Occupational Therapy Service, Peninsula Health, Frankston, Victoria, Australia.
Curr Opin Support Palliat Care. 2012 Jun;6(2):138-43. doi: 10.1097/SPC.0b013e3283537d0e.
This review aims to define and explore the contribution of occupational therapy in end-of-life care, with a particular focus on breathlessness. It examines occupational therapy interventions for the management of breathlessness and makes recommendations for future research.
An emerging body of research demonstrates people with advanced disease continue to strive for active participation in everyday activities in the face of debilitating symptoms such as breathlessness. It is through active participation that people adjust to bodily decline. When specific everyday activities are targeted for intervention, implantation of strategies to manage breathlessness within the context of these activities has been found to optimize function and well being for those with chronic obstructive pulmonary disease. Evidence examining the efficacy of energy conservation and relaxation is limited and requires more robust examination.
Symptoms such as dyspnoea need to be considered within the contexts in which they exist - that is, the bodily experience of breathlessness and its impact on everyday activities or occupations. The clinical and theoretical focus of occupational therapy supports the enablement of continued participation in valued and essential activities and offers a unique focal point for research. Emerging research demonstrates the importance of translating the benefits of effective symptom management into everyday activities and informs a future research agenda.
本文旨在定义和探讨职业治疗在临终关怀中的作用，特别关注呼吸困难。本文考察了职业治疗干预呼吸困难的措施，并为未来研究提出建议。
越来越多的研究表明，患有晚期疾病的人在面临呼吸困难等使身体虚弱的症状时，仍继续努力积极参与日常活动。正是通过积极参与，人们才能适应身体的衰退。当针对特定的日常活动进行干预时，在这些活动的背景下实施管理呼吸困难的策略，被发现可以优化慢性阻塞性肺疾病患者的功能和幸福感。关于能量节约和放松的功效的证据有限，需要更有力的检验。
呼吸困难等症状需要在其存在的背景下进行考虑——即呼吸困难的身体体验及其对日常活动或职业的影响。职业治疗的临床和理论重点支持继续参与有价值和必要的活动，并为研究提供了独特的焦点。新兴研究表明，将有效症状管理的益处转化为日常活动的重要性，并为未来的研究议程提供信息。
