There is no legally established perinatal hospice in the Czech Republic. Several initiatives work towards launching an institution to support parents in the event of a fatal prenatal diagnosis or life-limiting condition in their unborn baby. Parents use the label perinatal hospice as they subvert and transform the narrow legal and strictly medical framework for such institutions. Hospice care became a legitimate sector of care provision only recently. This study analyses four initiatives that strive to establish and formalise perinatal hospices in the Czech Republic, with a focus on the strategies these initiatives engage in to achieve change. A sociological qualitative empirical study (2017-2019) informs the findings. Initiatives vary in approach from cooperation to competition in being recognised as 'the first perinatal hospice'. The study shows how such rhetoric is adopted to attract the funding required for sustainability. Community cooperation and involvement can, then, form a contra position.

• Klíčová slova
• Czech Republic, Perinatal hospice, community, dying and bereavement, institutionalisation of care, late pregnancy loss, qualitative research, sociology of death,
• MeSH
• hospice * MeSH
• lidé MeSH
• nemocnice - spoluúčast lékařů mimo nemocnici MeSH
• péče v hospici * MeSH
• rodiče MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Palliative care is focused on enhancing quality of life for seriously ill. Hospice care is a comprehensive care provided by an interdisciplinary team for patients whose diseases cannot be cured and are approaching the end of life. To be eligible for admission to hospice care is required to be terminally ill with a life expectancy of 6 months or less. Currently, hospices are the main providers of specialized palliative care in the Czech Republic. This article is focused on the current state of palliative care and specifically on hospice care in the Czech Republic. This article should eliminate the myths associated with the hospice. It could also help physicians to better understand the role of hospice in delivering effective care for patients in the final stages of life.

• Klíčová slova
• hospice care end of life care., palliative care,
• MeSH
• hospice * MeSH
• kvalita života MeSH
• lidé MeSH
• paliativní péče MeSH
• péče v hospici * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: The aim of palliative care is the solution of bio-psycho-social and spiritual problems of patients and achievement of the highest possible quality of life. This is related to a need of understanding the patient and his needs. The aim of our research was to determine bio-psychosocial-spiritual needs of patients in hospice care in conjunction with the quality of life and rate of their saturation. Further then to determine, whether the needs vary depending on length of stay in hospice, gender, age and religion. METHODS AND RESULTS: The sample consisted of 36 patients from the hospice of St. Luke in Ostrava. For data collection we used modified questionnaire for the identification of needs PNPC and questionnaire for assessing the quality of life EORTC QOL-C30. As the most important need patients considered the privacy (4,80), the opportunity to make their own decisions (4,77), treatment with respect and dignity (4,75) and pain relieve (4,72). The most frequently reported problem was fatigue, sleep and fear of addiction. Patients have positively rated pain prevention. In repeated measurements were reported significant improvements of assessment of saturation needs in 10 items (p < 0.05). The patients evaluated overall quality of life rather positively. A relationship between quality of life and saturation of needs in the area of autonomy and physical needs (p < 0.05) was found. CONCLUSIONS: During the stay in hospice patients' satisfaction with saturation of some needs and overall assessment of quality of life increased.

• MeSH
• dospělí MeSH
• hospice * MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• péče v hospici * MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• umírající * psychologie   MeSH
• zdravotnické služby - potřeby a požadavky * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

In the Czech Republic, around 70 % of deceased people die in hospital settings every year. On the other hand, surveys showed that almost 78% Czech wish to die at home. General practitioners take care of most of dying at their homes. Unfortunately, hours of attendance and visiting hours are not always sufficient when complications develop and health status rapidly deteriorates and the goal is to die at home. Significant proportion of patients is then transferred to acute hospital settings and lots of them dies there during so called terminal hospitalization. Mobile hospice services (mobile specialized palliative care), multidisciplinary teams with medical staff (doctor/nurse) available 24 hours a day 7 days a week, are newly developing services with potential for change in these undesirable trends and for increasing chance of peaceful dying at home.

