Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Curr Opin Pulm Med. 2011 Sep;17(5):348-54. doi: 10.1097/MCP.0b013e328349721b.
Recently, an expert committee endorsed by the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and the Latin American Thoracic Society published an evidence-based guideline on the management of idiopathic pulmonary fibrosis (IPF). In the current document, we summarize and supplement this recent expert document and propose a comprehensive approach to the care and management of patients with IPF.
We propose three pillars of care for the patient with IPF titled 'disease-centered management', 'symptom-centered management', and 'education and self-management'. Disease-centered management involves both pharmacological and nonpharmacological approaches. Palliative care should be an integral and routine component of the care of patients with IPF. Education and self-management strengthens the provider-patient partnership by enabling patients to set realistic goals, remain in control of his or her care, and prepare for the future.
The comprehensive care of the patient with IPF involves balancing the three pillars of disease-centered management, symptom-centered management, and patient education and self-management upon a solid foundation of provider-patient partnership. Constant reassessment of the individual patient's goals of care, based on their values and preferences, is essential to the constant recalibration of these various interventions.
最近,美国胸科学会、欧洲呼吸学会、日本呼吸学会和拉丁美洲胸科学会的一个专家委员会发布了一份特发性肺纤维化(IPF)管理的循证指南。在本文件中,我们总结和补充了这一最新的专家文件,并提出了综合的方法来护理和管理 IPF 患者。
我们为 IPF 患者提出了三个护理支柱,分别是“以疾病为中心的管理”、“以症状为中心的管理”和“教育和自我管理”。以疾病为中心的管理涉及药物和非药物方法。姑息治疗应该是 IPF 患者护理的一个组成部分和常规部分。教育和自我管理通过使患者能够设定现实的目标、保持对自己护理的控制并为未来做好准备,加强了医患合作关系。
IPF 患者的全面护理涉及在医患合作关系的坚实基础上平衡以疾病为中心的管理、以症状为中心的管理和患者教育及自我管理这三个支柱。根据患者的价值观和偏好,对其护理目标进行持续评估,对于不断调整这些不同干预措施至关重要。