国外缓和医疗的政策经验及启示
|
摘要
我国缓和医疗尚处于起步阶段,还需借鉴发达国家的发展经验。发达国家有着相对完善的政策体系,其将缓和医疗纳入医疗保健系统,制定相应的法律法规以确保缓和医疗的顺利开展。此外,非政府组织积极开展各种会议及活动以促进缓和医疗研究、专业发展并为其筹集基金。对美国、日本、澳大利亚、德国等国家的缓和医疗政策进行综述,以期为我国缓和医疗的发展提供参考并向其借鉴经验。
China's palliative care is still in its infancy, and we need to learn from the development experience of developed countries. Developed countries have relatively mature policy system, which incorporates palliative care into the health care system and formulates relevant laws and regulations to ensure the smooth development of palliative care. In addition, non-governmental organizations(NGOs) actively carry out conferences and activities to promote palliative care research, professional development and fund-raising. This article reviews the palliative care policies of the United States, Japan, Australia and Germany in order to provide reference and experience for the development of palliative care in China.
China's palliative care is still in its infancy, and we need to learn from the development experience of developed countries. Developed countries have relatively mature policy system, which incorporates palliative care into the health care system and formulates relevant laws and regulations to ensure the smooth development of palliative care. In addition, non-governmental organizations(NGOs) actively carry out conferences and activities to promote palliative care research, professional development and fund-raising. This article reviews the palliative care policies of the United States, Japan, Australia and Germany in order to provide reference and experience for the development of palliative care in China.
引文
[1] World Health Organization.WHO definition of palliative care[EB/OL].(2012-10-25)[2018-11-23].http://www.who.int/cancer/palliative/definition/en/.
[2] World Health Organization.World Health Statistics 2017:Monitoring health for the SDGs[EB/OL].(2017-05)[2018-11-23].https://apps.who.int/iris/bitstream/handle/10665/255336/9789241565486-eng.pdf;jsessionid=6BA8AF8C846ACDE621576DBA87941F4D?sequence=1.
[3] 国家卫生和计划生育委员会.对十二届全国人大五次会议第1356号建议的回复[EB/OL].(2017-12-21)[2018-11-13].http://www.nhfpc.gov.cn/zwgk/jianyi/201712/3a814f3f0ce8469d9719f246dee29e43.shtml.
[4] 郭巧红.国际视角下安宁疗护[J].医学研究与教育,2018,35(1):1-6.
[5] LYNCH T,CONNOR S,CLARK D.Mapping levels of palliative care development:A global update[J].J Pain Symptom Manage,2013,45(6):1094-1106.
[6] Center to Advance Palliative Care.Palliative care programs continue rapid growth in US hospitals:Becoming standard practice throughout the country[EB/OL].(2010-04-05)[2018-11-23].http://www.capc.org/news-and-events/releases/04-05-10.
[7] MORRISON R S.Models of palliative care delivery in the United States[J].Curr Opin Support Palliat Care,2013,7(2):201-206.
[8] GRUHLER H,KRUTKA A,LUETKE-STAHLMAN H,et al.Determining palliative care penetrationrates in the acute care setting[J].J Pain Symptom Manage,2018,55(2):226-235.
[9] 陈静,王笑蕾.安宁疗护的发展现状与思考[J].护理研究,2018,32(7):1004-1007.
[10] MEIER D E.Increased access to palliative care and hospice services:Opportunities to improve value in health care[J].Milbank Q,2011,89(3):343-80.
[11] National Quality Forum.A national framework and preferred practices for palliative and hospicecare quality[EB/OL].(2016-12)[2018-11-23].http://www.qualityforum.org/Publications/2006/12/A_National_Framework_and_Preferred_Practices_for_Palliative_and_Hospice_Care_Quality.aspx.
[12] 姜珊,宁晓红.日本、韩国、新加坡的缓和医疗和终末期照顾现状[J].实用老年医学,2018,32(1):13-16.
