RESUMO
Our medicalised modern cultures render reason and mystery mutually exclusive, define death by disease as failure, and dying as disgraceful. Providers and policymakers alike marginalize aging and dying individuals, formulating largely ineffective strategies without palliative care and pain relief budgets. The aim of palliative care is to support the person with incurable illness to live their remaining life as well and as meaningfully as possible and to support them as they eventually die from their illness and reaching the natural end of their lives It acknowledges that each life is morally significant, restoring patients' and families' quality of life where possible, and attending meticulously to the dying period as necessary (Saunders, 1965). Hospices are far more than mere buildings; they house an ethos of care. The field is currently challenged by its variable situation over the world and the pressing need to incorporate new technology to its practice. This article provides a review of some important milestones in the history and development of Palliative Care and evolution of Palliative Medicine in some countries, some current issues concerning consistency in its implementation, and some likely prospects for its future advance and expected expansion, from the perspective of one central question: "What constitutes the ethos of Palliative Care replicating its foundational philosophy and principles?" which helps to set the scene for possible future advances to integrate ethical, legal, and social implications. Technology will help expansion by facilitating communication and predicting needs.
RESUMO
En 2010 con el Plan Estratégico de Cuidados Paliativos nace La Red de Formación, integrada por profesionales de los distintos equipos específicos de Cuidados Paliativos. La formación es parte integral del desarrollo de los Cuidados Paliativos y ha de considerarse una prioridad para impulsar la excelencia de los servicios. Para abordar los Cuidados Paliativos, la formación debe alcanzar a un amplio colectivo de profesionales de distintas disciplinas (Medicina, Enfermería, Psicología Clínica, Trabajo Social, entre otros) y en diferentes niveles formativos, con la finalidad de dotarnos de profesionales «competentes» para resolver problemas complejos siguiendo los principios fundacionales de la Dra. Cicely Saunders. Para dar respuesta a esta necesidad, se requieren distintos niveles de formación, identificados como niveles básico, intermedio, avanzado y experto. Así pues, se ha ideado un plan de formación basado en cuatro escalones o niveles que se han de ir adquiriendo y superando hasta alcanzar el grado de experto. Nuestros objetivos principales desde la Coordinación Regional de la Comunidad de Madrid, son ofertar y promover una formación de calidad para todos los profesionales implicados en el cuidado de pacientes susceptibles de recibir Cuidados Paliativos así como definir las competencias y asegurar la capacitación en conocimientos, habilidades y actitudes de los distintos colectivos profesionales implicados. Al mismo tiempo, contribuir a la formación de las personas atendidas y de sus cuidadores para desarrollar su capacidad de autocuidado
Madrid Palliative Care Teaching and Training Network consists of professionals from specialist palliative care teams. It was created in 2010 within the Regional Strategic Plan of Palliative Care. Training is an integral part of the development of palliative care and must be given priority to promote the excellence of the services. When addressing palliative care, training must reach a wide range of professionals from various disciplines (including, among others, doctors, nurses, nursing assistants, psychologists, and social workers), as well as different training levels, with the aim of providing skilful and competent professionals able to respond to complex needs, following the Dame Cicely Saunders foundational principles. Different levels of training are required, which have been identified by us as basic, intermediate, advanced, and expert. Thus a training plan needs to be based on the four steps or levels that need to be completed until the expert level. The main goals of the Regional Coordination of Palliative Care are to offer and promote quality training for all the professionals involved in the care of patients with needs of varying degrees, as well as to define the competencies and ensure the training in knowledge, skills and attitudes of the various professional groups involved. At the same time, to contribute to the training of patients and carers in order to develop self-care abilities
Assuntos
Humanos , Medicina Paliativa/educação , Educação Médica/tendências , Espanha , Equipe de Assistência ao Paciente/tendências , Avaliação Educacional , Capacitação ProfissionalRESUMO
Objetivo: Establecer la validez de composición, contenido y criterios de un cuestionario de recursos para la provisión de servicios en Cuidados Paliativos (CP) a través de una metodología cualitativa, mediante grupos focales con profesionales de CP; en el marco de un proyecto de validación y evaluación de los resultados de un cuestionario de recursos para la provisión de servicios en (CP) en la Comunidad de Madrid (CM). Método: Se lleva a cabo un abordaje cualitativo para la validación del cuestionario de recursos. Se selecciona el grupo de discusión como técnica de elección para obtener un discurso en base a la experiencia personal de los profesionales implicados en el ámbito de los CP. Los grupos se componen de médicos, enfermeras, psicólogos, trabajadores sociales y agente de pastoral. Resultado: Los temas de discusión en los grupos fueron: dispersión geográfica de los recursos humanos, motivación laboral y personal, "ayuda psico-emocional" para profesionales, valoración integral y holística del paciente, equidad de los equipos, presupuesto social, apoyo al cuidador, ayuda entre equipos, sobrecarga laboral y humana, relación con la gerencia, futuro de los equipos: "estar quemados", trabajo en equipo, formación en CP, labor de enfermería en CP, protocolo de acogida en CP y aclaraciones terminológicas o conceptuales. Conclusiones: Este trabajo pretende ser el punto de partida para la elaboración y validación de un cuestionario en la provisión de servicios en CP, y así evaluar los recursos humanosy técnicos de nuestra red asistencial sanitaria paliativa
Objective: To establish the composition, content and criteria validity of a questionnaire of resources for services provision in Palliative Care (PC) through a qualitative methodology using focus groups with PC professionals. This is a part of a validation and evaluation research project for the provision of services (CP) in the Community of Madrid (CM). Methods: We performed a qualitative approach to the resource questionnaire validation. It was selected the focus group technique based on the personal experience of the professionals involved in PC. The groups were made up of physicians, nurses, psychologists, social workers and pastoral agent. Results: Discussion items in the groups were: human resources, geographical dispersion, work and personal motivation, "psycho-emotional" help for professionals, comprehensive and holistic patient approach, equipment equity, social budget, caregiver support , support between teams, overburden and human relationship with CEOs, future of teams: "be burned", team-working, teaching in PC, PC nursing work, PC welcome protocol and terminological and conceptual clarifications. Conclusions: This study tries to be the starting point for the development and validation of the PC provision of services questionnaire. It will be useful to assess the human and technical resources of our palliative health care network (AU)
