在拉丁美洲中等收入国家实施以医院为基础的临终关怀和丧亲关怀计划。在阴云密布的日子里,为人们带来光明和同情。

IF 2.5 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Ximena Garcia-Quintero, Eddy Carolina Pedraza, María Isabel Cuervo-Suarez, Isabel Correa, Justin N Baker, Michael J McNeil
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引用次数: 0

摘要

背景:儿童死亡是一个家庭可能面临的最具破坏性的事件之一,会导致严重的身体和心理疾病。为满足这一需求,高收入国家制定了丧亲支持计划。然而,在中低收入国家(LMIC)实施丧亲支持项目的情况却鲜为人知。在此,我们介绍了针对子女因癌症或其他灾难性疾病去世的父母实施丧亲计划的情况:我们进行了一项回顾性分析,描述了一项以医院为基础的生命末期(EoL)护理和丧亲计划的实施情况。该计划的制定分为几个阶段,包括丧亲家庭评估、制定计划指南、员工培训、计划试点、完善和标准化。该计划于 2019 年至 2021 年期间在哥伦比亚西南部的一家非营利性教学医院和转诊中心制定:作为丧亲计划的重要组成部分,开发了几种工具:虚拟丧亲课程;EoL和丧亲沟通与护理指南、记忆制作和后续电话;吊唁信模板和小组支持研讨会。共有 956 名医护人员接受了培训,向丧亲父母拨打了 258 个跟进电话,对有复杂悲伤情绪的父母进行了 150 次个别心理跟进,发送了 79 封吊唁信,并开展了 10 次支持小组工作坊。我们发现并克服了各种挑战,如有限的资源和工作人员,以及对死亡的文化观念。2021 年,该计划被医院评为 "医疗保健人性化最佳战略":本研究强调了在低收入和中等收入国家的医院中为父母和家人制定和实施 EoL 和丧亲关怀计划的可行性。缺乏资源、人员和培训是实施过程中面临的一些挑战。利用方法论工具,我们可以确定促进因素以及我们的 EoL 和丧亲关怀项目的可实现成果。该模式为资源有限的环境提供了一个宝贵的框架。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of a hospital-based end-of-life and bereavement care program in a latin American middle-income country. A source of light and compassion in the midst of cloudy times.

Background: The death of a child is one of the most devastating events a family can face, resulting in significant physical and psychosocial morbidity. Bereavement support programs have been developed in high-income contexts to address this need. However, little is known about implementing bereavement programs in low-and middle-income countries (LMICs). Here, we describe the implementation of a bereavement program for parents whose children died due to cancer or other catastrophic illnesses.

Methods: We conducted a retrospective analysis to describe the implementation of a hospital-based End of Life (EoL) care and bereavement program. This program was developed in several stages, including an assessment of bereaved families, development program guidelines, staff training, piloting of the program, refinement, and standardization. The program was developed between 2019 and 2021 in a nonprofit, teaching hospital and referral center for southwestern Colombia.

Results: Several tools were developed as key components of the bereavement program: a virtual bereavement course; guidance for EoL and bereavement communication and care, memory making, and follow-up calls; a condolence letter template, and group support workshops. A total of 956 healthcare professionals were trained, 258 follow-up calls to bereaved parents were made, 150 individual psychological follow-ups to parents with complicated grief occurred, 79 condolence letters were sent, and 10 support group workshops were carried out. Challenges were identified and overcome, such as limited resources and staff, and cultural perceptions of death. In 2021, this program received an award by the hospital as the Best Strategy to Humanize Healthcare.

Conclusions: This study highlights the feasibility of developing and implementing EoL and bereavement care programs for parents and families within hospitals in LMICs. Lack of resources, staff, and training are some of the identified challenges to implementation. Utilizing methodological tools allows us to identify facilitator factors and deliverable outcomes of our EoL and bereavement program. This model provides a valuable framework for resource-limited settings.

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来源期刊
BMC Palliative Care
BMC Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.60
自引率
9.70%
发文量
201
审稿时长
21 weeks
期刊介绍: BMC Palliative Care is an open access journal publishing original peer-reviewed research articles in the clinical, scientific, ethical and policy issues, local and international, regarding all aspects of hospice and palliative care for the dying and for those with profound suffering related to chronic illness.
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