Supportive Care, Early Diagnosis and Advanced disease (SEDA) research group, Hull York Medical School, University of Hull, Hull, UK.
Palliat Med. 2013 Oct;27(9):822-8. doi: 10.1177/0269216313494960. Epub 2013 Jul 9.
Heart failure is a common condition with a significant physical and psychological burden for patients and their families. The need for supportive and palliative care: It is well recognised that palliative care is important in patients with advanced heart failure.
Heart failure patients have limited access to palliative care services. Barriers to palliative care include difficult prognostication due to the unpredictable disease trajectory and inadequate initiation of conversations about end-of-life care. WHAT IS NOT KNOWN: There are gaps in the evidence for symptom control, especially for symptoms other than pain or dyspnoea, but recommendations are becoming increasingly evidence based. IMPLICATIONS FOR RESEARCH, POLICY AND PRACTICE: There are challenges to research in this area although progress is being made with increasing numbers of trials and use of novel research methods. Integrated models of care based on symptom triggers rather than prognosis are recommended. At the centre is excellent communication both with the patient and between services to ensure the best possible care.
心力衰竭是一种常见病症，会给患者及其家庭带来沉重的身心负担。需要支持性和姑息治疗：人们普遍认识到，姑息治疗对于晚期心力衰竭患者很重要。
心力衰竭患者获得姑息治疗服务的机会有限。姑息治疗的障碍包括由于疾病轨迹不可预测和临终关怀谈话启动不足导致的预后困难。未知情况：在症状控制方面，特别是除疼痛或呼吸困难以外的症状方面，证据存在差距，但建议越来越基于证据。
对研究、政策和实践的影响：尽管随着越来越多的试验和新研究方法的使用，该领域的研究取得了进展，但仍存在挑战。建议采用基于症状触发而不是预后的综合护理模式。核心是与患者和服务之间进行出色的沟通，以确保提供尽可能好的护理。
