Vloga zdravnika družinske medicine pri paliativni obravnavi bolnika z rakom
Family doctor and his role in palliative care of cancer patients
AbstractRak poseže globoko v življenje obolelih in njihovih bližnjih. Paliativna oskrba pa je tista, ki zagotavlja optimalno funkcioniranje, počutje in socialno podporo bolniku in svojcem, ko ozdravitev ni več možna. Njena učinkovitost temelji na znanju in sodelovanju različnih strok. Poudarek je na kakovosti bolnikovega življenja. Med pokazatelji dobre kakovosti življenja je na prvem mestu malo hospitalnih dni v zadnjem obdobju življenja in paliativna oskrba na domu. Možnost in kakovost oskrbe na domu je odvisna od zdravnika družinske medicine in njegovih sodelavcev, ki pravočasno prepoznajo in učinkovito ublažijo vsak simptom in ugotovijo, ali so vse bolnikove potrebe zadovoljene. Pri tem je nenadomestljiva vloga družine. Nepogrešljive iztočnice za vse, ki so vključeni v oskrbo, so čas, sodelovanje, spoštovanje, potrpljenje, odprtost. Ob koncu paliativne oskrbe pa je pomembno, da prepoznamo tudi umiranje in spoštujemo smrt. Paliativna oskrba bo človekova pravica samo takrat, ko bo prepoznavni, sestavni del obveznega zdravstvenega varstva in ko bo vključena v obvezne izobraževalne programe zdravstvenih delavcev. Sicer pa bo ostala, kot je sedaj, odvisna od prizadevanja posameznikov in dostopna le majhnemu številu obolelih.
Abstract (Eng)Cancer may intrude deeply into the lives of cancer patients and their families. Palliative care is the care for patients which aims to optimize the comfort, function and social support of the patient and their family when cure is not possible The efficiency of palliative care is based on knowledge and teamwork of the experts of several disciplines. Palliative care principally aims at assuring quality of life to the patient. Indicators of high quality of life are only a few hospitalizations in the terminal period of life and palliative care at home. Possibilities to assure high quality home care depend primarily on family doctor and his partners in the team who should be skilled enough to recognize and alleviate efficiently in time every early symptom as well as to make sure that all the needs and wants of the patient are fulfilled. In palliative care, the role of the patient's family is vital, and the qualities that are indispensable in palliative care are time, team work respect, patience, sincerity, and awareness and respect of approaching death. Palliative care will be recognized as a human right only after it is acknowledged as a part of compulsory health insurance and also after it is included in the curriculum of compulsory education of health care professionals. Without fulfilling the above conditions the status of palliative care will be as it is now - a discipline, dependant on the endeavors and aspirations of few individuals and accessible to a few number of patients.
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