Care In Latvia Research Articles

Children’s Palliative Care in Latvia and its relation to improvement of Quality of Life of the families with incurably ill children

In Latvia’s health care sector children’s palliative care (PC) is comparatively new branch. There are relatively few scientific researches performed in PC by now. This can be explained by demographical and academic factors as well as by specific ethical problems. The Palliative Care Service at Children’s University Hospital is the only service of the kind in Latvia providing both – in-patient and home PC service for patients residing in Riga and Riga district. The service is not available to every child in all regions of Latvia. Hence, the main objective for the future would be establishing a high-quality, assessable children’s PC service system throughout the country. The specialists of the children’s PC team have launched an initial nation-wide research on quality of life of families with incurably ill children. The research on quality of life (QOL) in families with incurably ill children is essential in order to promote political decision-making in the government and in the private sector regarding health-care including development and improvement of children’s PC in Latvia. Results of the research on QOL of the families with incurably ill children will set base for improvement and perfection of service provided by PC team.

Economic evaluation as a decision-making tool in health care

For the assessment of the health care system efficiency result-oriented indicators should be exploited much more actively as without specific indicators oriented to the evaluation of the patient’s health outcomes it is impossible to acquire reasonable evidence for the effectiveness of the functioning of the health care system that has the decisive role for further decisions in the age of the evidence-based medicine. The main groups of the treatment results’ indicators are clinical, economic and patient-reported outcomes (PROs), and all these groups of outcomes should be considered to make the most objective economic evaluation. This research has been determined to investigate applying of PROs as a relatively new tool in evaluation of the health care in Latvia. The results of the scientific publications review show that the positive trend in using of the PROs in Latvia is observed, but the involvement of patients in treatment’ process assessment is not enough active yet. The relevant problems and possible suggestions for improvement of this process are discussed in the article.

PO26-TH-24 Experience of neuromuscular disease patients' care in Latvia

PO26-TH-24 Experience of neuromuscular disease patients' care in Latvia

Analysis of accessibility of pharmaceutical care in Latvia and obstacles of implementation of pharmaceutical care in Latvian pharmacies

Analysis of accessibility of pharmaceutical care in Latvia and obstacles of implementation of pharmaceutical care in Latvian pharmacies

Cross-infection prevention, basic hygiene practices and education within nursing and health care in Latvia: a Swedish–Latvian practice development project

The primary aim of this practice development project was to explore the level of knowledge of nursing and medical staff at the Infection Clinic at Liepaja regarding the spread of infectious diseases. Arrangements were also made for some of the Latvian health care staff to visit the Infection Clinic in Gothenburg to increase their knowledge about basic hygiene and to enable them to study the research in this area. Later we were able to formulate this new knowledge into written guidelines. The theoretical education started with questions regarding staffs expertise in preventing the spread of infections. Areas covered were handwashing, hand disinfection, use of disposable gloves and protective clothing. This revealed a need for development of both theoretical and practical knowledge in this area. However, hygiene practices improved after the theoretical education and the visits to the Infection Clinic in Gothenburg. On our return visit to Liepaja dispensers of liquid soap together with hand disinfectants were evident at every wash basin on the unit. Disposable gloves were also routinely used for the dressing of wounds and invasive procedures. Furthermore, disposable coats and masks were used when caring for highly infectious patients. The key cultural differences were the lack of nursing documentation and the relative absence of a dialogue directly between the nurse and the patient.

Perinatal deaths and insufficient antenatal care in Latvia.

A national audit on perinatal deaths was performed to assess the quality of antenatal care, and to suggest measures for improved antenatal care. Medical records of all the perinatal deaths in Latvia in the years 1995-1996 have been studied. Non-attenders and attenders of antenatal care were characterized by socio-economic and medical variables: maternal age, parity, history of perinatal outcome, health status and behavioral hazards during the index pregnancy, length of gestation and birth weight. The Nordic-Baltic perinatal death classification was used. In 85 of 442 cases (19%) of perinatal deaths women had not taken advantage of antenatal care provided for them. Non-attenders were more likely to be smokers (p<0.001) and alcohol abusers (p<0.005), above 35 years of age (p<0.005), and had higher parity (p<0.001). Non-attenders more often had systemic diseases and pregnancy complications. Neonatal complications, such as congenital syphilis (p<0.05) and other infections (p<0.05), were more common among non-attenders. There was no difference in rates of preterm birth and low birth weight between attenders and non-attenders. One fifth of mothers with perinatal death did not attend ANC, and in some women who attended ANC, lack of intervention was related to the perinatal death.

Perinatal deaths and insufficient antenatal care in Latvia

Perinatal deaths and insufficient antenatal care in Latvia

Average life span and health care in Latvia

Summary Questions around how best to improve health in Latvia will be central to the reorganization of the health care system. Health promotion aimed at changing personal behaviour that shortens the life span, such as excessive drinking, smoking and poor dietary habit, has not yet begun. Environmental problems have been made more visible by media publicity, but actual pollutants have diminished only marginally. The medical profession has gone through a prise de conscience but the tremendous shortages of equipment and medical drugs have led to a deterioration of medical care in a period of economic disorder. The total expenses in Latvia for health care were for a long time the lowest of all Soviet republics claiming 3.6% of the national budget in 1989 compared to an average of 4.1% in the USSR as a whole. In the United States over 12% of the GNP is devoted to health.47 Unfortunately, the comparative gaze of many Latvian doctors is to the United States. The level of their frustrations will no doubt rise considerably when they realize that, under circumstances of economic uncertainty and of competition with so many other needs, only marginal gains in financing will be possible. Under these conditions great strides could be made in upgrading health and extending average life span by concerted, well-planned educational campaigns and public policy which focus on health promotion and hygiene. The number of male smokers, for example, has decreased dramatically in Canada in the last two decades in large measure as a result of active publicity. In Latvia, not enough attention as yet has been paid to the relatively inexpensive prophylactic strategies for health improvement. At the same time unrealistic expectations are placed on the health benefits derived from sophisticated equipment and modern pharmaceutical drugs. To be sure, attention needs to be paid to both prevention and treatment but the former is much less costly and in the context of present day Latvia should receive far more attention. Improvement in health could be the catalyst that nudges people into a much more positive outlook on life, work and the future in general.