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加强成人和儿童姑息治疗体系:西班牙专业人员及家庭护理人员提出的全面改进建议

Enhancing the Adult and Paediatric Palliative Care System: Spanish Professionals' and Family Caregivers' Suggestions for Comprehensive Improvement.

作者信息

Llop-Medina Laura, García-Muñoz Paula, Ródenas-Rigla Francisco, Garcés-Ferrer Jorge

机构信息

Polibienestar Research Institute, University of Valencia, 46022 Valencia, Spain.

出版信息

Healthcare (Basel). 2023 Dec 27;12(1):65. doi: 10.3390/healthcare12010065.

Abstract

This research critically explores deficiencies in the palliative care system, focusing on evaluation and treatment aspects for both adult and paediatric patients. Using a qualitative methodology, the study engages healthcare professionals and family caregivers to uncover perspectives on the existing state of palliative care. Conducted through three focus groups and a semi-structured in-depth interview with participants recruited from Virgen de la Arrixaca University Clinical Hospital, this research illustrates critical issues, highlighting the insufficient healthcare workforce and resources to meet the comprehensive needs of patients and their families. Recommendations include holistic care addressing social, emotional, psychological, socio-familiar, and economic dimensions, supported by embedded support groups and the enforcement of relationships with palliative associations. This study also advocates for improved health institutional coordination, social worker support, and ongoing health professional satisfaction monitoring. In paediatric care, specific demands involve specialised units, medical team continuity, 24 h paediatrician care, and a more professional paediatric approach. Beyond problem identification, this study offers valuable insights for shaping health policies and tools, incorporating new indicators and introducing grief bereavement support in clinical reports, contributing to the advancement of patient evaluation in palliative care.

摘要

本研究批判性地探讨了姑息治疗系统中的不足,重点关注成人和儿科患者的评估与治疗方面。该研究采用定性研究方法,让医疗保健专业人员和家庭护理人员参与进来,以揭示他们对姑息治疗现状的看法。通过三个焦点小组以及对从比维耶纳·德·拉里萨卡大学临床医院招募的参与者进行的半结构化深度访谈开展此项研究,该研究阐明了关键问题,突出了医疗保健劳动力和资源不足以满足患者及其家庭全面需求的情况。建议包括提供涵盖社会、情感、心理、社会家庭和经济层面的整体护理,并通过嵌入式支持小组以及与姑息治疗协会加强合作来提供支持。本研究还主张改善卫生机构间的协调、加强社会工作者的支持以及持续监测医疗保健专业人员的满意度。在儿科护理方面,具体需求包括设立专门科室、保持医疗团队的连续性、提供24小时儿科医生护理以及采用更专业的儿科护理方法。除了识别问题之外,本研究还为制定卫生政策和工具提供了宝贵的见解,纳入新的指标并在临床报告中引入悲伤哀悼支持,有助于推动姑息治疗中患者评估的发展。

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