EAPC Atlas of Palliative Care in Europe 2019
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need. Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need.
Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
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PAEDIATRICS<br />
B<br />
KAZAKhsTAN<br />
In 2015 children with cancer were <strong>in</strong>cluded <strong>in</strong><br />
PC legislation as a special category <strong>of</strong> patients.<br />
Currently there are ongo<strong>in</strong>g efforts to support<br />
children and their families, provide pa<strong>in</strong><br />
management and end <strong>of</strong> life care for children.<br />
KyRGyZsTAN<br />
There is one Hospice for children supported by<br />
<strong>in</strong>ternational organisations.<br />
lATViA<br />
PPC is hospital-based. There are two programmes<br />
at the Children’s Cl<strong>in</strong>ical University<br />
Hospital - <strong>Palliative</strong> <strong>Care</strong> service and the Liepaja<br />
Regional Hospital. Both <strong>in</strong>stitutions also<br />
provide home care.<br />
liThUANiA<br />
Three programs provide PPC <strong>in</strong> hospitals. The<br />
paediatric <strong>in</strong>tensive care unit at the university<br />
hospital <strong>in</strong> Vilnius has four PPC beds. Two other<br />
PPC services are provided <strong>in</strong> the paediatric<br />
oncological cl<strong>in</strong>ics <strong>in</strong> Vilnius and Kaunas which<br />
<strong>in</strong>cluded <strong>in</strong>patient, outpatient and home nurs<strong>in</strong>g<br />
service. the first children’s hospice <strong>in</strong> the<br />
country is be<strong>in</strong>g built as part <strong>of</strong> an adult hospice<br />
complex <strong>in</strong> Vilnius.<br />
NoRWAy<br />
In Norway, PPC is the responsibility <strong>of</strong> the Paediatric<br />
hospital departments. Guidel<strong>in</strong>es for<br />
PPC were issued <strong>in</strong> 2016, organisational standards<br />
are currently be<strong>in</strong>g implemented. The<br />
build<strong>in</strong>g <strong>of</strong> one children’s hospice is planned<br />
to start <strong>in</strong> January 2020. This is the result <strong>of</strong> 10<br />
years <strong>of</strong> hard work, plann<strong>in</strong>g and lobby<strong>in</strong>g and<br />
will be a national pilot project for future developments<br />
<strong>in</strong> the field.<br />
sERbiA<br />
Few home palliative care teams are available<br />
both for adults and children. Coverage <strong>of</strong> children<br />
palliative care is limited, however efforts<br />
are underway to develop services with<strong>in</strong> the<br />
Republican Institute <strong>of</strong> Social Welfare. PPC is<br />
also provided <strong>in</strong> the University Childrens Hospital<br />
<strong>in</strong> Belgrade.<br />
lUXEmboURG<br />
National Paediatric Oncology and <strong>Palliative</strong><br />
<strong>Care</strong> Services are under construction s<strong>in</strong>ce<br />
2017.<br />
poRTUGAl<br />
As <strong>of</strong> January <strong>2019</strong> there are six <strong>of</strong>ficially<br />
recognized hospital support teams for PPC: 4<br />
public, a partnership between a public hospitals<br />
and PPC support teams and an NGO, Fundação<br />
do Gil, and one private team. Others<br />
are be<strong>in</strong>g developed across the country.<br />
sloVENiA<br />
All paediatric hospitals have paediatric PC hospital<br />
support teams.<br />
NEThERlANDs<br />
A special expertise-centre on PPC exist:<br />
Kenniscentrum K<strong>in</strong>derpalliatieve zorg<br />
https://www.k<strong>in</strong>derpalliatief.nl/. All university<br />
hospitals <strong>of</strong>fer a specific PPC services<br />
called K<strong>in</strong>der Comfort Teams. There<br />
are 45 day care programmes, mostly with<br />
nurs<strong>in</strong>g day-care services. Every child <strong>in</strong><br />
need <strong>of</strong> PC has a nurse at home. Additional<br />
services <strong>in</strong>clude respite care.<br />
molDoVA<br />
Potentially any home based palliative care<br />
team for adults can take care <strong>of</strong> a teenager.<br />
There is one NGO home based service for children,<br />
one NGO hospice for children, and one<br />
consultation team for children is available at<br />
the oncological hospital. They have recently<br />
received tra<strong>in</strong><strong>in</strong>g on PPC and plans for expansion<br />
<strong>of</strong> servcies are underway.<br />
spAiN<br />
Eight PPC programmes provid<strong>in</strong>g care for children<br />
and their families are availabale at home<br />
and hospital sett<strong>in</strong>gs. Efforts are be<strong>in</strong>g made<br />
to further develop services.<br />
sWiTZERlAND<br />
In recent years, some <strong>in</strong>dividual and hospital<br />
<strong>in</strong>itiatives have been directed towards the<br />
development <strong>of</strong> pr<strong>of</strong>essionals , to pr<strong>of</strong>essionalise<br />
the staff and services <strong>in</strong> paediatric palliative<br />
care. S<strong>in</strong>ce 2012 a PPC network <strong>in</strong> Switzerland<br />
exists, ma<strong>in</strong>ly composed <strong>of</strong> nurses.<br />
* Key notes were retrieved from key <strong>in</strong>formants’<br />
comments to the <strong>EAPC</strong> Survey on PPC. Only<br />
key notes <strong>of</strong> countries that commented are<br />
displayed. We are aware that many countries<br />
not <strong>in</strong>cluded <strong>in</strong> this section are also undertak<strong>in</strong>g<br />
remarkable efforts to improve PPC.<br />
UNiTED KiNGDom<br />
<strong>Care</strong> is home-centered with support from<br />
hospital-based oncology teams. The pediatric<br />
oncology outreach nurse specialist is<br />
responsible for liais<strong>in</strong>g between oncology<br />
centre, primary health care team and<br />
the family. Three charities are dedicated to<br />
provid<strong>in</strong>g children’s palliative care support<br />
at home. There are also two community<br />
children’s nurs<strong>in</strong>g teams, which provide<br />
non-specialist PC support for children with<br />
a range <strong>of</strong> complex health needs at home.<br />
many PPC programs are mixed. There are<br />
specialist PPC teams <strong>in</strong> many children’s<br />
hospitals, children’s hospice services and a<br />
range <strong>of</strong> community and home-based services,<br />
both charity and state-funded.<br />
ADDiTioNAl iNfoRmATioN<br />
Poland’s and <strong>Europe</strong>’s oldest children’s hospice<br />
is the Warsaw Hospice for Children. Romania<br />
has a PPC Programme called Hospice Casa<br />
Sperantei. Sweden has the first children’s hospice<br />
<strong>in</strong> Scand<strong>in</strong>avia. Hungary has established<br />
the Light <strong>of</strong> my Eyes Foundation which is seek<strong>in</strong>g<br />
to establish the first children’s hospice <strong>in</strong><br />
the country. Ukra<strong>in</strong>e is hold<strong>in</strong>g a third national<br />
forum on PPC.<br />
<strong>EAPC</strong> <strong>Atlas</strong> <strong>of</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>in</strong> <strong>Europe</strong><br />
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