THE AVAILABILITY AND QUALITY OF PALLIATIVE AND HOSPICE CARE ENSURING IN THE COVID-19 PANDEMIC CONTEXT.

OBJECTIVE: The aim: To study the availability, quality and features of outpatient palliative and hospice care (PHC) to the population, including the elderly, in the COVID-19 pandemic context in order to optimize the PHC-mobile-teams service. PATIENTS AND METHODS: Materials and methods: Domestic and foreign literary sources; sociological research results. The research methods: biblio-semantic, sociological (questionnaires), systemic approach and systemic analysis, conventional medical-statistical methods. RESULTS: Results: Based on the analysis of international regulatory documents, domestic and foreign literary sources, the socio-medical importance of PHC is shown. In Ukraine, as in other countries, the number of elderly people is constantly growing, which leads to an increase in the PHC need. The results of the sociological survey determine: PHC needs in terms of age showed that in Ukraine almost 78.86% of people in need of PHC were aged 60 and over; the most popular (86.0% of responses) were PHC-mobile-teams and home-based services; about 80% of respondents said that pain limited their ability to work and affected on their psycho-emotional state and their quality of life; 86.3% of respondents reported an pain increased after COVID-19. The results of an online survey showed the effectiveness of PHC-mobile-teams service by improving the availability of PHC. CONCLUSION: Conclusions: To ensure high-quality PHC availability it should be integrated at the Health and Social Care Systems. According to the experience of the Kyiv PHC-mobile-teams service, it significantly increases PHC availability, which is especially important in the COVID-19 pandemic context.

Professional postgraduate training of family doctors - an important part and condition of the optimal paliative and hospise care system implementation in Ukraine.

OBJECTIVE: The aim: To substantiate measures of optimization of the system of postgraduate training of GPs-Family Doctors (GP-FDs) on providing palliative and hospice care (PHC) in outpatient settings. PATIENTS AND METHODS: Materials and methods: Regulatory documents of Ukraine and International Professional Organizations; domestic and foreign literary sources; official statistics data; results of sociological research. The research methods were used: biblio-semantic, sociological (questionnaires), systemic approach and systemic analysis, and conventional medicalstatistical methods. RESULTS: Results: Based on the analysis of regulatory documents, the socio-medical importance of PHC and the importance of GP-FDs on PHC are shown. The results of the sociological survey determine: the estimated needs for PHC in Ukraine; insufficient number of inpatient beds for palliative patients (PPs); the absence of a PHC-mobile-teams service, which necessitates the involvement of GP-FDs for PHC at home. The results of the survey indicate an insufficient level of knowledge and an urgent need for special PHC education of GP-FDs. CONCLUSION: Conclusions: Multidisciplinary professional training for GP-FDs is of great importance for creating a PHC System. This will allow GP-FDs, together with social workers, NGOs to provide comprehensive PHC to PPs and their families, including medical, psychological, social and spiritual components.