V okviru Državnega programa obvladovanja raka (DPOR) smo z aktivnostmi za vzpostavitev celostne rehabilitacije onkoloških bolnikov pričeli leta 2017. Celostna rehabilitacija zajema medicinsko, psihološko, socialno in poklicno rehabilitacijo ter je prilagojena posameznemu bolniku. Omogoča zgodnje prepoznavanje somatskih in psihičnih posledic malignega obolenja in njegovega zdravljenja ter njihovo čim prejšnje odpravljanje. Njena dobrobit je boljša kakovost življenja bolnikov od postavitve diagnoze dalje ter hitrejša vrnitev na delovno mesto. Raziskava celostne rehabilitacije bolnic z rakom dojk OREH se na Onkološkem inštitutu (OI) Ljubljana izvaja od leta 2019 in je namenjena razvoju ter testiranju novega sistema celostne rehabilitacije za onkološke bolnike v Sloveniji. Osrednja oseba v celostni rehabilitaciji je koordinatorka celostne rehabilitacije (diplomirana medicinska sestra) za onkološke bolnike, ki z vprašalniki preverja, s katerimi težavami se bolnica sooča, in je bolnici v oporo med težkimi preizkušnjami na poti zdravljenja. Prek multidisciplinarnega konzilija OREH je bolnica v odvisnosti od izraženosti težav in v skladu s smernicami ter klinično potjo celostne rehabilitacije napotena na različne storitve celostne rehabilitacije v okviru mreže izvajalcev. Preliminarne analize rezultatov kažejo dobrobit celostne rehabilitacije na določenih področjih. V okviru celostne rehabilitacije vzpostavljamo tudi klinični register poznih posledic zdravljenja raka v otroštvu, v mesecu oktobru pa bomo začeli na OI Ljubljana izvajati Pilotno raziskavo celostne rehabilitacije bolnikov z rakom debelega črevesja in danke 2022– 2024. Naš namen je namreč razširiti celostno rehabilitacijo na širši krog onkoloških bolnikov, kar je zapisano tudi v zavezujočem dokumentu DPOR 2022–2026. V prihodnosti bomo razširili in izboljšali sodelovanje s sodelujočimi institucijami, zagotovili financiranje dejavnosti celostne rehabilitacije in si prizadevali spremeniti zakonodajo zgodnje poklicne rehabilitacije. Oviro za hitrejšo implementacijo celostne rehabilitacije predstavlja predvsem pomanjkanje ustreznih strokovnjakov in prostorov.
In 2017, we started activities for the establishment of comprehensive rehabilitation of cancer patients, as part of the Slovene National Cancer Control Programme (NCCP). Comprehensive rehabilitation includes medical, psychological, social and professional rehabilitation and is tailored to the individual patient. It enables early recognition of the somatic and psychological consequences of malignant disease and its treatment, and their elimination as soon as possible. The benefit is a better quality of life for patients from the time of diagnosis and a faster return to work. Research about comprehensive rehabilitation of patients with breast cancer OREH has been carried out at the Institute of Oncology (IO) Ljubljana since 2019 and is aimed at developing and testing a new comprehensive rehabilitation system for cancer patients in Slovenia. The central person in comprehensive rehabilitation is the coordinator of comprehensive rehabilitation (graduate nurse) for cancer patients, who uses questionnaires to check what problems the patient is facing, and supports the patient during the difficult aspects of treatment. Through the multidisciplinary team meeting OREH, depending on the severity of the problems and in accordance with the guidelines and the clinical path for comprehensive rehabilitation, the patient is referred to various services within the network of providers. Preliminary analyses of the results show the benefit of comprehensive rehabilitation in certain areas. As part of comprehensive rehabilitation, we are also establishing a clinical registry of late effects of childhood cancer treatment, and in the month of October, we will start conducting a pilot study of comprehensive rehabilitation of patients with colorectal cancer diagnosed between 2022–2024 at IO Ljubljana. Our aim is to extend comprehensive rehabilitation to a wider range of cancer patients, which is also stated in the binding document DPOR 2022–2026. In the future, we will expand and improve cooperation with participating institutions, provide funding for comprehensive rehabilitation activities, and strive to change the legislation on early vocational rehabilitation. Obstacles to the faster implementation of comprehensive rehabilitation are primarily the lack of appropriate experts and facilities.
How to CiteZadravec Zaletel, . L., Kurir Borovčić, M., & Bešić, N. (2022). Comprehensive rehabilitation of cancer patients. Onkologija : A Medical-Scientific Journal, 26(2), 36–39. https://doi.org/10.25670/oi2022-011on
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