and research progress. Nonetheless, workforce shortages, limited opioid access, and inadequate funding persist as barriers.

CONCLUSION

Jordan's collaborative development of the inaugural National Palliative and Home Care Strategic Framework, endorsed by the government and stakeholders, provides a comprehensive roadmap for PC advancement. While it promises improved services, effective solutions to workforce and opioid access issues are crucial for successful implementation.

摘要

背景

缓和医疗(PC)的整合至关重要,这得到了世界卫生组织的认可。然而,约旦是一个中东资源有限的国家,尽管努力改善缓和医疗和家庭护理,但仍面临持续的挑战。建立一个有政府和利益相关者共识的国家 PC 战略框架,对于确保所有人都能获得高质量的缓和医疗至关重要。然而,实现这一目标的过程,特别是在中东地区,报道较少。

目的

本研究描述了制定约旦国家缓和医疗和家庭护理战略框架的过程,反映了其五年的影响。此外,还确定了约旦缓和医疗进展的障碍,并向利益攸关方提出了建议。

方法

我们进行了快速审查并分析了报告、记录、会议和出版物。顺序框架的开发涉及内容和情境分析、专家审查、透明的专家咨询、多阶段共识程序和高级别宣传会议。

结果

国家缓和医疗和家庭护理战略框架包括六个领域:1)政策,2)财务,3)服务提供,4)阿片类药物获取,5)能力建设,6)信息、研究、监测和评估。2018 年 4 月,政府的认可引发了全国范围内的参与,推动了政策、服务提供、劳动力发展、教育、培训和研究的进展。然而,劳动力短缺、阿片类药物获取有限和资金不足仍然是障碍。

结论

约旦政府与利益相关者合作制定了首份国家缓和医疗和家庭护理战略框架,为 PC 的发展提供了全面的路线图。虽然这有望改善服务,但解决劳动力和阿片类药物获取问题的有效解决方案对于成功实施至关重要。

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