Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Front Public Health. 2024 Aug 27;12:1346234. doi: 10.3389/fpubh.2024.1346234. eCollection 2024.
Paying attention to palliative care has accelerated in Iran in the last 10 years. Considering the trend of aging, increasing burden of chronic diseases and increasing health costs, planning and development of palliative care is necessary in the future. This study was conducted with the aim of explaining the alternative scenarios of palliative care in the health system of Iran until the horizon of 2030.
This study was a multi-method scenario planning with a qualitative using multiple methods design, which was conducted in 3 phases in 2018-2020. In the first phase, a list of driving forces was extracted using qualitative interviews and literature review. In the second phase, all factors identified in the previous phase were examined in terms of degree of uncertainty and cross-impact analysis, and two key uncertainties were extracted. In the third phase, based on two key uncertainties, four future scenarios of palliative care were formulated, validated and scenario strategies were presented.
The results indicate two uncertainties, including "governance of palliative care in the health system" and "acceptance of palliative care by society," based on which, four scenarios with the names "climbing to the top," "excruciating climb," "edge of the abyss" and "The bottom of the valley" were compiled.
The development of palliative care in health system of Iran is faced with serious uncertainties that it is necessary to focus the developmental activities of palliative care on the two axes of acceptance by society and need for coherent governance by considering all the dimensions and influential components by ministry of health. The application of the results of this research can provide reasonable options for effective interventions and implementation of this category of services to the beneficiaries of palliative care.
在过去的 10 年中，伊朗对姑息治疗的关注度有所提高。考虑到人口老龄化、慢性病负担增加和医疗保健费用增加的趋势，未来有必要规划和发展姑息治疗。本研究旨在解释 2030 年之前伊朗卫生系统姑息治疗的替代方案。
这是一项多方法情景规划研究，采用定性使用多种方法设计，于 2018-2020 年分三个阶段进行。在第一阶段，使用定性访谈和文献回顾提取了驱动力清单。在第二阶段，根据不确定性程度和交叉影响分析，对前一阶段确定的所有因素进行了检查，并提取了两个关键不确定性因素。在第三阶段，根据这两个关键不确定性因素，制定了姑息治疗的四个未来情景，并进行了验证，提出了情景策略。
结果表明，存在两个不确定性因素，包括“卫生系统中姑息治疗的治理”和“社会对姑息治疗的接受程度”，在此基础上，制定了四个名为“攀登高峰”、“痛苦攀登”、“深渊边缘”和“谷底”的情景。
伊朗卫生系统姑息治疗的发展面临着严重的不确定性，有必要通过卫生部考虑所有层面和有影响力的组成部分，将姑息治疗的发展活动集中在社会接受和连贯治理这两个轴心上。本研究结果的应用可以为这一类服务的有效干预和实施提供合理的选择，使姑息治疗的受益者受益。
