巴西国家姑息关怀政策的进步与挑战

João Vitor Andrade, J. C. Souza
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摘要

亲爱的编辑和读者们,姑息关怀旨在改善面临重病的病人及其家属的生活质量,通过早期发现和治疗疼痛以及身体、社会心理和精神问题来预防和减轻痛苦。在巴西,对姑息关怀的需求令人震惊,约有 100 万巴西人需要姑息关怀,但供应不足。大多数服务都集中在大城市中心,使许多人得不到必要的支持,面临着本可以通过适当治疗减轻的痛苦。第 3681 号《通用法令》(GM No. 3681)的颁布确立了统一卫生系统(SUS)的国家姑息关怀政策,标志着在规范和扩大姑息关怀方面迈出了重要一步,为发展专门服务提供了法律依据。为了有效实施国家姑息关怀政策,需要克服一些挑战,包括培训卫生专业人员和消除与姑息关怀相关的耻辱感。目前,在对医生和其他专业人员进行姑息关怀培训方面存在很大差距,导致援助不足。该政策规定由矩阵和护理团队在全国范围内实施姑息关怀,但关键是要增加对物质、技术和教育资源的投资。只有在管理者、医疗专业人员和民间社会的共同努力下,才有可能保证为巴西所有需要姑息关怀的病人提供有尊严的人性化关怀。
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Avanços e desafios da política nacional de cuidados paliativos no Brasil
Dear Editor and readers, Palliative care aims to improve the quality of life of patients and their families facing serious illness, preventing and relieving suffering through early identification and treatment of pain and physical, psychosocial and spiritual problems. In Brazil, where the need for such care is alarming, approximately one million Brazilians need palliative care, but the supply is insufficient. Most services are concentrated in large urban centers, leaving many people without the necessary support, facing pain that could be mitigated with adequate treatment. The promulgation of Ordinance GM No. 3681, which establishes the National Palliative Care Policy in the Unified Health System (SUS), represents a significant step in the regulation and expansion of this care, providing a legal basis for the development of specialized services. In order to effectively implement the National Palliative Care Policy, several challenges need to be overcome, including training health professionals and combating the stigma related to this care. Currently, there is a significant gap in the training of doctors and other professionals in palliative care, resulting in inadequate assistance. The policy provides for the implementation of palliative care by matrix and care teams throughout the country, but it is crucial to increase investment in material, technological and educational resources. Only with a joint effort by managers, health professionals and civil society will it be possible to guarantee dignified and humanized care for all patients in need of palliative care in Brazil.
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