[13] AOYAMA M,MORITA T,KIZAWA Y,et al.The Japan Hospiceand Palliative Care Evaluation Study 3:Study Design,Characteristics of Participants and Participating Institutions,and Response Rates[J].Am J Hosp Palliat Care,2017,34(7):654-664.
[14] LEE C Y,KOMATSU H,ZHANG W,et al.Comparison of the hospice systems in the United States,Japan and Taiwan[J].Asian Nurs Res,2010,4(4):163-173.
[15] GORDON R,EAGAR K,CURROW D,et al.Current funding and financing issues in the Australian hospice and palliative care sector[J].J Pain Symptom Manage,2009,38(1):68.
[16] 陈晓琳.加拿大、澳大利亚、拉丁美洲缓和医疗概况[J].实用老年医学,2018,32(1):3-6.
[17] Commonwealth Department of Health and Aged Care.National Palliative Care Strategy:A National Framework for Palliative Care Service Development[EB/OL].[2018-11-23].http://elibrary.zdrave.net/document/Australia/natstrat.pdf.
[18] EAGAR K,WATTERS P,CURROW D C,et al.The Australian Palliative Care Outcomes Collaboration (PCOC):Measuring the quality and outcomes of palliative care on a routine basis[J].Aust Health Rev,2010,34(2):186-192.
[19] Palliative Care Australia.National Standards Assessment Program Canberra,Australian Capital Territory:2013[EB/OL].[2018-11-23].http://www.palliativecare.org.au/Policy/TheNationalStandards.aspx.
[20] Palliative Care Australia.National Standards Assessment Program Canberra,Palliative Care Australia:2012[EB/OL].[2018-11-23].http://www.palliativecare.org.au/Policy/TheNationalStandards.aspx.
[21] Australian Government,Department of Health.Living Longer,Living Better[EB/OL].[2018-11-23].http://webarchive.nla.gov.au/gov/20140802080607/http://www.health.gov.au/internet/main/publishing.nsf/Content/palliativecare-pubs-compac-guidelines.htm.
[22] Australian Government,Department of Health and Ageing.Guidelines for a Palliative Approach in Residential Aged Care:Enhanced Version[EB/OL].[2018-11-23].http://www.health.gov.au/internet/main/publishing.nsf/Content/palliativecare-pubs-workf-guide.htm.
[23] World Health Organization.The European Health Report 2012:Charting the Way to Well-being[R].Copenhagen:WHO Regional Office for Europe,2013.
[24] RADBRUCH L,BAUSEWEIN C,SIMON S T,et al.Europ ische Empfehlungen zur Palliativversorgungund Hospizarbeit und ihre Umsetzung in Deutschland[J].Zeitschrift Für Palliativmedizin,2011,12:175-183.
[25] KLAPPER B,KOJER M,SCHW?NKE U.Palliative Praxis-Ein Curriculum zur Begleitung alter Menschen am Ende des Lebens[M]//HELLER A,HEIMERL K,HUSEB? S.Wenn Nichts Mehr Zu Machen Ist,Ist Noch Viel Zu Tun Wie Alte Menschen Würdig Sterben K?nnen.Freiburg:Lambertus Verlag,2007:445-456.
[26] Kompetenzzentrum Pflegeunterstützung Berlin,Arbeitskreis-Arbeit mit Ehrenamtlichen in Niedrigschwelligen Betreuungsangeboten.Mustercurriculum für die Arbeit mit Ehrenamtlichen der Anerkannten Niedrigschwelligen Betreuungsangebote für Menschen mit Demenz in Berlin[EB/OL].[2018-11-23].http://www.pflegeunterstuetzung-berlin.de/uploads/media/Mustercurriculum_NsBA_Arbeit_mit_Ehrenamtlichen_Demenz_01.pdf.
[27] 北京松堂关怀医院.松堂简介[EB/OL].[2018-11-23].http://www.stghyy.com/do/alonepage.php?id=15.
[28] WU Y J,LI L Z,SU H,et al.Hospice and Palliative Care:Development and Challenges in China[J].Clin J Oncol Nurs,2016,20(1):E15-E19.
