London School of Hygiene and Tropical Medicine, London, UK.
Lancet Infect Dis. 2012 Jul;12(7):571-5. doi: 10.1016/S1473-3099(12)70085-3. Epub 2012 Jun 11.
People with HIV have a high burden of pain and physical, psychological, and social difficulties that can be managed effectively with palliative care. However, most individuals do not have access to this type of care. Palliative care is holistic patient-centred management of life-limiting progressive disorders and is recognised by WHO as an essential element of HIV care, from diagnosis to end of life. Historically, palliative care and HIV care were linked closely, but misconceptions divide the two disciplines today. Palliative care can augment patients' outcomes and boost adherence to antiretroviral treatments and life expectancy. In much of the world, services providing palliative care are isolated, and most individuals in need have no access to this care. The commitment to provide palliative care for all people with HIV can be fulfilled if clinical workers are trained in this therapeutic approach and if care is delivered at community level, with support for family caregivers.
HIV 感染者承受着沉重的痛苦,还面临身体、心理和社会等多方面的困难,这些都可以通过姑息治疗进行有效管理。然而,大多数人无法获得这种治疗。姑息治疗是对生命有限的进行性疾病进行整体以患者为中心的管理,世卫组织已将其确认为从诊断到生命终末期整个 HIV 护理的基本组成部分。从历史上看,姑息治疗和 HIV 护理紧密相连,但如今存在一些误解将这两个学科分开。姑息治疗可以改善患者的预后,提高抗逆转录病毒治疗的依从性和预期寿命。在世界上的许多地方,提供姑息治疗的服务是孤立的,大多数有需要的人无法获得这种治疗。如果临床工作者接受了这种治疗方法的培训,并在社区层面提供护理,同时为家庭照顾者提供支持,那么为所有 HIV 感染者提供姑息治疗的承诺是可以实现的。