Nuestros investigadores

Eduardo Garralda Domezain

Atlantes, Cuidados paliativos
Instituto Cultura y Sociedad (ICS). Universidad de Navarra
Líneas de investigación
Desarrollo de los cuidados paliativos en Europa
Índice H
5, (WoS, 21/03/2018)

Publicaciones científicas más recientes (desde 2010)

Autores: Arias, Natalia Sofía, (Autor de correspondencia); Garralda, Eduardo; De Lima, L. ; et al.
ISSN 1096-6218  Vol. 22  Nº 5  2019  págs. 580 - 590
Background: Indicators assessing national-level palliative care (PC) development used for cross-national comparison depict progress on this field. There is current interest on its inclusion in global monitoring frameworks. Objective: Identify and conceptualize those most frequently used for international PC development reporting. Design: Systematic review. Data Sources: PubMed, CINAHL, Google Scholar, and Google targeting national-level development indicators used for cross-national comparison. Additional search requesting experts' suggestions on key studies and "snow-balling" on reference section of all included studies. Identified indicators were listed and categorized in dimensions: services, use of medicines, policy, and education. Results: Fifty-four studies were included. Development has been evaluated using 480 different formulations of 165 indicators, 38 were highly reported. Thirty-two fell into proposed dimensions, 11 for use of medicines, 9 for policy, 7 for services, and 5 for education. Six into complementary dimensions: research, professional activity, and international cooperation. Six were the most frequently used indicators: number of PC services per population (40 reports), existence of PC national plan, strategy, or program (25), existence of palliative medicine specialization (22), availability and allocation of funds for PC (13), medical schools, including PC, in undergraduate curricula (13), and total use of opioids-morphine equivalents (11). Conclusion: There is a clear pattern for national-level PC development evaluation repeatedly using a small number of indicators. Indicators addressing generalistic provision, integration into health systems, and specific fields such as pediatric lack. This study invites international discussion on a global consensus on PC-development assessment.
Autores: Arias, Natalia Sofía, (Autor de correspondencia); Garralda, Eduardo; López-Fidalgo, J.; et al.
ISSN 0885-3924  Vol. 58  Nº 3  2019  págs. 445 - 453.e1
Context. International consensus on indicators is necessary to standardize the global assessment of palliative care (PC) development. Objectives. To identify the best indicators to assess current national-level PC development. Methods. Experts in PC development were invited to rate 45 indicators organized by domains of the World Health Organization Public Health Strategy in a two-round RAND/UCLA-modified Delphi process. In the first round, experts rated indicators by relevance, measurability, and feasibility (1-9). Ratings were used to calculate a global score (1-9). Indicators scoring >7 proceeded to the second round for fine-tuning of global scores. Median, confidence interval, Content Validity Index, and Disagreement Index were calculated. Indicators scoring a lower limit 95% confidence interval of >7 and a Content Validity Index of >= 0.30 were selected. Results. 24 experts representing five continents and several organizations completed the study. 25 indicators showed a high content validity and level of agreement. Policy indicators (n = 8) included the existence of designated staff in the National Ministry of Health and the inclusion of PC services in the basic health package and in the primary care level list of services. Education indicators (n = 4) focused on processes of official specialization for physicians, inclusion of teaching at the undergraduate level, and PC professorship. Use of medicines indicators (n = 4) consisted of opioid consumption, availability, and prescription requirements. Services indicators (n = 6) included number and type of services for adults and children. Additional indicators for professional activity (n = 3) were identified. Conclusion. The first list including 25 of the best indicators to evaluate PC development at a national level has been identified. (C) 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Autores: Noguera, Antonio Luís, (Autor de correspondencia); Robledano, R.; Garralda, Eduardo;
ISSN 1751-4258  Vol. 12  Nº 4  2018  págs. 495 - 503
Purpose of review The aim of this review is to understand how palliative care teaching (PCT) as a patient-centered learning model, influences medical undergraduate students' professional development. Recent findings To study PCT medical undergraduate students' learning experiences, we have employed the medical teaching concept, 'hidden curriculum,' as a way of describing attitudes and behavior conveyed implicitly by palliative care educators. Fifteen studies were selected: ten of those studies used a qualitative approach; two are theoretical explanations of the topic explored, one guideline, one review and just one quantitative study, made up the review. Medical undergraduate students reported that after PCT, they felt they had acquired better attitudes for effective integration with the patient, such as empathy or holistic care; ethical principles, such as respect or humanization of their clinical practice; and commitment to an improvement in competences, such as self-awareness or self-esteem. They also reported improved behavior in effective integration with patients, such as communication, caring for patients' families, and when addressing psychosocial, cultural and spiritual aspects; their commitment to improvement in competences, such as dealing with emotions and uncertainty; they learned team work as an effective way to interact within the health system; and to become more reliable, making themselves more available and dedicating enough time to each patient. Summary PCT seems to be an effective way of fostering medical undergraduate students' patient-centered professional development.
