缓和疗护服务的可及性:卢萨卡大学教学医院儿童及家庭住院经验的质性研究

W. Mutale, F. Goma, L. Gwyther
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引用次数: 0

摘要

导言:世卫组织建议根据需要和情况向所有需要的人提供姑息治疗。然而,在撒哈拉以南非洲,姑息治疗服务的覆盖率仍然很低,尤其是儿童。本研究报告了在赞比亚卢萨卡大学教学医院为儿童及其家庭提供姑息治疗服务的经验。方法:本研究是在赞比亚卢萨卡大学教学医院进行的横断面定性研究。结果:家庭面临的主要挑战包括缺乏经济/财政支持和丧亲支持。大多数家庭都是在没有任何支持的情况下从很远的地方转介到综合医院的。确定的提供姑息治疗的一个主要障碍是服务协调不力,大多数患者错过了已经提供的服务。虽然有社会工作者,但资金不足对这项服务产生了负面影响。在缓和治疗方面训练有素的保健工作者很少。疼痛管理仍然很差,许多临床医生仍然不愿意开更强的镇痛药,如吗啡对严重的疼痛。结论:该研究揭示了在赞比亚大学教学医院儿童姑息治疗服务的显著差距。确定的提供姑息治疗的一个主要障碍是服务协调不力。家庭报告说,除了缺乏信息外,还缺乏经济和丧亲支持。
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Access to Palliative Care Services: A Qualitative Study of Experiences of Children and Families Attending University Teaching Hospital in Lusaka
Introduction: WHO recommends provision of palliative care for all who need it according to needs and context. However, in Sub-Saharan Africa coverage of palliative care services remain low especially children. This study reports experiences of palliative care services for children and their families attending the University Teaching hospital in Lusaka, Zambia. Methodology: The was a cross-sectional qualitative study conducted at University teaching hospital in Lusaka, Zambia. Results: The major challenges faced by families included lack of economic/financial and bereavement support. Most families were referred to the UTH from very far places without any form of support. One major barrier identified to provision of palliative care was poor coordination of services with most patients missing out on services which were already available. While social workers were available, poor funding negatively affected this service. There were very few trained health workers in palliative care. Pain management remained poor with many clinicians still not comfortable to prescribe stronger analgesia such as morphine for severe pain. Conclusion: The study revealed significant gaps for children’s palliative care services in at the University teaching hospital in Zambia. One major barrier identified to provision of palliative care was poor coordination of services. Families reported lack of economic and bereavement support in addition to lack of information.
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