サハラ以南のアフリカにおける緩和ケア
Richard Harding1, Irene J Higginson
1Department of Palliative Care and Policy, Guy's King's & St Thomas' School of Medicine, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9PJ, UK. Richard.harding@kcl.ac.uk
Lancet (London, England)
|June 7, 2005
まとめ
サハラ以南のアフリカの緩和医療は,HIVとがん患者にとって不可欠ですが,資源とアクセシビリティの課題に直面しています. コミュニティの能力,オピオイドの利用可能性,統合ケアフレームワークの改善は,質の高い終末期医療に不可欠です.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 緩和ケアとは,緩和ケアです.
- 腫瘍学 腫瘍学
- 感染症 感染症は感染症です.
背景:
- サハラ以南のアフリカにおけるHIVとがんの治療の質は,終末期医療を含む効果的な痛みと症状管理を必要とします.
- この地域における実現可能で,アクセスしやすく,効果的な緩和ケアサービスの開発は,大きな課題を提示しています.
- アフリカの既存の緩和ケアモデルは,資源密集的な要素を含んでおり,持続可能性については慎重に検討する必要があります.
研究 の 目的:
- サハラ以南のアフリカで実現可能で,アクセシブルで,効果的な緩和医療のコンポーネントを探求する.
- 緩和ケアサービスの開発と実施における課題と改善すべき分野を特定する.
- 既存の医療システムにおける緩和ケア統合を強化するための勧告を提供すること.
主な方法:
- サハラ以南のアフリカにおける既存の緩和医療の実践と課題のレビュー.
- 家庭およびコミュニティベースのケアモデルの分析とその限界.
- 資源の可用性,コミュニティの能力,オピオイドへのアクセスなどの主要な制約を特定する.
主要な成果:
- 家庭およびコミュニティベースの緩和ケアモデルは有望ですが,十分なコミュニティ能力と臨床監督が欠如しています.
- シンプルなレイクおよびプロフェッショナルプロトコルの開発が進行中ですが,オピオイドの利用可能性は依然として重要な障壁です.
- 成功の鍵となる分野は,コミュニティのニーズに対応すること,病気の経路全体に緩和ケアを統合すること,教育を強化すること,紹介システムを強化することです.
結論:
- サハラ以南のアフリカで緩和ケアを強化するには,コミュニティの能力,統合されたサービスフレームワーク,そしてオピオイドの利用可能性の向上への注意が必要です.
- 強化された教育,多様な紹介システム,提唱の強化,堅実な監査/品質評価は,持続可能で質の高い緩和ケアに不可欠です.
- 資源の限度に対処し,適切な臨床監督を確保することは,緩和ケアサービスの成功を収めるために極めて重要です.
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