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Integrating palliative care into the trajectory of cancer care

机译:将姑息治疗纳入癌症治疗的轨道

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摘要

Over the past five decades, palliative care has evolved from serving patients at the end of life into a highly specialized discipline focused on delivering supportive care to patients with life-limiting illnesses throughout the disease trajectory. A growing body of evidence is now available to inform the key domains in the practice of palliative care, including symptom management, psychosocial care, communication, decision-making, and end-of-life care. Findings from multiple studies indicate that integrating palliative care early in the disease trajectory can result in improvements in quality of life, symptom control, patient and caregiver satisfaction, quality of end-of-life care, survival, and costs of care. In this narrative Review, we discuss various strategies to integrate oncology and palliative care by optimizing clinical infrastructures, processes, education, and research. The goal of integration is to maximize patient access to palliative care and, ultimately, to improve patient outcomes. We provide a conceptual model for the integration of supportive and/or palliative care with primary and oncological care. We end by discussing how health-care systems and institutions need to tailor integration based on their resources, size, and the level of primary palliative care available.
机译:在过去的五十年中,姑息治疗已经从生命尽头的患者发展成为高度专业化的学科,其重点是在整个疾病过程中为具有生命极限疾病的患者提供支持治疗。现在,越来越多的证据可用于姑息治疗实践中的关键领域,包括症状管理,社会心理治疗,沟通,决策和临终关怀。多项研究的结果表明,将姑息治疗纳入疾病轨迹的早期可以改善生活质量,症状控制,患者和护理人员的满意度,临终护理质量,生存率和护理成本。在这篇叙述性评论中,我们讨论了通过优化临床基础设施,流程,教育和研究来整合肿瘤学和姑息治疗的各种策略。整合的目标是使患者获得姑息治疗的机会最大化,并最终改善患者的治疗效果。我们为支持和/或姑息治疗与初级和肿瘤治疗的整合提供了一个概念模型。最后,我们讨论卫生保健系统和机构如何根据其资源,规模和可用的初级姑息治疗水平来定制整合。

著录项

  • 期刊名称 other
  • 作者

    David Hui; Eduardo Bruera;

  • 作者单位
  • 年(卷),期 -1(13),3
  • 年度 -1
  • 页码 159–171
  • 总页数 32
  • 原文格式 PDF
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