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[en] In this work we would like to describe the role of palliative medicine in the organizational frame of oncological care in Slovakia. Basic statistic data are revealing that number of beds in palliative medicine and hospices is shaped rather coincidently according to the reimbursement rates and the effort to reduce a number of chronic beds. Further on we would like to point out a distinction between palliative treatments of cancer and palliative medicine, a distinction between social care and hospice care, the role and relevance of palliative medicine and we bring about some suggestions how to improve the present situation. (author)
Journal
Onkologia (Bratislava); ISSN 1336-8176; 
; v. 7(4); p. 220-222
; v. 7(4); p. 220-222
[en] Climate change adaptation is increasingly concerned with how organisations develop capacity to adapt to uncertain futures. A participatory action research project conducted in Victoria, Australia, examined how health and social service organisations developed their organisational adaptive capacity through the use of adaptation decision-support tools. It can be challenging for any organisation to select and apply a decision-support tool, but this is particularly the case where resources and capacities are limited. For most organisations, climate change is only one of a complex set of dynamic stressors they must consider in meeting organisational goals. This paper shows that while decision-support tools can help co-generate knowledge and facilitate customised organisational adaptation processes, for them to be practically helpful for organisations with limited resources and capacities, intensive collaborative and discursive processes are needed to adjust such tools to fit specific organisational contexts and needs. Facilitators and participatory approaches that enable co-inquiry can play a critical role in supplementing scarce resources and initiating adaptation processes that go well beyond the scope and purpose of the decision-support tool used. Organisations working effectively with decision-support tools to adapt to climate change will need to feel ownership of them and have confidence in modifying them to suit their particular adaptation needs and organisational goals.
Journal
[en] Demographic changes will lead to increasing numbers of older people with cancer. The survival rate for people of older age is also increasing, which represents a great challenge for the healthcare system. Rehabilitation as a part of this system has an important role in supporting and securing social integration and participation. Older patients have special needs and goals concerning physical, psychological and social aspects. Often patients do not reveal psychological and social problems or they are not recognized by the treating physician who does not take the right steps to recommend and prescribe an oncological rehabilitation, which can take care of these special needs. Oncological rehabilitation helps people to cope with cancer and its various consequences, which can have enormous negative and often lasting effects on the ability to deal with day to day challenges. Whereas younger patients particularly focus on occupational reintegration, retired patients need long-term support in securing their autonomy and ability to lead an active and satisfying life for as long as possible. Rehabilitation also deals with the possible psychological impact cancer can have and thus helps avoid chronification or the development of a mental disorder. The social services are concerned with people suffering from adverse living conditions, financial problems or problems of social integration, which can affect older people in particular ways. The need for support should be routinely assessed, so that older cancer patients can profit from a rehabilitation that is based on a biopsychosocial concept.
[de]
< p>< b>< i>ZusammenfassungDer demografische Trend wird zu einer wachsenden Zahl älterer Krebspatienten führen; dabei steigt auch die Rate der Langzeitüberlebenden. Dies bedeutet eine große Herausforderung für das Gesundheitssystem. Die Rehabilitation als Teil dieses Systems hilft, die soziale Integration und Teilhabe zu fördern und zu sichern. Ältere Patienten haben dabei besondere Bedürfnisse und Ziele, die körperliche, psychische und soziale Aspekte umfassen. Der psychosoziale Unterstützungsbedarf älterer Menschen wird aber leicht übersehen. Die onkologische Rehabilitation unterstützt Menschen bei der Bewältigung der Erkrankung und ihren diversen Folgen und nachhaltigen Auswirkungen auf die Alltagsbewältigung. Während bei jüngeren Patienten v. a. die berufliche Wiedereingliederung im Vordergrund steht, benötigen Patienten im Rentenalter Hilfe zur möglichst langfristigen Sicherung ihrer Selbständigkeit und Lebensqualität. Daneben beachtet die Rehabilitation die möglichen psychischen Folgen der Krebserkrankung, die unbehandelt zu einer Chronifizierung oder einer psychischen Störung führen können. Der Sozialdienst widmet sich den Menschen, die unter ungünstigen Lebensbedingungen leiden, wie z. B. finanziellen Problemen oder mangelnder sozialer Integration. Gerade ältere Patienten können von einer onkologischen Rehabilitation mit routinemäßigem Bedarfsassessment, welches auf dem biopsychosozialen Konzept basiert, profitieren.Journal
Der Onkologe (Berlin); ISSN 0947-8965; ; v. 25(9); p. 796-801
; v. 25(9); p. 796-801
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