Palliative care in Međimurje county. Sociological research of the current state and perspective.

U hrvatskom društvu, a time i u Međimurskoj županiji, koja je u fokusu ovog rada, prepoznaje se sve veća važnost, ali i potreba palijativne skrbi. Polazeći iz sociološke perspektive ovaj rad ima za cilj istražiti trenutno stanje i perspektivu palijativne skrbi u Međimurskoj županiji te predstavlja jedno od početnih istraživanja o toj interdisciplinarnoj temi. Prvi, teorijski dio rada, prikazuje određenje palijativne skrbi, povijesnog razvoja u svijetu i u Hrvatskoj s posebnim osvrtom na Međimursku županiju. Potom se obrađuje interdisciplinarni pristup palijativnoj skrbi odnosno važnost komunikacije, psihološke podrške i duhovne snage, kako za pacijenta s potrebama za skrbi na kraju života, tako i za njegovu obitelj. Nakon toga dolazi sociološki uvid u starenje stanovništva te dostojanstvo ljudske osobe. Središnji dio rada je empirijski koji započinje prikazom metodologije kvalitativnog istraživanja (intervjua) te obuhvaća ciljeve istraživanja, metodu, provedbu istraživanja kao i metodologiju analize podataka. Cilj sociološkog istraživanja je bio dobiti uvid u funkcioniranje palijativne skrbi u Županiji te je provedeno šest polustrukturiranih intervjua među dionicima palijativne skrbi koji su aktivno uključeni u pružanje palijativne skrbi. Korišten je namjerni uzorak koji se ponekad naziva i uzorak stručnjaka. Između ostalog analizirana je važnost zakonskog okvira, organizacija palijativne skrbi, jakost i slabost palijativne skrbi, ključni problemi s kojima se dionici susreću, sociodemografske karakteristike korisnika i sl. U zaključnom djelu rada, na temelju teorijskog i empirijskog istraživanja, prikazuje se perspektiva za budućnost razvoja palijativne skrbi u Županiji te se izvode zaključci istraživanja. Temeljem provedenih intervjua ustanovilo se da je umreženost službi dobra, da posebno treba raditi na promjeni pristupa prema umiranju i smrti, ojačati rad postojećih službi, riješiti problem nedostatka stučnog kadra, smještaja palijativnih bolesnika i sl. Također ustanovljeno je da je zakonski okvir dobar putokaz za daljne planiranje palijativne skrbi kako bi se nastavilo raditi za dobrobit cijele zajednice.In the Croatian society, and therefore in Međimurje County, which is the primary focus of this graduate thesis – the importance of palliative care and the need for it are being recognized. From the sociological perspective, this paper aims to explore the current state and perspective regarding the palliative care in Međimurje County and represents one of the initial researches in this interdisciplinary subject. The first, theoretical part of this thesis, shows the main characteristics of palliative care, its historical development in the world and in Croatia, with special reference to Međimurje County. Afterwards, an interdisciplinary approach to palliative care is discussed – mainly, the importance of communication, psychological support, and spiritual strength, both for the patient who needs end-of-life care and for his family. The last argument in this part examines the sociological aspects of aging and the dignity of a human being. The central part of this thesis is an empirical one that begins with the presentation of the methodology of qualitative research (interviews), including research goals, method, implementation research and the methodology used in data analysis. The aim of this research was to get an insight into the functioning of palliative care in the County. Six semi-structured interviews were conducted among the palliative care stakeholders who were actively involved in providing palliative care. Deliberate sample, also known as the sample of experts, was used. Also, the importance of the legal framework, the palliative care organization, the strength and weaknesses of palliative care, the key problems people encountere, sociodemographic characteristics of users etc. were analyzed. In conlusion, based on theoretical and empirical research, the prospects for the future and the development of palliative care in the County are presented. Based on the interviews, it was found that the service networking is good, that it is necessary to work on changing the approach to dying and death, to strength the work of existing services and to solve the problems with deficit of expert cadre and the accommodation of palliative patients, etc. It has also been concluded that the legal framework is a valuable guideline for further planning of palliative care in order to continue working for the welfare of the community