ИНТЕГРАЦИЯ ПЕРВИЧНОЙ ПАЛЛИАТИВНОЙ МЕДИЦИНСКОЙ ПОМОЩИ И ДЕТСКОЙ ОНКОЛОГИЧЕСКОЙ СЛУЖБЫ С ИСПОЛЬЗОВАНИЕМ ВОЗМОЖНОСТЕЙ СТАЦИОНАРА КРАТКОВРЕМЕННОГО ЛЕЧЕНИЯ: ОПЫТ ОДНОГО ЦЕНТРА

Abstract

Objective of the study: to analyze children with various diagnoses of malignant neoplasms (MNs), who underwent treatment at the National Medical Research Center of Pediatric Hematology, Oncology, Immunology, recognized incurable due to the characteristics of the main disease, as well as determining the optimum approach in transferring the patient to the patronage of the palliative service in the place of residence. Materials and methods of research: the analysis included patients who were treated at the Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology from November 2018 to November 2020, – 116 patients aged 0 up to 18 years, who, in the course of their treatment, have been recognized incurable and discharged to the place of residence under the supervision of children's palliative services or left in the center for the severity of the condition. Results: the number of incurable patients at the National Medical Research Center of Pediatric Hematology, Oncology, Immunology for the period of the study was 116 (2,6%) out of 4,444 hospitalized. The majority – 99 (85%) of 116 patients – were discharged to their homes for palliative care. However, the algorithm developed at the center, which provides for the initial selection of the optimal palliative care regime in the hospital for short-term treatment, the assessment of risks of transport and its type (with or without medical personnel), made it possible to ensure safe transportation of all patients, as well as full control of symptoms during transportation. and at the first stages of the patient's stay at the place of residence. Subsequent palliative treatment of patients at the place of residence was also corrected, if necessary, with the participation of specialists of the center, either in person or by correspondence, which made it possible to provide adequate palliative therapy to all patients until the end of the need. Conclusion: early integration of primary palliative care into the activities of the Federal center providing specialized pediatric oncological care may be one of the successful models of interaction between pediatric oncology services and palliative care for children in the Russian Federation.