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King Saud University for Health Sciences, National Guards health Affairs, Riyadh, Saudi Arabia
Received date: Februay 11, 2013; Accepted date: Februay 16, 2013; Published date: Februay 18, 2013
Citation: Jazieh AR (2013) Capacity Building in Palliative Care. J Palliative Care Med 3:138.doi: 10.4172/2165-7386.1000138
Copyright: © 2013 Jazieh AR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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As a new discipline of medicine, Palliative Care (PC) field is facing major challenges such as lack of awareness of Health Care Professionals (HCP) and the public about its value in minimizing sufferings and improving the quality of life of patients with various ailments. However, a major challenge for the dissemination of palliative care as a main stream discipline of health care is the serious shortage of qualified and well trained health care professionals and support staff . The structured programs to train PC professionals are young and scarce worldwide and the interest to pursue this sub-specialty is timid.
The shortage of qualified and well trained manpower is not limited to physicians but it involves all other health care professionals such as nurses, pharmacists, educators, psychologists, social workers and other members of multidisciplinary teams. Therefore, a systematic approach to build capacity in this field is direly needed. This overview may help those who are interested in addressing the important need at least to think about it in comprehensive and strategic way. The approach to build capacity should address the following categories: The targeted health care professions, required skills and knowledge, and the methods of education.
It is very important to keep in mind the following points about HCP involved in palliative care
1. It is critical for all health care professionals to understand the concept of palliative care as each health care professional’s deals with patients will encounter issues relevant to palliation and symptom management .
2. While PC education should start as early as possible in graduate school, it is not too late for practicing HCP to have specific education and training in their area of interest.
3. Subspecialists should assume their full responsibilities in contributing to the palliation of patients and not refusing interventions just because “patient is palliative”
All HCPs who are involved in patient care should have essential knowledge and skills in palliative care (Table 1).
|Requirements for all Health Care Professionals||Type of Health Care Professionals||Special Requirements|
|•Understanding the discipline
•Identifying symptoms and need for evaluations
•Recognizing the importance of multidisciplinary team
•Communications skills with patients (e.g. Breaking bad news) and other workers
•Self-preservation and burn-out recognition
|Students||•Getting acquainted with the discipline as early as possible
•Learn how to approach palliative care patients.
|All physicians||•Identifying symptoms
•Ability to manage common simple symptoms
|All sub-specialists||•In depth knowledge and expertise in symptoms management, palliation and counseling within specialty|
|Palliative Care Specialists||•In depth knowledge and expertise in various symptoms management, palliation and counseling.|
|Nurses||•Skills in various patient care techniques and procedures|
|Pharmacists||•Adequate knowledge about Pharmacological interventions|
|Social Workers||•Knowledge on how to involve the family, address needs and continuation of home care|
|Psychologists||•Knowledge of mental health role in palliative care
•Burnout management for family members and co-workers
|Educators||•Proper education and communication about relevant issues to palliative care|
Table 1: Requirements for palliative care training for different health care professionals.
The education in PC should start with the students to incorporate the principles of PC into their education and training. Physicians of all specialties should maintain adequate knowledge and skills of PC based on their area of expertise (Table 2).
|Physicians||Scope of care||Examples|
|General Physicians||General mild to moderate symptoms management||Mild to moderate pain management|
|Palliative Care Physicians||In depth and comprehensive care plans for the whole patient or for specific symptoms||End of life care Severe pain|
|Subspecialty Physicians (examples)||Anesthesia and pain service||Nerve block|
|Interventional Radiology||Stenting hollow organs, stenting SVC|
|Gastroenterologist||Management of gastrointestinal tract symptoms: severe constipation, nausea, vomiting, stenting obstructive organ|
|Pulmonary||Respiratory symptoms management such as shortness of breath and cough|
|Surgeon||Surgical intervention with palliative nature: fixing fracture, deflating colostomy|
Table 2: Examples of palliative care services based on scope of practice.
Multidisciplinary team members should also get educated in various aspects of PC based on their scope of service.
1. Incorporation of PC in the academic curricula of all HCP schools.
2. Incorporate the principles of PC in all residency and fellowship trainings.
3. Create more fully accredited PC fellowship programs to train experts in the fields.
4. Offer focused short duration tailored training about certain aspects of palliative care.
5. Develop train the trainers’ workshops to develop local expertise in capacity building.
6. Use remote education, remote consultation on line training to access available resources and expertise .
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