• Klíčová slova
• home hospice, mobile specialized palliative care general practitioner.,
• MeSH
• hospice MeSH
• hospitalizace MeSH
• lidé MeSH
• paliativní péče * MeSH
• péče o umírající * MeSH
• péče v hospici * MeSH
• služby domácí péče * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• lidé MeSH
• paliativní péče statistika a číselné údaje   MeSH
• péče v hospici statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH

• MeSH
• časové faktory MeSH
• hospice * MeSH
• lidé MeSH
• návštěvníci pacientů * MeSH
• péče v hospici MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Since its creation, the Czech Republic has developed an advanced health system and social system. Life expectancy at birth has increased by an average of 7 years in only 20 years. However, polymorbidity and multicausality have now become topics of concern. In some ways they are products of our success. Yet, the health system and social system were not designed for these patients nor are health care professionals trained and willing to assess and address clinical needs of fragile, chronically ill, and incurable patients. This is true in much of the developing world where initial improvements have led to this new population-based challenge. In that sense, the Czech Republic is an example of what needs to happen in developing countries. Inpatient hospice care, which has been developing in the Czech Republic since 1993, is not the answer to this problem. Rather, approaches to ensure that the early introduction of palliative care in the course of serious illness care, personalized medicine, and a multidisciplinary approach in the system is required. Focusing only on terminal illness care is insufficient. Beginning in 2005-2006, we have worked to create a system of education and clinical services in specialized palliative care in the health and social system. This article seeks to describe the leadership steps of this systemic change in the Czech Republic with the objective of helping others make the same journey.

• Klíčová slova
• hospice, leadership, multicausality, polymorbidity, specialized palliative care,
• MeSH
• lidé MeSH
• novorozenec MeSH
• paliativní péče * MeSH
• péče v hospici * MeSH
• rozvojové země MeSH
• vůdcovství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

In the Czech Republic more than 70,000 patients with chronic incurable diseases need palliative care each year. In 50,000 this need is manageable in the context of general palliative care, 20,000 patients would greatly benefited from specialized palliative care. Most chronically ill patients (> 60 %) died in acute or post acute inpatient health care facilities. Here s the availability and quality of palliative care varies substantially. Inpatient hospices provide end of life palliative care to less than 3000 patients each year. Outpatient and mobile specialized palliative care services are available only to a few hundreds of patients.In the year 2016 palliative care at the appropriate professional level ("state of art") is not a generally available and guaranteed within Czech health care and social system. We perceive an urgent need for the systematic development of general and specialized palliative care at the level of education, healthcare organization and the development of new health and social services.

• Klíčová slova
• general palliative care, specialized palliative care hospice care.,
• MeSH
• ambulantní péče MeSH
• chronická nemoc MeSH
• dostupnost zdravotnických služeb MeSH
• hospice MeSH
• hospitalizace MeSH
• lidé MeSH
• paliativní péče * MeSH
• péče o umírající * MeSH
• péče v hospici * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers. Overall experts strongly agreed that hospice and palliative care should be available in long-term care facilities and that both are defined by holistic, interdisciplinary approaches using measures of comfort across domains. However, it appears the experts felt that in most countries the reality fell short of what they believed would be ideal care. As a result, experts call for increased training, communication, and access to specialized EOL services within the nursing home.

• Klíčová slova
• End-of-life care, hospice, nursing home research, palliative care,
• MeSH
• internacionalita * MeSH
• lidé MeSH
• paliativní péče MeSH
• péče o umírající * MeSH
• péče v hospici MeSH
• pečovatelské domovy * MeSH
• průzkumy zdravotní péče MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Background: A key issue in the development of population-based access to palliative care is identification of appropriate patients. Objective: To evaluate the NECPAL (NECesidades Paliativas) tool to identify unmet palliative care needs in the Czech Republic in regional hospitals of the Vysocina region. Methods: We used the End-of-Life care information system (ELFis) to evaluate prognostication to aid the identification of palliative care needs. The evaluation process was developed in cooperation with the regional government and central health care insurance agency as a step toward the development of a nation-wide palliative care program. Results: Our results demonstrate that the NECPAL tool successfully identified palliative care needs in specifically prepared clinical environment. An important part of this is a support of main stakeholders and an effective leadership. Conclusion: An unexpected finding was the role that leadership played in testing the tool, and very short time (10 months) needed for statistically visible changes in a regional system of care.

• Klíčová slova
• NECPAL, early indication for palliative care, hospice, leadership, multicausality, networking in palliative care, polymorbidity, specialized palliative care,
• MeSH
• chronická nemoc MeSH
• hospicová a paliativní ošetřovatelská péče * MeSH
• lidé MeSH
• paliativní péče metody   MeSH
• péče v hospici * MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH