识别治疗负担是晚期心力衰竭患者临终关怀的一个重要概念。
Identifying treatment burden as an important concept for end of life care in those with advanced heart failure.
机构信息
Department of General Practice and Primary Care, Institute of Health and Wellbeing MVLS, University of Glasgow, Glasgow, Scotland, UK.
出版信息
Curr Opin Support Palliat Care. 2013 Mar;7(1):3-7. doi: 10.1097/SPC.0b013e32835c071f.
PURPOSE OF REVIEW
The concept of treatment burden is receiving increasing attention and this review seeks to show that treatment burden is an important issue for end-of-life care in those with advanced heart failure.
RECENT FINDINGS
Review of the qualitative literature on patient experience of end-stage heart failure since the year 2000, including 2012, suggests that treatment burden, the work that patients have to do to manage their condition, is a readily identifiable concept in advanced heart failure. Treatment burden relates to four main areas of work, namely: coherence (sense making work) which refers to the work of developing an understanding of the illness (including its implications), treatment and management; appraisal, which refers to the work of judging, monitoring and adjusting treatments; relationship work which describes the effort put into engaging with others for support; and enacting work, that is the effort put into operationalizing treatments, which includes activities such as taking medications, attending appointments, enduring side effects of treatments and dealing with communication difficulties.
SUMMARY
Treatment burden has the potential to be an important barometer of quality of care from the patient perspective in advanced heart failure.
目的综述
治疗负担的概念越来越受到关注，本综述旨在表明，在晚期心力衰竭患者的临终关怀中，治疗负担是一个重要问题。
最近的发现
对 2000 年以来，包括 2012 年在内的晚期心力衰竭患者的体验的定性文献进行综述表明，治疗负担（患者为管理其病情而必须做的工作）是晚期心力衰竭中一个易于识别的概念。治疗负担与以下四个主要工作领域有关：一致性（意义构建工作），指的是发展对疾病（包括其影响）、治疗和管理的理解的工作；评估，指的是对治疗进行判断、监测和调整的工作；关系工作，描述了为获得支持而与他人交往的努力；实施工作，即实施治疗的努力，包括服用药物、参加预约、忍受治疗的副作用和处理沟通困难等活动。
总结
从患者的角度来看，治疗负担有可能成为晚期心力衰竭护理质量的一个重要指标。
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