姑息治疗是难民在新东道国克服跨文化障碍的有效手段

M. Silbermann, L. Baider, D. Respini, P. Tralongo, M. Daher, Rana F. Obeidat, N. Gafer, S. Fadhil, M. Rassouli, S. Cheli, A. Eniu, L. Balducci
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摘要

从非洲和中东到欧洲的前所未有的难民潮给欧洲卫生专业人员和整个社会带来了重大挑战。最近在西西里岛锡拉丘兹举办的一次讲习班汇集了来自意大利、黎巴嫩、以色列、伊拉克、伊朗、苏丹、突尼斯、约旦和欧洲肿瘤医学学会的医生、护士、心理学家和政府机构的管理人员,目的是制定一个培训方案,以便在各自地区的专业人员与意大利的难民之间开展对话。难民面临的一个主要障碍是缺乏交流(语言和文化),这阻碍了他们顺利融入社会。讲阿拉伯语和意大利语并了解难民的信仰、传统和信仰的文化调解人对于成功地在这种多样性之间建立桥梁至关重要。可以预见的是,大多数寻求庇护者在抵达欧洲后都会经历焦虑、恐惧和抑郁。经过深入讨论后,所有讲习班与会者一致认为,在癌症患者身上采用姑息治疗方法,在治疗上有利于克服难民在欧洲最初逗留期间所经历的心理痛苦。因此,所有各方都同意开始在难民原籍国和欧洲为代表或调解人(最好有一些临床背景和经验)举办培训班;为此,我们将付出巨大的努力来创造一种包括生物、心理和社会因素在内的有效的姑息治疗模式。这种模式或范式将采用一种文化敏感的方法,以核心伦理原则为基础,考虑到难民的精神需求。
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Palliative Care is a Useful Means to Overcome Intercultural Barriers Faced by Refugees in their New Host Countries
The unprecedented wave of refugee migration from Africa and the Middle East to Europe presents major challenges to European health professionals and to society at large. A recent workshop which took place in Syracuse, Sicily, brought together physicians, nurses and psychologists and managers of governmental agencies from Italy, Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan, and the European Society of Medical Oncology, aimed to create a training program to formulate a dialogue between professionals in their regions and refugees in Italy. A major barrier refugees face is a lack of communication (verbal and cultural) which hinders their smooth absorption into society. Cultural mediators who speak Arabic and Italian and understand the refugees’ faith, tradition and beliefs, are paramount to successfully building bridges between such diversities. Predictably, most asylum seekers undergo anxiety, fear, and depression after arriving in Europe. Following intensive deliberations, all workshop participants agreed that applying palliative care methodologies, as practiced in cancer patients, would be therapeutically advantageous in overcoming the psychological suffering that refugees experience during their initial stay in Europe. Accordingly, all agreed to start with training courses, both in refugees’ countries of origin and in Europe, for representatives or mediators (preferably with some clinical background and experience); whereby tremendous efforts would be made to create a working palliative care model that includes bio-psycho-social elements. This model or paradigm will employ a culturally sensitive approach that takes refugees’ spiritual needs into consideration, relying on core ethical principles.
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