Autores: Centeno, Carlos; Sitte, T.; de-Lima, L.; et al.
ISSN 1096-6218  Vol. 21  Nº 10  2018  págs. 1389 - 1397
ackground: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC (PAL-LIFE group). Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development. Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented. Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world.
Autores: Rhee, J.; Garralda, Eduardo; Namisango, E.; et al.
ISSN 0885-3924  Vol. 55  Nº 5  2018  págs. 1313 - 1320
CONTEXT: Factors contributing to and impeding palliative care (PC) development in Africa can provide insights into current strategies for advancing PC. OBJECTIVES: To identify key factors affecting PC development in African countries from in-country PC experts' perspectives. METHODS: Sixteen PC experts from seven African countries undertook semi-structured interviews on PC development in their respective countries. An interpretive description approach was adopted, with data analyzed using constant comparison. RESULTS: Emerged themes included: drivers, strengths, challenges, and aspirations for PC development in Africa. Drivers included advocates and pioneering organizations, HIV/AIDS, culture of caregiving, and the World Health Assembly PC Resolution. Strengths included community health workers, the special role of nurses, diversity of services, and short training courses. Challenges included lack of PC education, lack of standardization in implementation, limited availability of and/or accessibility to morphine, poverty and disease burden, and lack of funding for PC. Aspirations included integration of PC, specialization in PC, nurse prescribing, and strong partnerships with Ministries of Health. Factors already highlighted in the literature were only briefly discussed. CONCLUSION: The key factors underpinning PC development in the seven countries contributed to the beginnings of PC in Africa, fueled by advocates that built on existing strengths to maximize opportunities
Autores: Rhee, J. Y., (Autor de correspondencia); Garralda, Eduardo; Namisango, E.; et al.
ISSN 1096-6218  Vol. 21  Nº 3  2018  págs. 342-353
Autores: Rhee, J. ; Garralda, Eduardo; Centeno, Carlos;
ISSN 1134-248X  Vol. 25  Nº 3  2018  págs. 119 - 120
Autores: Rhee, J. Y.; Garralda, Eduardo; Namisango, E.; et al.
ISSN 0885-3924  Vol. 56  Nº 2  2018  págs. 230 - 238
CONTEXT: To date, there is no study comparing palliative care (PC) development among African countries. OBJECTIVE: To analyze comparatively PC development in African countries based on region-specific indicators. METHODS: Data were obtained from the APCA Atlas of PC in Africa and a comparative analysis conducted. Nineteen indicators were developed and defined through qualitative interviews with African PC experts and a two-round modified Delphi consensus process with international experts on global PC indicators. Indicators were grouped by the WHO public health strategy for PC dimensions. These indicators were then sent as a survey to key informants in 52/54 African countries. Through an expert weighting process and ratings from the modified Delphi, weights were assigned to each indicator. RESULTS: Surveys were received from 89% (48/54) of African countries. The top three countries in overall PC development were, in order, Uganda, South Africa, and Kenya. Variability existed by dimension. The top three countries in specialized services were Uganda, South Africa, and Nigeria; in policies, it was Botswana followed by parity among Ethiopia, Rwanda, and Swaziland; in medicines, it was Swaziland, South Africa, then Malawi; in education, it was equivalent between Uganda and Kenya, then Ghana and Zambia. CONCLUSION: Uganda, South Africa, and Kenya are the highest performing countries and were the only ones with composite scores greater than 0.5 (50%). However, not one country universally supersedes all others across all four PC dimensions. The breakdown of rankings by dimension highlights where even high-performing African countries can focus their efforts to further PC development.
Autores: Noguera, Antonio Luís; Bolognesi, D.; Garralda, Eduardo; et al.
