The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 19: Palliative Care in Resource-Poor SettingsSTEP 2:EDUCATION26 picasThe second foundation measure in a national public health approach to palliative care involveshealthcare worker training and public education.Training Healthcare WorkersEducation of healthcare professionals is crucial for the dissemination and implementation ofexisting palliative care knowledge. Training programs should exist for medical students, residents,practicing physicians, nurses, pharmacists, social workers, pastors, community-basedhome-care workers, and rural health workers. Successful experiences in several countries indicatethat palliative care education can be incorporated into existing healthcare system trainingprograms. 23, 24, 25 Distance learning and certification programs developed for each group ofhealthcare workers will further increase education coverage. Education must be appropriate tothe situation in which they are performing their activities.Training in palliative care focuses on six major skill sets:1. Communication2. Decisionmaking3. Management of complications of treatment and the disease4. Symptom control5. Psychosocial care of patient and family6. Care of the dyingWHO recommends that multi-dimensional education include at least a minimum of learning inthree important areas: 61. Attitudes, beliefs and values:• The philosophy and ethics of palliative care• Personal attitudes towards HIV/AIDS, pain, dying, death, and bereavement• Illness as a complex state with physical, psychological, social,and spiritual dimensions• Multi-professional team-work• The family as the unit of care2. Knowledge base:• Principles of effective communication• Pathophysiology of the common symptoms of advanced disease• Assessment and management of pain and other symptoms• Psychological and spiritual needs of seriously ill and dying patients• Treatment of emotional and spiritual distress• Psychological needs of the family and other key peopleXIXU.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 395