Sabatowski R, Radbruch L, Nauck F, Loick G, Steden E, Grond S, Lehmann K A
Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universität Köln.
Z Arztl Fortbild Qualitatssich. 1998 Aug;92(6):377-83.
Hospice services can be divided into three groups. Few institutions deliver the full scope of palliative home care, most of the others can provide considerably less. The third group of services are those that do not support patients but aim to establish a home care service or a hospice. In February, 1997 396 home care services were working in Germany. 48 of these services provided palliative home care, 69 services were hospice initiatives. The scope of services rendered is very broad and reaches from psychosocial support to complex medical tasks. In the last year, 13,700 patients have been supported at home by hospice services in Germany. Palliative care services usually have professional staff, but they would not be able to work without honorary help. Beside of support for patients and relatives tasks of the home care service are the coordination and exchange between in-patient units, general physicians and social care ward. By cooperation with all institutions for out-patient and home care as well as with general physicians, they contribute to avoid in-patient treatment for their patients. Another important function is to spread the hospice idea and work as multipliers for knowledges and attitudes in palliative care. The number of home care services available in Germany is not sufficient. Only 48 institutions can be ranked as palliative care services. The distribution of the hospice services in Germany is very irregular, and providers of home care services are even more scarce in the eastern part of Germany.
临终关怀服务可分为三类。很少有机构能提供全面的姑息性家庭护理，其他大多数机构所能提供的则要少得多。第三类服务是那些不支持患者，而是旨在建立家庭护理服务或临终关怀机构的服务。1997年2月，德国有396项家庭护理服务在开展工作。其中48项服务提供姑息性家庭护理，69项服务是临终关怀项目。所提供的服务范围非常广泛，从心理社会支持到复杂的医疗任务都有涉及。去年，德国的临终关怀服务在家中为13700名患者提供了支持。姑息治疗服务通常有专业工作人员，但如果没有志愿者的帮助，他们将无法开展工作。除了为患者和亲属提供支持外，家庭护理服务的任务还包括住院科室、全科医生和社会护理病房之间的协调与交流。通过与所有门诊和家庭护理机构以及全科医生合作，它们有助于避免让患者接受住院治疗。另一个重要功能是传播临终关怀理念，并成为姑息治疗知识和态度的传播者。德国现有的家庭护理服务数量不足。只有48家机构可被列为姑息治疗服务机构。德国临终关怀服务的分布非常不均衡，德国东部的家庭护理服务提供者更为稀缺。
