Ozaveščanje javnosti o paliativni oskrbi Erika Zelko; Edvard Jakšič; Nevenka Krčevski Škvarč
AS. Andragoška spoznanja,
10/2021, Volume:
27, Issue:
2
Journal Article
Peer reviewed
Open access
Ozaveščanje in izobraževanje splošne javnosti o paliativni oskrbi lahko izboljša tako paliativno oskrbo kot zadnje dneve življenja bolnikov z neozdravljivo boleznijo. To je tudi namen mednarodnega ...programa Zadnja pomoč (Last Aid), v okviru katerega poteka skupnostno izobraževanje o paliativni oskrbi, ki ga izvajajo v 18 državah. V Sloveniji smo ga začeli izvajati v drugi polovici 2019 in doslej izvedli 25 tečajev. Do zdaj se je tečaja udeležilo 350 ljudi, 255 jih je izpolnilo in vrnilo ocenjevalne vprašalnike. Namen prispevka je predstaviti analizo evalvacije tečaja Zadnja pomoč v Sloveniji. Na podlagi analize podatkov, pridobljenih s kvalitativno in kvantitativno metodo, lahko ugotovimo, da je bil izobraževalni program dobro sprejet tudi v slovenskem okolju, saj so bili udeleženci zelo zadovoljni tako z vsebino kot z izvedbo tečaja. Z najvišjo oceno (5) je tečaj v celoti ocenilo 87,7 % udeležencev, posamezne module pa je z najvišjo oceno ocenilo več kot 75 % udeležencev. Medtem ko so udeleženci večinoma pozitivno ovrednotili interaktivnost tečaja in priložnost izmenjave izkušenj na njem, pa analiza evalvacije kaže tudi, da je treba program nadgraditi z dodatnimi temami.
Spending one's last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of ...palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.
This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.
This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.
This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.
To help general practitioners (GPs) in early identification of patients with palliative care (PC) needs, this pilot study aimed to determine the potential of the combined original surprise question ...(SQ1) ('Would I be surprised if this patient died within the next 12 months?') and the second surprise question (SQ2) ('Would I be surprised if this patient was still alive after 12 months?'). We hypothesized that answering these SQs would trigger them to make a multidimensional care plan.
26 Slovenian GPs, randomized into 4 groups, were invited to write a care plan for each of the four patients described in case vignettes (2 oncologic, 1 organ failure and 1 frailty case). GPs in group 1 were only asked to write a care plan for each patient. GPs in group 2 answered SQ1 and GPs in groups 3 and 4 answered SQ1 and SQ2 before writing the care plan. The type and number of PC aspects mentioned in the respective care plans were quantified into a numeric RADboud ANTicipatory (RADIANT) score.
Mean RADIANT scores in groups 1-4 were 2.2, 3.6, 2.5 and 3.1, respectively. When comparing the different vignettes, vignette B (terminal oncologic patient) scored best (3.6). Mean RADIANT scores in groups 3 and 4 were slightly higher for GPs who would be surprised compared to GPs who would not be surprised if the patient was still alive in 12 months.
The combined SQs were considered helpful in the early identification of patients in need of PC in Slovenian general practice.
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