Jak se kde umírá – Žebříček zemí podle kvality paliativní péče

2015 Quality of Death Index Co je paliativní péče podle WHO?

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:

• provides relief from pain and other distressing symptoms;
• affirms life and regards dying as a normal process;
• intends neither to hasten or postpone death;
• integrates the psychological and spiritual aspects of patient care;
• offers a support system to help patients live as actively as possible until death;
• offers a support system to help the family cope during the patients illness and in their own bereavement;
• uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
• will enhance quality of life, and may also positively influence the course of illness;
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

Co mají společné země s vysokou úrovní paliativní péče?

Countries with a high quality of death share several characteristics.

The leading countries have the following elements in place:

• A strong and effectively implemented national palliative care policy framework;
• High levels of public spending on healthcare services;
• Extensive palliative care training resources for general and specialised medical workers;
• Generous subsidies to reduce the financial burden of palliative care on patients;
• Wide availability of opioid analgesics;
• Strong public awareness of palliative care

Česká republika je na 33. místě s 51,8 z celkových ideálních 100 bodů. Kromě Slovenska se ve všech sousedních státech umírá lépe. Slovensko je na 55. místě s 33,2 body. Pro ČR autoři diskuse říkají: Chybí jasná a dodržovaná strategie na úrovni státu (známka 4 z 5):

There is a government-led strategy for the development and promotion of national palliative care. However, it is merely a statement of broad intent. It does not contain a clear vision or specific milestones to achieve. There are no clear mechanisms in place to achieve the strategy.

Chybí dostatek personálu (známka 3):

There are specialised palliative care professionals but there are shortages of physicians, nurses and other support staff.

Existuje sice finanční podpora paliativní péče, ale je těžko dostupná a nehlídá se efektivita (známka 3):

There are adequate government subsidies or programmes for individuals accessing palliative care services. The qualification criteria are clear, but funds and programmes are difficult to access. The effectiveness of programmes is not monitored.

Opioidní léky proti bolesti jsou dobře dostupné (známka 1):

Freely available and accessible

Veřejnost má o paliativní péči málo informací (známka 4)

Public has a limited understanding and awareness of palliative care services. Little to no information on palliative care is available from government portals and community mechanisms.

Kompletní zpráva v PDF je zde.

Super, je na tom grafu krásně vidět, jak jsou nahoře především ekonomicky svobodné země. http://www.heritage.org/index/rankingJá osobně bych si vybral na stáří Chile. S českým důchodem si tam člověk žije lépe, je tam teplo a z jižní ameriky tam mají nejlepší zdravotnictví. Samozřejmě bejt trochu bohatší tak hrabu po Novým Zélandu nebo Austrálii :)

Diky za zajimavy clanek. Vlastne beru 2. linii chemie a jestli nezabere, tak uz mi zustane pouze palioativni leceni. Takze kluci, jestli Vas boli koule, nebo na nem nahmatate nake hrbolky, tak nevahejte a sup do urologa. Cas hraje proti nam.PS: Ahoj Martine, co Te vedlo ke zverejneni zrovna tohoto clanku?