Palliatīvās aprūpes iespējas Latvijā un ģimenes ārstu loma

Abstract

Title: Possibilities of Palliative Care in Latvia and the Role of Family Doctors. Background: Palliative care is a great part of public health. Family practitioners hereby play an especially important role, providing primary care, particularly in more rural areas. Hence, it is crucial to assess the care situation in each country and find possible shortcom-ings of palliative care. Objectives: The objective of the study is to evaluate if all dimensions of palliative care, either physiological, psychosocial or spiritual needs are met in the Latvian Palliative care system and how satisfied both family doctors and patients are within it. Materials and Methods: The study collected data on Latvian palliative care using firstly, an online questionnaire (using soscisurvey) sent to all eligible family doctors in Latvia (n= 847) that disclosed their email address online and a second questionnaire for a randomly chosen sample of palliative care patients on the Palliative Care Unit of the Latvian Oncolo-gy Centre. Results: Of 847 family doctors, 32 GPs (3%) responded. In 91%, palliative care is provided by general practitioners. 62.5% of GPs agree that PC is a central part of their role. A total of 78% of GPs have not received special education in PC. 91% of GPs feel overwhelmed and uncomfortable by their PC work and a majority is dissatisfied with the availability of PC services for their patients. 20 palliative care patients were interviewed, of which all had can-cer. 70% of patients were satisfied with their care, while 50% feel they are not sufficiently respected and do not completely trust GPs. 40% of patients report to have no say in their care and treatment plan and on average, patients do not feel doctors are listening well. The management of symptoms is satisfactory to patients. Psychotherapy or pastoral coun-selling is only provided in 15%, additionally, spiritual or religious beliefs are only ad-dressed in 10% of cases. 60% of patients worry over the payment of care. Conclusion: Family doctors play an important part in the provision of PC with over half of doctors agreeing to it being a central part of their role. The overall satisfaction with care is good, however patients criticize a lack of self-determination and respect by doctors. Author: Emily Bärmann Supervisor: Dr. Ilze Aizsilniece