ISSN 1096-6218  Vol. 21  Nº 11  2018  págs. 1621 - 1626
Background: In Europe in recent decades, university teaching of palliative medicine (PM) has evolved. In some countries it has been introduced as a compulsory subject in all medical schools, but in a majority of countries it remains an isolated subject at few universities. Objective: To explore how PM has been introduced into the curricula and how it is currently being taught at different European universities. Method: Case study method using face-to-face semistructured interviews with experienced PM professors, comparing how they have developed PM undergraduate programs at their universities. Results: An intentional sample of eight university professors from Spain, France, UK, Italy, Hungary, Sweden, Germany, and Poland was chosen. The introduction of PM in the universities depends on the existence of a favorable social and political context in relation to palliative care and the initiative of pioneers, trusted by students, to push this education forward. A PM curriculum frequently starts as an optional subject and becomes mandatory in a short period. In the reported universities, PM uses a wide variety of teaching methods, such as lectures, workshops, role-plays, and discussions. PM assessment included tests, discussions, reflections, portfolios, and research works. According to respondents' opinions, lack of recognition, funding, and accredited teachers, along with competition from other curricula, are the main barriers for palliative medicine teaching development at universities. Conclusion: Diverse paths and tools have been identified for PM teaching in Europe. The described cases may shed light on other medical schools to develop PM curricula.
Autores: Centeno, Carlos; Sitte, T.; de Lima, L.; et al.
ISSN 1096-6218  Vol. 21  Nº 10  2018  págs. 1398-1407
Resumen Contexto: La Academia Pontificia de la Vida (PAV) es una institucion academica de la Santa Sede (Vaticano) cuyo objetivo es promover una vision catolica de la etica biomedica. La PAV invito a una serie de expertos en Cuidados Paliativos (CP) de todo el mundo, de todas las creencias, a desarrollar recomendaciones estrategicas para el desarrollo global de CP (Grupo PAL-LIFE). Diseno: Trece expertos internacionales reconocidos por su actividad promotora global de CP participaron en un estudio Delphi on-line. En un proceso de cuatro rondas, se pidio a los participantes que identificasen los grupos de interes o instituciones claves para la promocion de CP y que propusieran, para cada uno de ellos, recomendaciones estrategicas para el desarrollo de CP. Cada ronda incorporaba los comentarios de las rondas previas hasta lograr el consenso en las recomendaciones mas importantes. En una ultima fase, al grupo de expertos se le solicito la jerarquizacion por importancia de los grupos clave en una escala de 1 a 13. Tambien se solicitaron sugerencias concretas para la implementacion de las recomendaciones. Mediante analisis cluster se ordenaron los grupos de interes en dos niveles de importancia para el desarrollo de CP. Resultados: Trece recomendaciones fueron seleccionadas como las mas importantes (una por cada grupo clave). Las recomendaciones para los grupos mejor puntuados fueron: (1) Responsables Politicos: garantizar el acceso universal a los CP; (2) Academia: ofrecer cursos obligatorios de CP en el pregrado; (3) Profesionales sanitarios: promover una certificacion adecuada; (4) Hospitales e Instituciones sanitarias: asegurar el acceso a medicamentos de CP; y (5) Asociaciones de CP: ser promotoras eficaces y trabajar con los gobiernos en la implementacion de las recomendaciones internacionales sobre CP. Tambien se presentan recomendaciones para los ocho grupos clave restantes. Discusion: Este documento representa la posicion oficial de la PAV en lo que respecta a estrategias de promocion para el desarrollo de los CP en el mundo.
Autores: Rhee JY; Garralda, Eduardo; Torrado C; et al.
