Онкопедиатрия. 2014; 1: 14-18
Приоритетные направления деятельности государственных и общественных организаций по улучшению ситуации с обезболиванием у детей
Аннотация
Актуальность. Контроль болевого синдрома — наиболее сложная проблема в детской паллиативной помощи в развитых и развивающихся странах, несмотря на то, что предпринято много шагов для улучшения ситуации с обезболиванием.
Целью исследования было выявление приоритетных направлений деятельности государства и общественных организаций в данной области.
Материалы и методы. Международная сеть детской паллиативной помощи (International Children’s Palliative Care Net, ICPCN) провела международное мультипрофессиональное исследование с помощью рабочей группы из 25 специалистов по паллиативной помощи детям из 15 стран путем онлайн-анкетирования 80 членов этой организации — представителей 32 стран.
Результаты. Повышение образования в области ведения болевого синдрома у детей признано наиболее приоритетным направлением.
Заключение. Выбор большинством респондентов такого направления, как образование и практические навыки, наиболее приоритетным видом деятельности может свидетельствовать о том, что проблема с компетенцией в области обезболивания у детей универсальна для развитых и развивающихся стран. Это требует разработки и внедрения программ обучения, подготовки преподавательского состава/тренеров для обучения медицинских специалистов и родителей. В России пробелы в знаниях у специалистов наряду с отсутствием необходимых наркотических лекарственных средств/форм и несовершенной «антиопиоидной» нормативно-правовой базой могут служить существенным барьером для адекватного обезболивания у детей.
Список литературы
1. Collins J., Frager G. Pain and Pain Relief in Pediatric Endof-Life Care. Bringing Pain Relief to Children: Treatment Approaches. Edited by: G.A. Finley, P.J. McGrath, C.T. Chambers. Humana Press Inc., Totowa, NJ. 2006. P. 59–82.
2. Taylor E., Kristina B., Campbell F. Pain in hospitalized children: A prospective cross- sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Res Manage. 2008; 13 (1): 25–32.
3. Kopf А. Guide to Pain Management in Low-Resource Settings. IASP. 2010. 359 р.
4. Devis M., Walsh D. Epidemiology of cancer pain and factors influencing poor pain control. American Journal of Hospice and Palliative Medicine. 2004; 21 (2): 137–142.
5. King S., Chambers C., Huguet A., MacNevin R., McGrath P., Parker L., MacDonald A. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. J Pain. 2011; 152: 2729–2738.
6. Breivik H., Cherny N., Collett B., Conno F., Filbet M., Foubert A., Cohen R., Dow L. Cancer- related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Annals of Oncology. 2009; 20: 1420–1433.
7. Walker S.M. Pain in children: recent advances and ongoing challenges. British Journal of Anaesthesia. 2008; 101 (1): 101–110.
8. Reid K.J. Review. Epidemiology of chronic non-cancer pain in Europe: narrative review of prevalence, pain treatments and pain impact. Current Medical Research Opinion. 2011; 27 (2): 449–462.
9. Stevens B. Pain assessment and intensity in hospitalized children in Canada. J Pain. 2012; 13 (9): 857–865.
10. WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. World Health Organization. 2012. ISBN 978 92 4 1548120.
11. Freeman G., Halton J. Note on an exact treatment of contingency, goodness of fit and other problems of significance. Biometrika. 1958; 38: 141–149.
12. Agresti A. Categorical Data Analysis. John Wiley Sons, New York. 2002. 250 p.
13. European Association of Palliative Care. Core competencies in palliative care: an EAPC White Paper on palliative care education, Part 1. European Journal of Palliative Care. 2013; 20 (2): 86–91.
14. European Association of Palliative Care. Core competencies in palliative care: an EAPC White Paper on palliative care education, Part 2. European Journal of Palliative Care. 2013; 20 (3): 140–145.
Oncopediatrics. 2014; 1: 14-18
Priorities of Governmental and Non-Governmental Organizations for Pain Management Improvement in Children
Abstract
Introduction. Pain management in children is a problem that is universal for developed and developing countries.
Material and Methods. International Children’s Palliative Care Network (ICPCN) performed an International Multiprofessional Study with taskforce team of 25 children’s palliative care professionals from 15 countries created on-line survey of 80 participants from 32 countries.
Results. According to the results of the survey, education and training of professionals and families was selected as a first priority to improve situation with pain control over the world.
Conclusion. By opinion of the most survey participants, improvement of pain control in children over the world can be achieved, first of all, with education and training of staff and development of the country-specified algorithms. In Russia, gap in knowledge may be a barrier for successful pain control additionally to the lack of necessary analgesics and strong anti-opioids rules
References
1. Collins J., Frager G. Pain and Pain Relief in Pediatric Endof-Life Care. Bringing Pain Relief to Children: Treatment Approaches. Edited by: G.A. Finley, P.J. McGrath, C.T. Chambers. Humana Press Inc., Totowa, NJ. 2006. P. 59–82.
2. Taylor E., Kristina B., Campbell F. Pain in hospitalized children: A prospective cross- sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Res Manage. 2008; 13 (1): 25–32.
3. Kopf A. Guide to Pain Management in Low-Resource Settings. IASP. 2010. 359 r.
4. Devis M., Walsh D. Epidemiology of cancer pain and factors influencing poor pain control. American Journal of Hospice and Palliative Medicine. 2004; 21 (2): 137–142.
5. King S., Chambers C., Huguet A., MacNevin R., McGrath P., Parker L., MacDonald A. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. J Pain. 2011; 152: 2729–2738.
6. Breivik H., Cherny N., Collett B., Conno F., Filbet M., Foubert A., Cohen R., Dow L. Cancer- related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Annals of Oncology. 2009; 20: 1420–1433.
7. Walker S.M. Pain in children: recent advances and ongoing challenges. British Journal of Anaesthesia. 2008; 101 (1): 101–110.
8. Reid K.J. Review. Epidemiology of chronic non-cancer pain in Europe: narrative review of prevalence, pain treatments and pain impact. Current Medical Research Opinion. 2011; 27 (2): 449–462.
9. Stevens B. Pain assessment and intensity in hospitalized children in Canada. J Pain. 2012; 13 (9): 857–865.
10. WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. World Health Organization. 2012. ISBN 978 92 4 1548120.
11. Freeman G., Halton J. Note on an exact treatment of contingency, goodness of fit and other problems of significance. Biometrika. 1958; 38: 141–149.
12. Agresti A. Categorical Data Analysis. John Wiley Sons, New York. 2002. 250 p.
13. European Association of Palliative Care. Core competencies in palliative care: an EAPC White Paper on palliative care education, Part 1. European Journal of Palliative Care. 2013; 20 (2): 86–91.
14. European Association of Palliative Care. Core competencies in palliative care: an EAPC White Paper on palliative care education, Part 2. European Journal of Palliative Care. 2013; 20 (3): 140–145.
