Journal of pain and symptom management
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J Pain Symptom Manage · May 2007
ReviewBotucatu, Brazil: a regional community palliative care model.
The Pain Management and Palliative Care Service in the Department of Anesthesia at Botucatu Medical School, UNESP is a pioneer in Brazil. Based on an interdisciplinary team that provides specialized inpatient, ambulatory outpatient, and home care to patients in Botucatu and the surrounding region, the service is also able to provide extensive educational opportunities in pain management and palliative care for medical students, anesthesia residents, practicing anesthetists, and nurses.
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The quality of life of at least 100 million people would have improved--if today's knowledge of palliative care was accessible to everyone. A Public Health Strategy (PHS) offers the best approach for translating new knowledge and skills into evidence-based, cost-effective interventions that can reach everyone in the population. For PHSs to be effective, they must be incorporated by governments into all levels of their health care systems and owned by the community. ⋯ It included advice and guidelines to governments on priorities and how to implement both national palliative care programs and national cancer control programs where palliative care will be one of the four key pillars of comprehensive cancer control. The WHO PHS addresses 1) appropriate policies; 2) adequate drug availability; 3) education of policy makers, health care workers, and the public; and 4) implementation of palliative care services at all levels throughout the society. This approach has demonstrated that it provides an effective strategy for integrating/establishing palliative care into a country.
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In India, a million people with cancer and an unknown number of people with other incurable and disabling diseases, need opioids for pain relief. Only about 0.4% of the population in need have access to them. Major barriers to access to opioids are complicated regulations and problems related to attitude and knowledge regarding pain relief and opioids among professionals and the public. ⋯ Establishment of simple standard operating procedures to implement the simplified regulations, advocacy, and improved education of professionals are essential for further improvement of the situation. The past decade has demonstrated that government policy can be changed if palliative care enthusiasts work in tandem with the government. The progress has been slow, but real and encouraging.
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Palliative care has been present in Hungary since 1991. However, the development of palliative care policy has lagged behind clinical and educational activities. ⋯ This campaign stimulated growth and gave us the opportunity to begin a dialogue with policy makers on financing. The Open Society Institute's Palliative Care Policy Development Conferences held in 2004 and 2005 greatly assisted the change of palliative care financing and integration of palliative care into the Hungarian National Cancer Control Program.
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J Pain Symptom Manage · May 2007
Promoting the integration of quality palliative care: the South African Mentorship Program.
This article provides a brief outline of the HIV/AIDS situation in South Africa and the development of the Hospice Palliative Care Association (HPCA) as the background to an exploration of the changing face of palliative care in light of the demands of HIV/AIDS. It describes the South African Palliative Care Mentorship Program, including a description of the Integrated Community-Based Home Care (ICHC) model and its promotion of collaboration with the formal health care sector and other networking partners. The role mentorship played in its application to HPCA member hospices in response to the increasing demands of HIV/AIDS is outlined. ⋯ The key results of the promotion of the ICHC model and the effects of the mentorship program are highlighted, including possibilities for the expansion of the model beyond its original context in South Africa. The difficult issue of sustainability within an African context is also mentioned. In conclusion, there is a challenge to readers to explore the use of mentorship within their own palliative care settings.