WAYS TO OPTIMIZE THE PROVISION OF HOSPICE CARE IN UKRAINE AND THE ROLE OF THE NURSE IN IMPROVING THE QUALITY OF LIFE OF PALLIATIVE PATIENTS
DOI:
https://doi.org/10.11603/2411-1597.2024.1.14473Keywords:
quality of life, EQ-5D-5L, palliative care, hospice care, nurseAbstract
Introduction. Palliative care is designed to provide appropriate living conditions for patients in the final stages of their lives, to improve their quality of life, and to alleviate suffering. The development and functioning of palliative care indicates a high level of development in society, and the training of qualified palliative care nurses and their participation in a multidisciplinary team will provide comprehensive medical care for an incurable patient and improve their psychological stability. The analysis of the available regulatory and scientific literature shows the difficult situation of the industry in Ukraine, which is at the stage of organization and development, and the implementation of the main postulates of the Development Strategy has become difficult in the context of the military conflict.
The aim of the study – to analyze the provision of palliative care in Ukraine at the present stage and to propose ways to optimize it. To evaluate the quality of life of palliative patients and determine the nurse’s role in improving it.
The main part. In Ukraine, more than 600 thousand patients need palliative care annually. The progressive aging of the population due to medical advances and access to treatment contributes to the extension of life expectancy for patients with chronic diseases and leads to an increase in the number of patients who lose the ability to care for themselves and need outside help. According to the latest recommendations, the priority form of palliative care development is the provision of home-based medical and social care, which is not only as good as traditional inpatient treatment but also more effective, humane, and cost-effective. The model of a multidisciplinary palliative care team makes it possible to provide a patient with comprehensive medical and social support. As part of a multidisciplinary team, the role of a nurse, in addition to performing medical procedures, is to talk to relatives and teach them how to care for a patient with terminal cancer. One of the most common general questionnaires EQ-5D-5L (European Quality of Life Questionnaire) was used to study the quality of life. The study was conducted in 2023-2024 based on the Palliative and Hospice Care Department of the City Hospital No. 10 of the Zaporizhzhia City Council. A survey of 42 palliative care patients was conducted on the first day of admission to the hospital (group I, n 21) and after 10 days of stay in the palliative and hospice care unit (group II, n 21). The results of the study showed that all the items of the questionnaire (mobility, self-care, daily activities, pain, anxiety/depression) improved on day 14, and the «life thermometer» score doubled (from 32,64 to 41,71), indicating an improvement in the perception of their condition and the emergence of the ability to self-care, with a large role in this belonging to nursing care.
Conclusions. The article analyzes the situation of palliative and hospice care in Ukraine at the present stage and provides ways to improve it. The important role of a nurse in improving the quality of life of a palliative patient at the end of his or her life is determined.
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