Vol. 18  Nº 9  2017  págs. e522-e531
Since the last comprehensive review on the development of national palliative care in Africa was undertaken 12 years ago, in 2005, we did a scoping review of peer-reviewed, published articles on palliative care development between 2005-16 for each African country. The scoping review was conducted by assessing the medical literature and including local expert recommendations of suggested articles. We did a basic quality assessment of the articles using the journals' impact factor, journal quartile, and the number of citations as suitable metrics for quality consideration. Articles published in English, Spanish, Portuguese, and French that mentioned at least one dimension of WHO's palliative care public health strategy (implementation of services, education, policies, or medicine availability) and vitality (activity by professionals or advocates) were included. Of the 518 articles found, 49 met the inclusion criteria. Information on 26 (48%) of 54 African countries was found. Most services were concentrated in Kenya, South Africa, and Uganda, and 14 (26%) countries showed an increase in services during this timeframe. Stand-alone palliative care policies exist in Malawi, Mozambique, Rwanda, Swaziland, Tanzania, and Zimbabwe. Postgraduate diplomas in palliative care are available in Kenya, South Africa, Uganda, and Tanzania. Restricted access to opioids, prescriber restriction laws, and a low prevalence of morphine use remain common barriers to adequate palliative care provision
Autores: Carrasco, JM; García, M.; Navas, Alejandro; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 12  Nº 10  2017  págs. e0184806
Introduction The goal of palliative care (PC) is to improve the quality of life of terminal stage patients and their families. The subject frequently appears in the mass-media and this helps create a socially accepted identity. The aim of this study is to describe and analyse PC related news items appeared in the Spanish written media. Methodology A descriptive cross-sectional study was designed. Considering diffusion, scope and the range in editorial policy criteria, four printed newspapers (PN) were selected, together with four exclusively digital media sources (DM). Through Mynews, a newspaper content depository, and the search tool for each DM website, articles published between 2009 and 2014 which included the terms "palliative care" and "palliative medicine" were sought. A questionnaire was created to characterise each article identified and a descriptive analysis was undertaken. Results A total of 627 articles were identified, of which 359 (57%) were published in PN (42% in the printed editions -PE- 16% in their online editions -OE-) and 268 (43%) in DM. In general, they appeared mainly in sections concerning Health (23%), Culture and Society (18%) and General/Home News (15%). In PE, just 2% were found in the Health section and nearly 70% in Culture and Society and General/Home News. Most of the articles were informative in nature and contained socio-political messages (90%). Statements by PC professionals were found in 35% of the articles and by politicians in 32%. The most frequent content was related to facing end of life (74%) and patient quality of life (70%). Conclusions The Spanish written media reflects the socio-political interest aroused by PC. Nevertheless, messages circulating about PC do not describe professional practice, or the contribution of the same for patients. Content more in line with the clinical practice might help contribute to the development of this new area of medicine.
Autores: Rhee, J. Y.; Garralda, Eduardo; Torrado, C.; et al.
ISSN 1096-6218  Vol. 20  Nº 12  2017  págs. 1372-77
Background: Palliative care (PC) research in Africa has been proposed as a fifth dimension of the World Health Organization PC Public Health Strategy. We conducted a scoping review of published articles (2005-2016) on palliative care development (PCD) in African countries. Forty-seven articles were found across 26 countries. Objective: To study whether the number of published articles on PCD in countries in Africa can be used as an indicator of PCD. Design: This is a secondary analysis of a completed scoping review. Measurements: Spearman correlations were applied to the number of published articles ("published articles") and the number of published articles with a coauthor from a high-income country (HIC) ("HIC published articles") with level of PCD using Lynch et al's updated world map (PC World Map) as a proxy. A subanalysis was undertaken for Anglophone versus non-Anglophone countries. Results: There were positive Spearman correlations (r) between the PC World Map's levels and published articles (r¿=¿0.73; p¿<¿0.001), and with HIC published articles (r¿=¿0.68; p¿<¿0.001). For Anglophone countries, the r was statistically significant (p¿<¿0.001) at 0.69 and 0.70, versus 0.58 and 0.45 for non-Anglophone countries for published articles and HIC published articles, respectively. Kruskal-Wallis test showed a statistically significant difference between Anglophone and non-Anglophone countries for both published articles and HIC published articles (p¿<¿0.01). Conclusion: Publish
Autores: Centeno, Carlos; Garralda, Eduardo; Carrasco, JM; et al.
ISSN 1096-6218  Vol. 22  Nº 11  2017  págs. 1195-1204
Results: In total, 48/53 (91%) European countries responded to the survey. A total of 43 barriers and 65 opportunities were identified as being related to PC integration. Main barriers were (1) lack of basic PC training, with a particular emphasis on the absence of teaching at the undergraduate level; (2) lack of official certification for professionals; (3) lack of coordination and continuity of care for users and providers; (4) lack of PC integration for noncancer patients; (5) absence of PC from countries¿ regulatory frameworks; and (6) unequal laws or regulations pertaining to PC within countries. Innovations in education and new regulatory frameworks were identified as main opportunities in some European countries, in addition to opportunities around the implementation of PC in home care, nursing home settings, and the earlier integration of PC into patients¿ continuum of care. With increasing provision of services, more challenges for the integration are detected ( p < 0.005).
