{"id":4792,"date":"2018-10-07T15:16:41","date_gmt":"2018-10-07T13:16:41","guid":{"rendered":"http:\/\/www.easistent.ro\/?p=4792"},"modified":"2024-08-06T13:00:23","modified_gmt":"2024-08-06T11:00:23","slug":"viitorul-ingrijirilor-paleative","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=4792","title":{"rendered":"Viitorul \u00eengrijirilor paleative"},"content":{"rendered":"<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ1.jpg\"><img class=\"alignleft size-medium wp-image-4780\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ1-300x200.jpg\" alt=\"paleativ1\" width=\"300\" height=\"200\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ1-300x200.jpg 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ1-405x270.jpg 405w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ1.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>\u00cen Rom\u00e2nia, speciali\u015ftii estimeaz\u0103 c\u0103 150 000 de persoane au nevoie, \u00een fiecare an, de \u00eengrijiri paleative. Vasta majoritate a acestora este, de fapt, \u00eengrijit\u0103 acas\u0103, de familii \u015fi apar\u0163in\u0103tori adu\u015fi de familii, unul dintre motivele principale fiind \u015fi dorin\u0163a pacien\u0163ilor de a muri acas\u0103. Ca urmare, domeniul \u00eengrijirilor paleative s-a dezvoltat mult mai \u00eencet \u00een Rom\u00e2nia dec\u00e2t \u00een alte \u0163\u0103ri.<\/p>\n<p>La nivel interna\u0163ional, \u00eengrijirile paleative \u015fi de sf\u00e2r\u015fit al vie\u0163ii (de tip \u201ehospice\u201d) au cunoscut o dezvoltare remarcabil\u0103 \u00eencep\u00e2nd cu anii 2000. \u015ei. totu\u015fi, \u00een ciuda acestui lucru, doar 10% din cererea actual\u0103 de \u00eengrijiri paleative poate fi satisfacut\u0103.<\/p>\n<p>\u00cengrijirile paleative reprezint\u0103 o abordare care \u00eembun\u0103t\u0103\u0163e\u015fte calitatea vie\u0163ii pacien\u0163ilor \u015fi a familiilor acestora, adres\u00e2nd problemele asociate cu bolile grave, prin prevenirea \u015fi ameliorarea suferin\u0163ei.<\/p>\n<p>Acest lucru implic\u0103 identificarea timpurie \u015fi evaluarea \u015fi tratarea durerii \u015fi a altor suferin\u0163e, fizice, psiho-sociale \u015fi spirituale.<\/p>\n<p>\u00cengrijirile paleative urm\u0103resc \u015fi s\u0103 ofere pacien\u0163ilor un sistem de sprijin pentru a \u00eei ajuta pe ace\u015ftia s\u0103 tr\u0103iasc\u0103 c\u00e2t mai activ posibil p\u00e2n\u0103 la moarte. De asemenea, ofer\u0103 familiei \u015fi \u00eengrijitorilor de acas\u0103 ai pacientului un sistem de sprijin pentru a gestiona boala acestuia \u015fi propria lor suferin\u0163\u0103.<\/p>\n<p>\u00cen \u00eengrijirile paleative, se pune accentul pe abordarea multidisciplinar\u0103 \u015fi de echip\u0103 pentru ca nevoile pacien\u0163ilor \u015fi familiilor lor s\u0103 poat\u0103 fi rezolvate holistic. \u00cengrijirile paleative nu numai c\u0103 \u00eembun\u0103t\u0103\u0163esc calitatea vie\u0163ii pacien\u0163ilor dar, \u00een anumite cazuri, pot chiar influen\u0163a cursul bolii.<\/p>\n<p>Se recomand\u0103 ca \u00eengrijirile paleative s\u0103 fie aplicate c\u00e2t mai repede, odat\u0103 ce procesul de management al bolii a \u00eenceput, \u00een conjugare cu alte terapii de prelungire a vie\u0163ii, precum chimioterapia sau radioterapia, \u00een cazul cancerului. Pentru determinarea \u00eengrijirilor paleative optime, speciali\u015ftii vor \u00eencepe prin administrarea acelor investiga\u0163ii care sunt necesare pentru \u00een\u0163elegerea mai bun\u0103 \u015fi gestionarea complica\u0163iilor clinice perturbatoare.