Trueman Jacqui, Trueman Ian
Lincolnshire Community Health Services, School of Nursing, University of Nottingham, Lincoln.
Br J Nurs. 2011;20(6):364-5, 367-9. doi: 10.12968/bjon.2011.20.6.364.
For people with chronic obstructive pulmonary disease (COPD), hospital admission can be associated with a poor prognosis. Consequently, the end-stage of the illness needs to be recognized for timely palliative care to be initiated. Tools to enhance the palliative phase, such as the Gold Standards Framework and the Liverpool Care Pathway, rely on the recognition of the final phase of a person's life. The illness trajectory of cancer makes this recognition far easier than for COPD, and as a result, many patients and their families manage at home with limited support. The Lincolnshire Respiratory Network has developed criteria to help recognize the end stage of COPD, which correlate well with recommendations from the Consultation on a Strategy for Services for COPD in England (Department of Health, 2010). However, there needs to be appropriate training to assist practitioners in their confidence to refer patients with end-stage COPD to palliative care providers.
对于慢性阻塞性肺疾病（COPD）患者而言，住院可能与预后不良相关。因此，需要识别疾病的终末期以便及时启动姑息治疗。诸如黄金标准框架和利物浦护理路径等用于强化姑息阶段的工具，依赖于对患者生命最后阶段的识别。癌症的疾病轨迹使得这种识别比COPD容易得多，结果，许多患者及其家人在有限的支持下在家中应对。林肯郡呼吸网络已经制定了标准来帮助识别COPD的终末期，这些标准与英格兰慢性阻塞性肺疾病服务战略咨询（卫生部，2010年）的建议高度相关。然而，需要进行适当的培训，以帮助从业者有信心将终末期COPD患者转介给姑息治疗提供者。
