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Summary. For the
first time ever the 2011 Federal order "On
fundamental healthcare principles in the Russian Federation"
institutionalized palliative care as one type of medical care to be provided to
the Russian population. Development of Federal guidelines for palliative care
delivery to children and adults is under way. Education is one of the three
fundamental pillars of the strategy aimed at successful development of
palliative care as a healthcare sector along with availability of drugs and
governmental policy on organization of services at all levels of care delivery.
The role of education becomes even more important in case of problems related
to workforce and organization of health care. The share of patients who died at
home in Nizhniy Novgorod region increased 1.5 times in 2006 and remains high
(73.68%). Patients diagnosed with malignant neoplasms mainly die at home
(82.96%). Therefore, the main specialists providing care to incurable patients
at the terminal stage are primary care physicians and general practitioners.
However, by large, those care providers lack training in palliative care. The
survey aimed at assessing knowledge in terminal-stage palliative care among
physicians showed that half of respondents have difficulties with providing
palliative care to patients at the terminal stage and assisting with decision
making; 98% of respondents noted that palliative care should be included in
professional training of doctors.
Education in
palliative care will be at issue at the top levels soon. Primary care
physicians and general practitioners should be trained in palliative care along
with specialists of specialized palliative care facilities. The article dwells
upon background of education in palliative care for doctors in Russia and
abroad; lists specific issues to be included in training programs in palliative
care.
Keywords. Palliative care;
education of doctors; incurable patients; patients with life-limiting diseases,
doctors' skills and knowledge in care delivery at terminal stage; death at
home.
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