<\/p>\n<p>At\u00e2t \u00eengrijirile paleative c\u00e2t \u015fi \u00eengrijirile de sf\u00e2r\u015fit al vie\u0163ii ofer\u0103 confort pacien\u0163ilor, dar cele dou\u0103 se deosebesc \u00een mod fundamental \u2013 \u00eengrijirile paleative pot \u00eencepe \u00een momentul diagnostic\u0103rii \u015fi se desf\u0103\u015foar\u0103 \u00een acela\u015fi timp cu tratamentul. \u00cengrijirile de sf\u00e2r\u015fit al vie\u0163ii \u00eencep c\u00e2nd tratamentul bolii este stopat \u015fi c\u00e2nd este evident c\u0103 pacientul nu va supravie\u0163ui bolii. De obicei, \u00eengrijirile de sf\u00e2r\u015fit al vie\u0163ii \u00eencep c\u00e2nd pacientul mai are de tr\u0103it cel mult 6 luni.<\/p>\n<p>\u00cen ceea ce prive\u0219te viitorul, acesta va fi marcat de o explozie a cererii pentru \u00eengrijirile paleative. Vorbim despre o propor\u0163ie \u00een cre\u015ftere a popula\u0163iei v\u00e2rstnice: popula\u0163ia global\u0103 \u00een v\u00e2rst\u0103 de peste 65 de ani va atinge aproape un miliard p\u00e2n\u0103 \u00een 2030, aproape dublu fa\u0163\u0103 de anul 2010, 12% din popula\u0163ia total\u0103 la nivel global \u015fi 24% \u00een Europa. Acest grup de v\u00e2rst\u0103 va avea comorbidit\u0103\u0163i combinate \u015fi de severit\u0103\u0163i diferite, va suferi de o inciden\u0163\u0103 crescut\u0103 a cancerului \u015fi a altor boli cronice cauzate de un stil de via\u0163\u0103 defectuos precum obezitatea, diabetul, hipertensiunea, bolile cardiovasculare. De asemenea, inciden\u0163a bolilor infec\u0163ioase cronice este \u015fi ea \u00een cre\u015ftere.<\/p>\n<p><a href=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ2.jpg\"><img class=\"alignleft size-medium wp-image-4781\" src=\"http:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ2-300x225.jpg\" alt=\"paleativ2\" width=\"300\" height=\"225\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ2-300x225.jpg 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ2-1024x768.jpg 1024w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2018\/11\/paleativ2-80x60.jpg 80w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>Astfel, domeniul \u00eengrijirilor paleative trebuie s\u0103 fie extins pentru a \u0163inti \u015fi alte boli cronice \u00een afar\u0103 de cancer, cele cu o povar\u0103 simptomatic\u0103 major\u0103. Pentru a preg\u0103ti domeniul pentru provoc\u0103rile viitorului, mai multe bariere actuale trebuie dep\u0103\u015fite prin eforturi constante \u00een formarea ini\u0163ial\u0103 \u015fi educa\u0163ia medical\u0103 continu\u0103 a profesioni\u015ftilor din s\u0103n\u0103tate, \u00een cercetare, \u00een dezvoltarea abord\u0103rii bazate pe dovezi, \u00een preg\u0103tirea de ghiduri \u015fi protocoale, \u00een accesibilitatea medicamentelor necesare \u015fi \u00eenfiin\u0163area de organisme na\u0163ionale \u015fi interna\u0163ionale pentru reglementarea domeniului, inclusiv din punct de vedere etic \u015fi al promov\u0103rii lor ca drept fundamental al omului, dreptul de a avea o via\u0163\u0103 demn\u0103 \u015fi o moarte demn\u0103. De asemenea, trebuie pus mai mult accentul pe sprijinirea familiilor \u015fi a apar\u0163in\u0103torilor, o component\u0103 mai degrab\u0103 mai pu\u0163in dezvoltat\u0103 p\u00e2n\u0103 acum.