[29] 国家卫生和计划生育委员会.关于政协十二届全国委员会第五次会议第0387号(社会管理类040号)提案回复[EB/OL].(2018-01)[2018-11-23].http://www.nhc.gov.cn/zwgk/tian/201801/40d0a85623b2419390f667b0dbd8dc72.shtml.
[30] 桂欣钰,杨晶,杨丹,等.中国本土舒缓医学的发展现状和前景[J].医学与哲学,2016,37(12B):83-87.
[31] 张杰,彭琰,王治仁,等.中日两国医学院校医学专业老年临终关怀教育的比较[J].中国老年学杂志,2010,30(3):818-820.
[32] 周霜,王海容,程文玉,等.临终关怀立法现状及探索[J].医学与哲学,2017,38(6A):57-60.
[2] World Health Organization.World Health Statistics 2017:Monitoring health for the SDGs[EB/OL].(2017-05)[2018-11-23].https://apps.who.int/iris/bitstream/handle/10665/255336/9789241565486-eng.pdf;jsessionid=6BA8AF8C846ACDE621576DBA87941F4D?sequence=1.
[3] 国家卫生和计划生育委员会.对十二届全国人大五次会议第1356号建议的回复[EB/OL].(2017-12-21)[2018-11-13].http://www.nhfpc.gov.cn/zwgk/jianyi/201712/3a814f3f0ce8469d9719f246dee29e43.shtml.
[4] 郭巧红.国际视角下安宁疗护[J].医学研究与教育,2018,35(1):1-6.
[5] LYNCH T,CONNOR S,CLARK D.Mapping levels of palliative care development:A global update[J].J Pain Symptom Manage,2013,45(6):1094-1106.
[6] Center to Advance Palliative Care.Palliative care programs continue rapid growth in US hospitals:Becoming standard practice throughout the country[EB/OL].(2010-04-05)[2018-11-23].http://www.capc.org/news-and-events/releases/04-05-10.
[7] MORRISON R S.Models of palliative care delivery in the United States[J].Curr Opin Support Palliat Care,2013,7(2):201-206.
[8] GRUHLER H,KRUTKA A,LUETKE-STAHLMAN H,et al.Determining palliative care penetrationrates in the acute care setting[J].J Pain Symptom Manage,2018,55(2):226-235.
[9] 陈静,王笑蕾.安宁疗护的发展现状与思考[J].护理研究,2018,32(7):1004-1007.
[10] MEIER D E.Increased access to palliative care and hospice services:Opportunities to improve value in health care[J].Milbank Q,2011,89(3):343-80.
[11] National Quality Forum.A national framework and preferred practices for palliative and hospicecare quality[EB/OL].(2016-12)[2018-11-23].http://www.qualityforum.org/Publications/2006/12/A_National_Framework_and_Preferred_Practices_for_Palliative_and_Hospice_Care_Quality.aspx.
[12] 姜珊,宁晓红.日本、韩国、新加坡的缓和医疗和终末期照顾现状[J].实用老年医学,2018,32(1):13-16.
[13] AOYAMA M,MORITA T,KIZAWA Y,et al.The Japan Hospiceand Palliative Care Evaluation Study 3:Study Design,Characteristics of Participants and Participating Institutions,and Response Rates[J].Am J Hosp Palliat Care,2017,34(7):654-664.
[14] LEE C Y,KOMATSU H,ZHANG W,et al.Comparison of the hospice systems in the United States,Japan and Taiwan[J].Asian Nurs Res,2010,4(4):163-173.
[15] GORDON R,EAGAR K,CURROW D,et al.Current funding and financing issues in the Australian hospice and palliative care sector[J].J Pain Symptom Manage,2009,38(1):68.
[16] 陈晓琳.加拿大、澳大利亚、拉丁美洲缓和医疗概况[J].实用老年医学,2018,32(1):3-6.
[17] Commonwealth Department of Health and Aged Care.National Palliative Care Strategy:A National Framework for Palliative Care Service Development[EB/OL].[2018-11-23].http://elibrary.zdrave.net/document/Australia/natstrat.pdf.
[18] EAGAR K,WATTERS P,CURROW D C,et al.The Australian Palliative Care Outcomes Collaboration (PCOC):Measuring the quality and outcomes of palliative care on a routine basis[J].Aust Health Rev,2010,34(2):186-192.
[19] Palliative Care Australia.National Standards Assessment Program Canberra,Australian Capital Territory:2013[EB/OL].[2018-11-23].http://www.palliativecare.org.au/Policy/TheNationalStandards.aspx.
[20] Palliative Care Australia.National Standards Assessment Program Canberra,Palliative Care Australia:2012[EB/OL].[2018-11-23].http://www.palliativecare.org.au/Policy/TheNationalStandards.aspx.
[21] Australian Government,Department of Health.Living Longer,Living Better[EB/OL].[2018-11-23].http://webarchive.nla.gov.au/gov/20140802080607/http://www.health.gov.au/internet/main/publishing.nsf/Content/palliativecare-pubs-compac-guidelines.htm.
[22] Australian Government,Department of Health and Ageing.Guidelines for a Palliative Approach in Residential Aged Care:Enhanced Version[EB/OL].[2018-11-23].http://www.health.gov.au/internet/main/publishing.nsf/Content/palliativecare-pubs-workf-guide.htm.
[23] World Health Organization.The European Health Report 2012:Charting the Way to Well-being[R].Copenhagen:WHO Regional Office for Europe,2013.
[24] RADBRUCH L,BAUSEWEIN C,SIMON S T,et al.Europ ische Empfehlungen zur Palliativversorgungund Hospizarbeit und ihre Umsetzung in Deutschland[J].Zeitschrift Für Palliativmedizin,2011,12:175-183.
[25] KLAPPER B,KOJER M,SCHW?NKE U.Palliative Praxis-Ein Curriculum zur Begleitung alter Menschen am Ende des Lebens[M]//HELLER A,HEIMERL K,HUSEB? S.Wenn Nichts Mehr Zu Machen Ist,Ist Noch Viel Zu Tun Wie Alte Menschen Würdig Sterben K?nnen.Freiburg:Lambertus Verlag,2007:445-456.
[26] Kompetenzzentrum Pflegeunterstützung Berlin,Arbeitskreis-Arbeit mit Ehrenamtlichen in Niedrigschwelligen Betreuungsangeboten.Mustercurriculum für die Arbeit mit Ehrenamtlichen der Anerkannten Niedrigschwelligen Betreuungsangebote für Menschen mit Demenz in Berlin[EB/OL].[2018-11-23].http://www.pflegeunterstuetzung-berlin.de/uploads/media/Mustercurriculum_NsBA_Arbeit_mit_Ehrenamtlichen_Demenz_01.pdf.
[27] 北京松堂关怀医院.松堂简介[EB/OL].[2018-11-23].http://www.stghyy.com/do/alonepage.php?id=15.
[28] WU Y J,LI L Z,SU H,et al.Hospice and Palliative Care:Development and Challenges in China[J].Clin J Oncol Nurs,2016,20(1):E15-E19.
[29] 国家卫生和计划生育委员会.关于政协十二届全国委员会第五次会议第0387号(社会管理类040号)提案回复[EB/OL].(2018-01)[2018-11-23].http://www.nhc.gov.cn/zwgk/tian/201801/40d0a85623b2419390f667b0dbd8dc72.shtml.
[30] 桂欣钰,杨晶,杨丹,等.中国本土舒缓医学的发展现状和前景[J].医学与哲学,2016,37(12B):83-87.
[31] 张杰,彭琰,王治仁,等.中日两国医学院校医学专业老年临终关怀教育的比较[J].中国老年学杂志,2010,30(3):818-820.
[32] 周霜,王海容,程文玉,等.临终关怀立法现状及探索[J].医学与哲学,2017,38(6A):57-60.