Palliative Medicine Department, Calvary Health Care, Sydney, New South Wales, Australia.
Cancer J. 2010 Sep-Oct;16(5):532-41. doi: 10.1097/PPO.0b013e3181f2894c.
Caring for dying patients is challenging for oncologists, but a crucial aspect of cancer care. It requires highly developed communication skills and an understanding of prognostication at the end of life, which can potentially be improved by training and use of appropriate tools. Psychosocial concerns are as important as physical symptoms. Specific strategies for supporting dying patients are evolving, including dignity therapy and other meaning-based therapies. Symptoms affecting dying patients' comfort, including pain, dyspnea, delirium, and terminal secretions, require different clinical management as death approaches. Equally important is the ability to discuss transitions in goals of care from cure to comfort and supporting families and patients to make wise decisions without feeling they have been abandoned. Involving a palliative care team supports both oncologists and patients by providing whole-person assessment and care and excellent symptom control and can offer bereavement services to follow up family members after death.
照顾临终患者对肿瘤学家来说是具有挑战性的,但这是癌症护理的一个重要方面。它需要高度发达的沟通技巧和对生命末期预后的理解,而这可以通过培训和使用适当的工具来提高。心理社会问题与身体症状同样重要。支持临终患者的具体策略正在不断发展,包括尊严疗法和其他基于意义的疗法。影响临终患者舒适度的症状,包括疼痛、呼吸困难、谵妄和终末分泌物,随着死亡的临近,需要不同的临床管理。同样重要的是,能够讨论从治愈到舒适的护理目标的转变,并支持家庭和患者做出明智的决策,而不会让他们感到被抛弃。引入姑息治疗团队可以通过提供全面的评估和护理以及出色的症状控制来支持肿瘤学家和患者,并为患者家属提供丧亲服务。