<\/p>\n<p>Dintre obiectivele pe care \u00eengrijirile paleative pot \u015fi trebuie s\u0103 le ating\u0103, putem enumera:<\/p>\n<ol>\n<li>Furnizarea de \u00eengrijiri paleative echitabile, optime din punct de vedere al costurilor \u015fi bazate pe dovezi c\u0103tre to\u0163i cei care au nevoie de ele, indiferent de diagnostic, prognoz\u0103 \u015fi localizare geografic\u0103.<\/li>\n<li>Promovarea \u00eengrijrilor paleative ca specialitate medical\u0103.<\/li>\n<li>Adoptarea unei abord\u0103ri cu adev\u0103rat multidisciplinare.<\/li>\n<li>Sprijin efectiv pentru familii \u015fi apar\u0163in\u0103tori.<\/li>\n<\/ol>\n<p>Este de importan\u0163\u0103 vital\u0103 s\u0103 angaj\u0103m \u015fi s\u0103 dezvolt\u0103m resursele necesare \u015fi s\u0103 preg\u0103tim mult mai mul\u021bi profesioni\u015fti \u00een domeniul \u00eengrijirilor paleative.\u00a0 Acest domeniu trebuie s\u0103 primeasc\u0103 un loc mai important \u00een curriculum-ul facult\u0103\u0163ilor de medicin\u0103 \u015fi \u00een portofoliul de educa\u0163ie medical\u0103 continu\u0103, precum \u015fi pe agenda dezbaterii publice.<\/p>\n<p>\u00cengrijirile paleative trebuie considerate complementare, \u015fi nu secundare, complementare, \u0219i nu alternative, fa\u0163\u0103 de \u00eengrijirile curative.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Mirela Musta\u021b\u0103, Redactor executiv eAsistent<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>Surse de documentare:<\/em><\/strong><\/p>\n<p><a href=\"http:\/\/www.who.int\/cancer\/palliative\/definition\/en\/\">http:\/\/www.who.int\/cancer\/palliative\/definition\/en\/<\/a><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4332140\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4332140\/<\/a><\/p>\n<p><a href=\"https:\/\/medlineplus.gov\/ency\/patientinstructions\/000536.htm\">https:\/\/medlineplus.gov\/ency\/patientinstructions\/000536.htm<\/a><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28823641\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28823641<\/a><\/p>\n<p><a href=\"https:\/\/www.jpsmjournal.com\/article\/S0885-3924(17)30384-6\/pdf\">https:\/\/www.jpsmjournal.com\/article\/S0885-3924(17)30384-6\/pdf<\/a><\/p>\n<p><a href=\"https:\/\/www.jpsmjournal.com\/article\/S0885-3924(17)30384-6\/pdf\">https:\/\/www.jpsmjournal.com\/article\/S0885-3924(17)30384-6\/pdf<\/a><\/p>\n<p><a href=\"http:\/\/goondiwindiplusmore.com.au\/help-shape-the-future-of-palliative-care\/\">Goondiwindi Plus More<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00cen Rom\u00e2nia, speciali\u015ftii estimeaz\u0103 c\u0103 150 000 de persoane au nevoie, \u00een fiecare an, de \u00eengrijiri paleative. Vasta majoritate a acestora este, de fapt, \u00eengrijit\u0103 acas\u0103, de familii \u015fi apar\u0163in\u0103tori adu\u015fi de familii, unul dintre motivele principale fiind \u015fi dorin\u0163a pacien\u0163ilor de a muri acas\u0103. Ca urmare, domeniul \u00eengrijirilor paleative s-a dezvoltat mult mai \u00eencet [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4780,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4792"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4792"}],"version-history":[{"count":1,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4792\/revisions"}],"predecessor-version":[{"id":4793,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/4792\/revisions\/4793"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/4780"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4792"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4792"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4792"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}