Organisation des soins palliatifs intégrés en Belgique

IF 0.2 Q4 HEALTH CARE SCIENCES & SERVICES

Medecine Palliative Pub Date : 2024-03-01 DOI:10.1016/j.medpal.2023.09.004

S. Elst , M. Friedel

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引用次数: 0

Abstract

In the Declaration of Astana (2018), the World Health Organization underlines the emergency of strengthening our health systems and the relevance of the primary health care (PHC) model to achieve this, including regarding palliative care. In the light of the principles of PHC, this article presents and questions the current organization of palliative care in Belgium: do they meet their main criteria, which are comprehensiveness, accessibility, acceptability, permanence and continuity of care? As palliative support is provided at all levels of the health care pyramid, the base – the first line – supports a large part of it. This organization encourages practices where local health professionals – the general practitioner and the family nurse – are the main actors in the support. Specialists in the palliative sector only intervene to help front-line professionals in difficulty or to enable them to accompany particularly complex situations. The decompartmentalization of health specialties and the meeting of palliative care with PHC brings here a gain in quality and meaning. However, this perspective on our care model also reveals certain shortcomings – mostly financial – and certain inadequate practices that jeopardize an organization that is nevertheless sustainable, up to the challenges of today and tomorrow.

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比利时综合姑息关怀的组织情况

在《阿斯塔纳宣言》（2018）中，世界卫生组织强调了加强卫生系统的紧迫性，以及初级卫生保健（PHC）模式在实现这一目标方面的相关性，包括在姑息关怀方面。根据初级医疗保健的原则，本文介绍并质疑比利时目前的姑息关怀组织：它们是否符合其主要标准，即关怀的全面性、可及性、可接受性、持久性和连续性？由于姑息关怀支持是在医疗金字塔的各个层面上提供的，因此基础--第一线--支持了其中的大部分。该组织鼓励当地的医疗专业人员--全科医生和家庭护士--成为支持的主要参与者。姑息治疗部门的专业人员只是在一线专业人员遇到困难时提供帮助，或使他们能够陪同处理特别复杂的情况。医疗专业的去部门化以及姑息关怀与初级保健的结合，在此带来了质量和意义上的提升。然而，从这个角度来审视我们的医疗模式，也会发现一些不足之处--主要是财务方面的不足--以及一些不恰当的做法，这些都会危及一个组织的可持续发展，使其无法应对当今和未来的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medecine Palliative HEALTH CARE SCIENCES & SERVICES-

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： La revue des soins palliatifs, des soins de support, de l''accompagnement et de l''éthique et pratique médicales. Un lieu d''information et de réflexion. Outil de transmission et d''échange des différents savoirs scientifiques, Médecine palliative vous permettra d''enrichir et d''élargir vos connaissances grâce à une approche globale, transversale et pluridisciplinaire.Les différents acteurs, professionnels ou non, impliqués dans la prise en charge palliative et continue ainsi que dans l''accompagnement et dans la réflexion éthique rendent compte de leurs travaux, de leurs expériences, de leur vécu, de leur dynamisme et de leur complémentarité.Un contenu scientifique riche dans sa diversité. Retrouvez une information variée : synthèses sur des sujets médicaux, publications d''études originales, rapports de pratiques, informations professionnelles, expériences partagées, analyses de presse, agenda...