{"id":29596,"date":"2017-11-23T17:57:54","date_gmt":"2017-11-23T16:57:54","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29596"},"modified":"2017-11-23T18:03:22","modified_gmt":"2017-11-23T17:03:22","slug":"detska-paliativni-pece-je-temer-nedostupna","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29596","title":{"rendered":"D\u011btsk\u00e1 paliativn\u00ed p\u00e9\u010de je t\u00e9m\u011b\u0159 nedostupn\u00e1"},"content":{"rendered":"

Jakkoli bolestn\u00e9 t\u00e9ma to je, i d\u011bti um\u00edraj\u00ed a pot\u0159ebuj\u00ed paliativn\u00ed p\u00e9\u010di. V \u010cesk\u00e9 republice zdravotn\u00edci upozor\u0148uj\u00ed, \u017ee je t\u00e9m\u011b\u0159 nedostupn\u00e1, v \u0159ad\u011b region\u016f nen\u00ed nikdo, kdo by nevyl\u00e9\u010diteln\u011b nemocn\u00fdm d\u011btem a jejich rodin\u00e1m pomohl tr\u00e1vit posledn\u00ed spole\u010dn\u00e9 chv\u00edle v jejich p\u0159irozen\u00e9m prost\u0159ed\u00ed. <\/strong><\/p>\n

foto: MUDr. Irena Z\u00e1vadov\u00e1<\/p>\n

Rodiny s um\u00edraj\u00edc\u00edm d\u00edt\u011btem nav\u00edc pot\u0159ebuj\u00ed nejen zdravotn\u00ed, ale i psychickou podporu, proto\u017ee se kv\u016fli tabuizaci smrti d\u011bt\u00ed \u010dasto dost\u00e1vaj\u00ed do soci\u00e1ln\u00ed izolace. D\u011btsk\u00e1 paliativa nen\u00ed dostate\u010dn\u011b ukotvena v zdravotnictv\u00ed a problematick\u00e1 je i jej\u00ed \u00fahrada.<\/p>\n

Zat\u00edm u n\u00e1s nen\u00ed dostatek paliativn\u00edch t\u00fdm\u016f, kter\u00e9 by pacienty a jejich rodiny p\u0159ipravily na p\u0159ed\u00e1n\u00ed do dom\u00e1c\u00ed p\u00e9\u010de. \u201eOdborn\u00e9 vzd\u011bl\u00e1n\u00ed zdravotn\u00edk\u016f v paliativn\u00ed p\u00e9\u010di je minim\u00e1ln\u00ed, komunika\u010dn\u00ed schopnosti person\u00e1lu jsou limitov\u00e1ny vlastn\u00ed nejistotou z d\u016fvodu nedostate\u010dn\u00e9 p\u0159ipravenosti,\u201c uv\u00e1d\u00ed odborn\u00edci, kte\u0159\u00ed zdravotn\u00edky vzd\u011blan\u00e9 v paliativ\u011b postr\u00e1daj\u00ed nejen v nemocnic\u00edch, ale apeluj\u00ed i na nedostatek ter\u00e9nn\u00edch pracovn\u00edk\u016f a vy\u0161kolen\u00fdch praktick\u00fdch l\u00e9ka\u0159\u016f.<\/p>\n

V \u010cR existuje minimum m\u00edst, kde se postupy paliativn\u00ed p\u00e9\u010de vyu\u010duj\u00ed. Jedn\u00edm z nich je 1. l\u00e9ka\u0159sk\u00e1 fakulta Univerzity Karlovy. Garantem p\u0159edm\u011btu paliativn\u00ed medic\u00edna je odborn\u00fd asistent na Onkologick\u00e9 klinice 1. LF UK a VFN v Praze MUDr. Irena Z\u00e1vadov\u00e1. <\/strong>\u201e Hl\u00e1s\u00ed se n\u00e1m i studenti z jin\u00fdch fakult, ale t\u0159eba tak\u00e9 psychologov\u00e9,\u201c \u0159\u00edk\u00e1 MUDr. Irena Z\u00e1vadov\u00e1.<\/p>\n

