Geddes da Filicaia Marco
Recenti Prog Med. 2014 Jan;105(1):5-6. doi: 10.1701/1398.15552.
The management of patients with end-stage organ failure necessitates a considerable integration between palliative care and those who care the patient in different clinical settings: the general practitioner, who is - or should be - always involved and, in relation to the steps of care, the emergency department, the hospital units, and the intensive care unit. The staff involved should have skills and competences to plan with the patient or his/her family a shared schedule, which may result in the interruption of disproportionate treatments. All this leads to many concerns discussed in the document by the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI); the paper provides a useful guide to where, how, and when we care, inform, and communicate. In this editorial, the author discusses these three topics, setting them in the reality of the Italian health care system. The aim is to emphasize the aspects of space, time and organization of care, focusing on the communication challenges that influence the process of defining a "shared schedule" between the patients, their families, and the health care system.
终末期器官衰竭患者的管理需要姑息治疗与在不同临床环境中照顾患者的人员之间进行大量整合，这些人员包括全科医生，其一直（或应该一直）参与其中，以及在护理步骤方面涉及的急诊科、医院科室和重症监护室。相关工作人员应具备技能和能力，以便与患者或其家属共同制定一份共享计划，这可能会导致中断过度的治疗。意大利麻醉、镇痛、复苏和重症治疗学会（SIAARTI）在该文件中讨论了所有这些引发诸多关注的问题；该论文为我们在何处、如何以及何时进行护理、提供信息和沟通提供了一份有用的指南。在这篇社论中，作者讨论了这三个主题，并将它们置于意大利医疗保健系统的实际情况中。目的是强调护理的空间、时间和组织方面，重点关注影响患者、其家属与医疗保健系统之间确定“共享计划”过程的沟通挑战。
