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2012, vol. 18, br. 3-4, str. 63-69
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Da li postoji diskriminacija u zbrinjavanju starih osoba od strane Hitne pomoći u Beogradu?
Occurrence of ageism present in treatment of seniors by EMS Belgrade?
aGradski zavod za hitnu medicinsku pomoć, Beograd bKliničko-bolnički centar Zvezdara, Beograd, Srbija
e-adresa: slavoljubz3@open.telekom.rs
Sažetak
Uvod. Diskriminacija starih - ejdžizam (ageism), označava ponašanje koje ide na štetu starih u raznim vidovima. U svetu jača opšta gerontofobična ideologija koja starost negativno vrednuje i predstavlja kao neizbežnu pošast, i ide sve do stigmatizacije starih. Zdravstveni sistem igra važnu ulogu u dobrom osećanju pojedinca, posebno starijih osoba. Puno je starijih građana koji u ličnom kontaktu izjavljuju da su iskusili diskriminatorsko ponašanje od strane zdravstvene službe. Često se saučestvovanje u lošem odnosu prema starima u zdravstvenom sistemu pravda neodgovarajućim pravilima-standardima u radu i često se ovaj problem prebacuje na polje nužnog izbora i nedovoljnih materijalnih sredstava, ne udubljujući se previše u etiku. Ima i istraživanja koja pokazuju da su stariji zaista lošije zbrinuti od strane Hitne pomoći. Vreme kao faktor zbrinjavanja je vrlo bitan u radu Hitne pomoći. Cilj rada. Cilj rada je bio da se utvrdi: da li postoji vremenska razlika u raspodeli poziva bola u grudima ekipama HP kod osoba mlađeg i starijeg životnog doba; da li postoji vremenska razlika u raspodeli poziva ekipama HP za pozive prvog reda hitnosti kod osoba mlađeg i starijeg životnog doba; da li postoji vremenska razlika u raspodeli poziva ekipama HP za pozive drugog reda hitnosti kod osoba mlađeg i starijeg životnog doba; da li postoji razlika u broju - učestalosti procenjenih poziva prvog reda hitnosti između grupe osoba mlađeg i starijeg životnog doba. Metod. Analizirane su 1.667 intervencije sa bolom u grudima. Rezultati. Ispitanici su podeljeni u grupu do navršenih 65 godina života kao grupa mlađih, i drugu grupu preko 65 godina kao grupa starijeg životnog doba. Postoji statistički značajna razlika u distribuciji poziva - zadržavanje kod dispečera pre davanja ekipama na izvršenje od 68 sekundi (p<0,01). Pozivaoci stariji od 65 godina čekaju duže da se njihov poziv za pomoć dodeli ekipama na izvršenje u odnosu na one mlađeg životnog doba. Postoji razlika u distribuciji poziva prvog reda hitnosti poredeći osobe mlađeg i starijeg životnog doba, ali ne postoji statistički značajna razlika u raspodeli poziva prvog reda hitnosti kod osoba do 65 godina i više od 65 godina. Postoji jasna razlika u raspodeli poziva drugog reda hitnosti između grupe mlađih i starijih osoba (r<0,01). Upoređujući broj hitnih poziva u grupi starijih i grupi mlađih osoba χ2 testom, vidimo da postoji statistički visoko značajna razlika (r<0,01), tj. da se u grupi starijih ređe dodeljuje oznaka hitno jedan. Zaključak. Očigledno je da medicinski profesionalci koji rade na prijemu i distribuciji poziva i zbrinjavanju starijih na terenu, moraju posebno da se upoznaju sa problemom rada sa starijim osobama jer to od njih zahtevaju brze demografske promene u društvu.
Abstract
Introduction. Ageism denotes discrimination against elderly people. Gerontofobic ideas, including stigmatization of elderly population, are expanding world-wide. Health care system has an important role in well-being of old people. A lot of senior citizens have experienced discriminatory behavior in their dealings with health care services. These incidents are often justified by outdated standards and insufficient funding of the healthcare system, with complete disregard of ethical principles. A number of studies claim that emergency medical service (EMS) manages elderly patients in poorer way. Time, as a factor of management, is extremely important in the work of EMS. Objective. To confirm: (1) whether there is a time difference in EMS dispatching orders for patients with chest pain, symptoms between younger and older patients; (2) whether there is a time difference in EMS dispatching orders for the 'Urgent 1' calls between younger and older patients; (3) whether there is a time difference in EMS dispatching orders for 'Urgent 2' calls between younger and older patients; (4) whether there is a difference in the number of calls that have been deemed 'Urgent 1' in younger and older patients. Method. We have analyzed 1667 EMS interventions in patients with chest pains symptoms Results. All patients were divided into two groups - below 65 (which would constitute younger population) and over the age of 65 (older population). There is a statistically significant difference in order distribution (order kept at the dispatch center until assigned to an EMS team) of 68 seconds P<0.01. Patients over the age of 65 wait longer for their call to get assigned to an EMS team compared to the younger patient group. There is a difference in order distribution of 'Urgent 1' calls in younger and older patient population; however, there is no statistically significant difference in order distribution between patients > 65 years of age and < 65. There is a clear difference in order distribution of 'Urgent 2' calls in younger and older patients (P<0.01). When comparing the total number of 'Urgent 1' calls between the groups of older and younger patients, using the χ2 test, we see that difference is statistically significant (P<0.01), i.e. in the older patient group there were less 'Urgent 1' calls. Conclusion. It is evident that medical professionals working at EMS dispatch centers and in EMS teams on the field need to familiarize themselves better with the issues surrounding senior population. Rapid demographic changes in our society already require this.
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Živanović, S. (2011) Razlika u vremenskoj raspodeli poziva prvog i drugog reda hitnosti, kod bola u grudima, u Gradskom zavodu za hitnu medicinsku pomoć u Beogradu. Opšta medicina, 17(3-4): 136-140
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