\u201eKolegov\u00e9 l\u00e9ka\u0159i Kate\u0159ina Rusinov\u00e1 a Ond\u0159ej Kopeck\u00fd z Kliniky ARO VFN ve sv\u00e9 studii zji\u0161\u0165ovali \u00farove\u0148 poskytov\u00e1n\u00ed paliativn\u00ed p\u00e9\u010de u 1000 zem\u0159el\u00fdch pacient\u016f. P\u0159esto, \u017ee v\u011bt\u0161ina \u00famrt\u00ed byla o\u010dek\u00e1vateln\u00e1, do hospicov\u00e9 p\u00e9\u010de bylo p\u0159ed\u00e1no pouze 33 pacient\u016f, tedy 3 procenta z nich. V moment\u011b jejich \u00famrt\u00ed bylo p\u0159\u00edtomno pouze 10 procent rodin. Ze studie tak\u00e9 vyplynulo, \u017ee na p\u0159\u00e1n\u00ed pacienta se zdravotn\u00edci neptaj\u00ed a v\u010das nen\u00ed s pacientem ani rodinou probr\u00e1no vymezen\u00ed \u010di ukon\u010den\u00ed \u2013 tzv. limitace \u2013 terapie. Pouze p\u016fl procenta zem\u0159el\u00fdch sepsalo dokument tzv. d\u0159\u00edve vysloven\u00fdch p\u0159\u00e1n\u00ed,\u201c dopl\u0148uje MUDr. Irena Z\u00e1vadov\u00e1, kter\u00e1 je z\u00e1rove\u0148 prim\u00e1\u0159kou neziskov\u00e9 organizace Cesta dom\u016f. Ta je jedn\u00edm z poskytovatel\u016f d\u011btsk\u00e9 dom\u00e1c\u00ed paliativn\u00ed p\u00e9\u010de u n\u00e1s.<\/p>\n

studenti 1. LF UK nyn\u00ed p\u0159ipravili benefi\u010dn\u00ed kalend\u00e1\u0159 a v\u00fdt\u011b\u017eek z jeho prodeje pouk\u00e1\u017e\u00ed Cest\u011b dom\u016f pr\u00e1v\u011b na podporu d\u011btsk\u00e9 paliace.<\/p>\n

Kde um\u00edraj\u00ed \u010desk\u00e9 d\u011bti?<\/strong><\/p>\n

Paliativn\u00ed p\u00e9\u010de o d\u011btsk\u00e9 pacienty je v \u010cR t\u00e9m\u011b\u0159 nedostupn\u00e1. P\u0159itom by ji u n\u00e1s ro\u010dn\u011b pot\u0159ebovalo minim\u00e1ln\u011b 2000 d\u011bt\u00ed.<\/p>\n

\u201eD\u011bti \u010dasto cht\u011bj\u00ed b\u00fdt doma a tak\u00e9 rodiny obvykle cht\u011bj\u00ed m\u00edt d\u011bti v dob\u011b pr\u016fb\u011bhu onemocn\u011bn\u00ed a um\u00edr\u00e1n\u00ed v dom\u00e1c\u00edm prost\u0159ed\u00ed. Z na\u0161ich osobn\u00edch zku\u0161enost\u00ed vypl\u00fdv\u00e1, \u017ee podm\u00ednky, kter\u00e9 by rodin\u00e1m umo\u017enily m\u00edt d\u00edt\u011b v pr\u016fb\u011bhu onemocn\u011bn\u00ed a um\u00edr\u00e1n\u00ed v dom\u00e1c\u00ed p\u00e9\u010di, jsou nedosta\u010duj\u00edc\u00ed,\u201c \u0159\u00edk\u00e1 \u0159editel Centra paliativn\u00ed p\u00e9\u010de a v\u011bdeck\u00fd sekret\u00e1\u0159 \u010cesk\u00e9 spole\u010dnosti paliativn\u00ed medic\u00edny \u010cLS JEP PhDr. Martin Lou\u010dka, Ph.D.<\/p>\n

Dostupnost d\u011btsk\u00e9 paliativy u n\u00e1s st\u00e1le z\u00e1vis\u00ed na m\u00edst\u011b bydli\u0161t\u011b a na druhu onemocn\u011bn\u00ed d\u011bt\u00ed, pro ty s onkologick\u00fdm onemocn\u011bn\u00edm je alespo\u0148 \u010d\u00e1ste\u010dn\u011b dostupn\u00e1 z komplexn\u00edch onkologick\u00fdch center v Praze a Brn\u011b. Hor\u0161\u00ed je to u d\u011bt\u00ed v termin\u00e1ln\u00edm st\u00e1diu jin\u00fdch nemoc\u00ed, tam odborn\u00edci ud\u00e1vaj\u00ed \u201evelmi omezenou\u201c \u010di \u201enulovou\u201c dostupnost p\u00e9\u010de, kter\u00e1 nav\u00edc nen\u00ed systematicky hrazena ze zdravotn\u00edho poji\u0161t\u011bn\u00ed.<\/p>\n

Kdo a kde nyn\u00ed d\u011btskou paliativn\u00ed p\u00e9\u010di v \u010cR poskytuje?<\/p>\n

Cesta dom\u016f (dom\u00e1c\u00ed hospic) \u2013 Praha<\/p>\n

Mobiln\u00ed hospic Ondr\u00e1\u0161ek \u2013 Ostrava<\/p>\n

Nejste sami (mobiln\u00ed hospic) \u2013 Olomouc<\/p>\n

Mobiln\u00ed paliativn\u00ed t\u00fdm p\u0159i Klinice d\u011btsk\u00e9 onkologie FN Brno<\/p>\n

Mobiln\u00ed hospic p\u0159i Masarykov\u011b nemocnici v \u00dast\u00ed nad Labem, o. z.<\/p>\n

Obdob\u00ed z\u00e1rmutku a truchlen\u00ed<\/p>\n

\u2022 Podpora v obdob\u00ed z\u00e1rmutku a truchlen\u00ed je ned\u00edlnou sou\u010d\u00e1st\u00ed paliativn\u00ed p\u00e9\u010de. Ta mus\u00ed b\u00fdt zah\u00e1jena v okam\u017eiku stanoven\u00ed diagn\u00f3zy \u017eivot ohro\u017euj\u00edc\u00ed \u010di \u017eivot limituj\u00edc\u00ed nemoci a pokra\u010dovat v pr\u016fb\u011bhu nemoci i b\u011bhem \u00famrt\u00ed tak dlouho, jak je pot\u0159eba, a po smrti pak navazuje p\u00e9\u010de o poz\u016fstal\u00e9.<\/p>\n

\u2022 Tato pomoc mus\u00ed b\u00fdt k dispozici rodin\u011b, pe\u010dovatel\u016fm a dal\u0161\u00edm, kter\u00fdch se dotkne onemocn\u011bn\u00ed a \u00famrt\u00ed d\u00edt\u011bte.<\/p>\n

\u2022 sou\u010d\u00e1st\u00ed d\u011btsk\u00e9 paliativn\u00ed p\u00e9\u010de je podpora pro sourozence.<\/p>\n

Co se mus\u00ed zlep\u0161it<\/p>\n

Pracovn\u00ed skupina d\u011btsk\u00e9 paliativn\u00ed p\u00e9\u010de \u010cesk\u00e9 spole\u010dnosti paliativn\u00ed medic\u00edny chce nyn\u00ed v praxi zajistit jej\u00ed dostupnost v r\u00e1mci cel\u00e9 republiky. Aby byla paliativn\u00ed p\u00e9\u010de pro d\u011bti v jejich p\u0159irozen\u00e9m prost\u0159ed\u00ed dostupn\u00e1 ve v\u0161ech regionech, je d\u016fle\u017eit\u00e9 za\u010d\u00edt spolupracovat s fakultn\u00edmi i region\u00e1ln\u00edmi nemocnicemi, s praktick\u00fdmi pediatry a mobiln\u00edmi i kamenn\u00fdmi hospici. Pracovn\u00ed skupina se tak\u00e9 sna\u017e\u00ed o zaji\u0161t\u011bn\u00ed \u00fahradov\u00fdch mechanism\u016f t\u00e9to p\u00e9\u010de.<\/p>\n

Na nedostatek v oblasti financov\u00e1n\u00ed upozornili tak\u00e9 \u00fa\u010dastn\u00edci ned\u00e1vn\u00e9 diskuze v Sen\u00e1tu P\u010cR, a vyzvali proto ministerstvo zdravotnictv\u00ed (MZ), aby podpo\u0159ilo vznik syst\u00e9mu \u00fahrady paliativn\u00ed p\u00e9\u010de v l\u016f\u017ekov\u00fdch zdravotnick\u00fdch za\u0159\u00edzen\u00edch akutn\u00ed i n\u00e1sledn\u00e9 p\u00e9\u010de.
\nto zat\u00edm tak nevypad\u00e1. <\/p>\n","protected":false},"excerpt":{"rendered":"

Jakkoli bolestn\u00e9 t\u00e9ma to je, i d\u011bti um\u00edraj\u00ed a pot\u0159ebuj\u00ed paliativn\u00ed p\u00e9\u010di. V \u010cesk\u00e9 republice zdravotn\u00edci upozor\u0148uj\u00ed, \u017ee je t\u00e9m\u011b\u0159 nedostupn\u00e1, v \u0159ad\u011b region\u016f nen\u00ed […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29597,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-29596","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29596","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29596"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29596\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29597"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29596"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29596"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29596"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}