Cedars Sinai Heart Institute, Division of Cardiology, Cedar Sinai Medical Center, 8700 Beverly Blvd, Suite 6215, Los Angeles, CA 90048, USA.
J Relig Health. 2011 Jun;50(2):348-58. doi: 10.1007/s10943-010-9415-y.
Chronic heart failure is a lifelong disease that involves a large variety of symptoms and, ultimately, the entire organism relatively early in the disease process. At least in part, this is in contrast to other chronic conditions such as diabetes, renal failure or cancer. Modern treatment of patients with chronic heart failure goes beyond the mere prescription of vasodilators or inotropes. The multitude of multi-organ involvements and associated symptoms unrelated to pure cardiac contractile failure, as well as the psychosocial burden for patients and their direct environment, calls for a re-engagement with the philosophical aspects of medical care. Such a process may well challenge the approach commonly taken by health care providers. We further suggest a broader and more holistic view of medical care--in this case in regard to heart failure--and one that is based on patients' and physicians' understanding of health and disease, autonomy, suffering, existential values and expectations that might positively affect treatment strategies and outcomes.
慢性心力衰竭是一种终身性疾病，涉及多种症状，并且在疾病过程中相对较早地涉及整个机体。至少在一定程度上，这与其他慢性疾病（如糖尿病、肾衰竭或癌症）不同。慢性心力衰竭患者的现代治疗方法不仅仅是开血管扩张剂或正性肌力药。多器官受累和与纯心脏收缩功能衰竭无关的相关症状，以及患者及其直接环境的心理社会负担，需要重新关注医疗保健的哲学方面。这一过程很可能会挑战医疗保健提供者通常采取的方法。我们进一步建议对医疗保健有更广泛和更全面的看法——在这种情况下是心力衰竭——并基于患者和医生对健康和疾病、自主性、痛苦、存在价值和期望的理解，这些可能会对治疗策略和结果产生积极影响。
