In Serbia there
are about 7.5 million people (last census).
Malignant disease affect about 33,000 people annually, and about 400 children.
Approximately 22,000 people and about 250 children die every year from malignant
diseases. Unfortunately, no precise data for other children's life-limiting and
life-threatening diseases. In our society exists a lack of attention towards psycho-social needs
of cancer patients and their families (psychological, social or spiritual needs) during the all phases of illness and especially in terminal phases . Problems are overlooked and rejected (patient`s rights
especially).Death and dying belonged to the taboo.Patients mainly die
in their home alone, depressed , in bad conditions, without dignity,suffering in
pain and other symptoms. Traditional medical model with strong
attitudinal barriers for psycho-social care for cancer patients and their
families during the illness trajectory, is dominant
in Serbian hospitals and throughout health
care system, also. Communication
skills, breaking bad news, bereavemnt support were not included into medical curriculum. We haven`t basic or additional education in the field
of Psycho-Oncology or Palliative Care (in the school or at the academical
level) There are five
specialized children's hospitals in Serbia (three in Belgrade, in the cities of
Novi Sad and Nis). There are no specialized department, hospice or home care
teams for palliative care of children. All of us who work with children and
teenagers with limited prognoses are faced with the suffering of children,
families and we use isolated interventions in our work (cropping pain and
psychological support).In situations when you need to decide whether to stop
treatment or continue treatment although it will not lead to desired outcomes,
in our environment it is almost always a decision to continue treatment,
regardless of the quality of life of children and their families and without
care for psycho/social aspects.