Risultati per: Linee guida pratiche sulle cure palliative

This Viewpoint considers whether medical assistance in dying should be included as a tenet of palliative care medicine.

This randomized, multisite, comparative effectiveness trial investigates whether early palliative care delivered via video or in-person visits demonstrated equivalent effects on quality of life for patients with advanced non–small cell lung cancer and their caregivers.

Palliative care is not new. It evolved in the 1960s and 1970s before many other medical specialties, such as medical oncology, emergency medicine, and critical care medicine. Although it would be unimaginable to conceive of hospitals, cancer centers, or universities without these 3 specialties, for palliative care, the road toward recognized specialty and adoption by organized medicine was much more difficult, at least in part because of its origins in community hospices and palliative care teams rather than major academic centers and its focus on care of the person rather than more traditional biomedical issues.

Coordina l’Università Cattolica, approccio ‘vedo e curo’

Objectives
Paramedics have the potential to make a substantial contribution to community-based palliative care provision. However, they are hindered by a lack of policy and institutional support, as well as targeted education and training. This study aimed to elicit paramedics’, palliative care doctors’ and nurses’, general practitioners’, residential aged care nurses’ and bereaved families and carers’ attitudes and perspectives on how palliative paramedicine can be improved to better suit the needs of community-based patients, their families and carers, and the clinicians involved in delivering the care.

Design
In this qualitative study underpinned by a social constructivist epistemology, semistructured interviews were conducted.

Setting and participants
50 participants with palliative paramedicine experience, from all jurisdictions of Australia. Participants were interviewed between November 2021 and April 2022.

Results
All participants suggested paramedics play an important adjunct role in the provision of palliative and end-of-life care in home-based settings. Three levels of opportunities for improvement were identified: macrolevel (policy and frameworks; funding and education; accessing medical records and a widening scope); mesolevel (service-level training; interprofessional understanding and communities of practice and community expectations) and microlevel (palliative care subspecialty; debriefing and self-care and partnering with families).

Conclusion
To enhance paramedic capacity to provide palliative care support, improvements targeting systems, services, communities and individuals should be made. This calls for stronger inclusion of paramedicine in interdisciplinary palliative care and greater investment in both the generalist and specialist palliative paramedicine workforce.

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