Autores: Van Beck K; Siouta N; Preston N; et al.
ISSN 1472-684X  Vol. 15  Nº 1  2016  págs. 26
Overall, most of the identified guidelines/pathways highlighted the importance of the holistic approach of IPC. The studies that were found to fulfil at least 10/11 Emanuel's IPC criteria could serve as benchmarks of IPC.
Autores: Siouta N; Van Beck K; Preston N; et al.
ISSN 1472-684X  Vol. 15  Nº 1  2016  págs. 18
The results illustrate that there is a growing awareness for the importance of integrated PC in patients with advanced CHF or COPD. At the same time, however, they signal the need for the development of standardized strategies so that existing barriers are alleviated.
Autores: Siouta N; van Beek K; van der Eerden ME; et al.
ISSN 1472-684X  Vol. 15  Nº 1  2016  págs. 56
Based on our findings, a generic framework for integrated PC in cancer and chronic disease is proposed. This framework fosters integration of PC in the disease trajectory concurrently with treatment and identifies the importance of employing a PC-trained multidisciplinary team with a threefold focus: treatment, consulting and training.
Autores: Garralda, Eduardo; Hasselaar, J.; Carrasco, JM; et al.
ISSN 1472-684X  Vol. 15  Nº 1  2016  págs. 49
The results show that explications of IPC in the Spanish literature exist, but that there is insufficient evidence of its impact in clinical practice. This review may be of interest for Spanish-speaking countries and for others seeking to know the status of IPC in the literature in their home nations.
Autores: Woitha, Kathrin; Garralda, Eduardo; Martín-Moreno, J. M.; et al.
ISSN 0885-3924  Vol. 52  Nº 3  2016  págs. 370 - 377
The ranking method permitted a comparison of palliative care development between countries and shows changes over time. Recommendations for improving the ranking include improvements to the methodology and greater explanation of the levels and changes it reveals.
Autores: Aldridge, Melissa; Hasselaar, Jeroen; Garralda, Eduardo; et al.
ISSN 0269-2163  Vol. 30  Nº 2  2015  págs. 224-39
We describe the key policy and educational opportunities in the United States to address and potentially overcome the barriers to greater integration of palliative care into the healthcare of Americans with serious illness.
Autores: Centeno, Carlos; Lynch T.; Garralda, Eduardo; et al.
ISSN 0269-2163  Vol. 30  Nº 4  2015  págs. 251 - 262
Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.
Autores: Carrasco, JM; Lynch, T. J.; Garralda, Eduardo; et al.
ISSN 0885-3924  Vol. 50  Nº 4  2015  págs. 516 - 523.e2
CONTEXT: The lack of palliative medicine (PM) education has been identified as a barrier to the development of the discipline. A number of international institutions have called for its implementation within undergraduate medical curricula. OBJECTIVES: The objectives are to describe the situation of undergraduate PM education in Europe and to propose a scoring system to evaluate its status. METHODS: This descriptive study was conducted with data provided by key experts from countries of the World Health Organization European Region (n = 53). A numerical scoring system was developed through consensus techniques. RESULTS: Forty-three countries (81%) provided the requested information. In 13 countries (30%), a PM course is taught in all medical schools, being compulsory in six of them (14%). In 15 countries (35%), PM is taught in at least one university. In 14 countries (33%), PM is not taught within medical curricula. A full professor of PM was identified in 40% of countries. Three indicators were developed to construct a scale (rank 0-100) of educational development: 1) proportion of medical schools that teach PM (weight = 32%); 2) proportion of medical schools that offer PM as a compulsory subject (weight = 40%); 3) total number of PM professors (weight = 28%). The highest level of PM educational development was found in Israel, Norway, the U.K., Belgium, France, Austria, Germany, and Ireland. CONCLUSION: PM is taught in a substantial number of undergraduate medical programs at European universities, and a qualified teaching structure is emerging; however, there is a wide variation in the level of PM educational development between individual countries.
Autores: Woitha, Kathrin; Carrasco, JM; Clark, D.; et al.
ISSN 1101-1262  Vol. 26  Nº 2  2015  págs. 230 - 235
Background: With the goal of achieving greater unity and coherence, the Council of Europe developed a national palliative care (PC) policy framework-Recommendation (2003) 24. Although directed at member states, the policy spread to the wider World Health Organisation (WHO) European Region. This article aims to present the current situation relating to national PC health policies in European countries. Methods: A cross-sectional survey was conducted in 53 European countries of the WHO European Region. Relevant data reported (i) the existence of official documents concerning the provision of PC; (ii) the role of health departments and policymakers in the evaluation of PC provision and (iii) the availability of financial resources for PC provision. Results: In total, 46/53 (87%) EU and non-EU countries responded. PC legislation is established in 20 (71%) EU and nine (50%) non-EU countries. A total of 12 (43%) EU countries possess a PC plan or strategy in comparison with six (33%) non-EU countries. Individuals from Departments of Health and designated policymakers have established collaborative PC efforts. Quality systems have been initiated in 15 (54%) EU and four (22%) non-EU countries. Significant differences were not found in the reporting of payments for PC services between European regions. Conclusion: An improvement in national PC policy in both EU and non-EU countries was observed. Future priorities include potential initiatives to improve relationships with policymakers, establish quality control programmes and ensure financial support for PC.
Autores: Centeno, Carlos; Bolognesi, Deborah; Garralda, Eduardo; et al.
ISSN 1352-2779  Vol. 21  Nº 6  2014  págs. 306-308
Autores: Centeno, Carlos; Garralda, Eduardo;
Libro:  Integrated palliative care
2016  págs. 9 - 12
Autores: Centeno, Carlos; Carrasco, JM; Woitha, Kathrin; et al.
Libro:  Palliative care for older people. A public health perspective
2015  págs. 76 - 85
Autores: Arias-Casais, N.; Garralda, Eduardo; Rhee, J. Y.; et al.
Autores: Arias-Casais, N.; Garralda, Eduardo; López-Fidalgo, J.; et al.
List of national-level palliative care indicators providing a specific, evidence-based starting point on the development of palliative care, adding evidence to existence studies and allowing for replication. Furthermore, this allows for assessing national level progress and conducting comparative analysis and prospective studies. Tracking the indicators across time offers the opportunity to pool data data in a same repository that could be prospectively evaluated, allowing for trends in palliative care development at the international level.
Autores: Arias Casais, N.; Garralda, Eduardo; Rhee, J. Y.; et al.
Autores: Osman, H.; Rihan, A.; Garralda, Eduardo; et al.
This book aims to fill the gap in knowledge on the status of palliative care development in the Eastern Mediterranean region. It presents the most relevant information on palliative care development in a way that is clear, accessible, and easy to interpret for professionals, policymakers, and the general public. We explore the existence and availability of specialized palliative care services; the existence of a licensing process for physicians in the form of a specialty or sub-specialty; and the existence of educational initiatives within the field of palliative care in medical schools, nursing schools, or other settings. We also document the number of professors engaged in teaching palliative care in various disciplines; the existence of a policy umbrella insuring the proper implementation of palliative care services, such as a national law on palliative care, a national palliative care plan or strategy, or a concrete reference to palliative care in a national cancer control program; the existence of funding and coverage for palliative care; and the presence of evidence-based documents such as guidelines, recommendations, or clinical pathways. Data on the availability of strong opioids, as well as general data on consumption of opioids expressed in morphine equivalence are presented. Finally, existence of national palliative care organizations, and of individuals or larger groups devoted to research in palliative care are listed, as these are indications of vitality in the
Autores: Rhee, J. Y.; Luyirika, E.; Namisango, E.; et al.
The current APCA Atlas provides the most up-to-date information of palliative care development in nearly all countries in Africa, using indicators derived, rated, and chosen by in-country African experts followed by a thorough Delphi consensus process with a panel of international experts on palliative care indicators. Therefore, the current APCA Atlas also provides an up-to-date base of indicators specific to the African context, chosen by African experts. The Atlas offers a panoramic view utilising the World Health Organization¿s (WHO) palliative care public health strategy dimensions and palliative care professional activity (vitality) through a combination of methods including data collection from national experts in the field and peer-reviewed literature, ensuring data quality. These results provide the most comprehensive and reliable information on palliative care development, to date.