Supportive and Palliative Care
During the comprehensive control stages of cancer, there is more room for supportive and palliative care than other services. Many patients, despite spending much on treatment do not recover completely due to mental and psychological problems, or after the progression of the disease and the discontinuation of treatment, go through the end-of-life stages without receiving supportive care, with great pain and suffering, facing the limited capacity of the public hospitals and significant costs of the private hospitals, and lack of home care, and therefore experience the most complex emotional, social, livelihood, mental and psychological conditions.
Palliative care refers to care that, from the time of diagnosis, leads to a reduction in the patient’s physical and mental suffering, and the complications of the treatment, with the aim of improving the quality of life with the help of the patient and his family, and to increase the satisfaction of patients and their families. This care integrates fully with the treatment process and, through coordination between the specialists and the care team, provides multidisciplinary services in the management and control of physical illnesses such as pain, nausea and vomiting, respiratory problems, appetite loss, intestinal and bladder problems, constipation, wounds, as well as trying to solve emotional, mental, cultural, social, spiritual, occupational, and family problems of the patient’s. Simultaneous attention to the education, counseling, support, and care of the patient’s family to manage the optimal process of the disease is a hallmark of these services, which prevents the patient and his/ her family from causing serious psychological, social and economic harm.
PALLIATIVE CARE IMPORTANCE
In supportive and palliative care, one of the most important goals is to reduce pain and illness in the patient. The pain might be physical, mental, or even spiritual. For The Care Team, there is no different between a painful body, mind or thought. The members of The Care Team, relying on a variety of specializations, are trying to eliminate any kind of annoyance of the patient and his relatives.
The importance of supportive and palliative care from a human rights perspective
The World Health Organization (WHO) believes that supportive and palliative care should be a priority in public health and disease management. Countries should ensure, with their available resources, that they take all the steps necessary to implement this plan, with a proper policy and a comprehensive plan for the implementation of these services. As part of this commitment, countries must take steps to protect people from unnecessary health-related pain and failing to prioritize the development of palliative medicine services among health care providers will be a violation of human rights.
The need to provide supportive and palliative care from the point of view of public satisfaction
Satisfaction of people is one of the five main goals of the health system in the world. According to Higginson et al., over 90% of patients with fatal illnesses are eager to have a slow death in an environment similar to their home situation. However, even in developed countries, only 30% to 20% of patients die at home. Although reliable information is not available from Iran, it is predictable that many such patients will be admitted to hospitals for special care and will die in these hospitals. Death at home is not the only wish of patients with severe illness. The need for these patients to support, calm and relieve them to cope with their illness is far more than their need for treatment. The supportive care system has been created with such a purpose.
The need for supportive care and relief from the perspective of reducing health costs
In the absence of centers for supportive and palliative medicine and the home care network, patients with serious illnesses will go to various centers of the health system, especially to the specialized ones, to meet their basic needs, and are admitted in the emergency or ICU sections of the hospitals for hours and days to get rid of symptoms. Costly tests are imposed on these patients and in some cases, unnecessary therapeutic measures are taken. This, in addition to imposing great suffering on the patient and his family, costs too much for the health system of the country. Unofficial statistics show that currently, more than 32% of cancer patients in Iran occupy the capacity of the ICU sectors. The limited capacity of hospitals, especially in the ICU sector, should be optimally allocated to priority patients, and the occupancy of this capacity by cancer patients in the final stages of the disease that are not scientifically expected to improve, in addition to imposing heavy costs to the patient and the health system, limits the possibility of providing services to other patients.
The need to consolidate and formulate a management model for providing supportive and palliative care centers
The 2006 International Monitoring Service on End-of-Life Care has reviewed the status of palliative care in 234 countries and is categorized into four categories:
Group 1: No known activity
Group Two: Capacity building for palliative care
Group Three: Provide palliative care in some areas
Group Four: Integration and Care Integration Approach
In this report, Iran is in the second group. In the report of 2011, the institute has promoted the status of Iran to Group 3. Currently, few palliative care centers in Iran operate locally, and the lack of an integrated management system and standardization of structures, operational processes, and educational protocols for supportive and supportive medicine are evident as a necessity. The present research is an attempt to promote dear Iran to the highest level of provision of relief and relief medicine in the future reports of the International End-of-Life Care Surveillance Authority.
