Our Lady of Lourdes Hospital, Drogheda, Co. Louth and Our Lady's Hospital, Navan, Co. Meath. HSE Northeast, Dublin, Ireland.
Curr Opin Support Palliat Care. 2009 Dec;3(4):241-6. doi: 10.1097/SPC.0b013e328332e808.
Patients with heart failure seem particularly suited to palliative care having needs that fall within the prototypical palliative care domains. Despite this there is still much debate as to who should respond to these needs and when.
Since the early 1990s many studies have been published outlining the unmet needs of patients with heart failure. However, there have been limitations to these studies and they have not guided professionals as to how to respond. More recently comparative studies using cancer as the reference have explored similarities and highlighted differences in need between heart failure and cancer patients. These studies are useful for informing future service development.
Patients with heart failure have variable needs and variable disease trajectories. A targeted response to these needs is required. Palliative triggers or transitions should be recognized by professionals caring for patients with heart failure. It is unlikely that either specialist palliative care or medical specialists working in isolation will be sufficiently experienced to respond to these needs. Research is required to determine the effectiveness of different collaborative approaches; heart failure specialist care aligned with palliative care consultancy or heart failure-oriented palliative care services.
心力衰竭患者似乎特别适合接受姑息治疗,因为他们的需求属于姑息治疗的典型领域。尽管如此,对于应该由谁来满足这些需求以及何时满足,仍存在许多争议。
自 20 世纪 90 年代初以来,许多研究已经发表,概述了心力衰竭患者未满足的需求。然而,这些研究存在局限性,并没有指导专业人员如何做出回应。最近,使用癌症作为参照的比较研究探讨了心力衰竭患者和癌症患者之间需求的相似之处和差异。这些研究有助于为未来的服务发展提供信息。
心力衰竭患者的需求具有变异性,疾病轨迹也具有变异性。需要针对这些需求做出有针对性的回应。姑息治疗的触发因素或过渡应该被照顾心力衰竭患者的专业人员识别。专门的姑息治疗专家或单独工作的医学专家都不太可能有足够的经验来满足这些需求。需要研究不同协作方法的有效性;心力衰竭专科护理与姑息治疗咨询相结合,或针对心力衰竭的姑息治疗服务。