姑息治疗与神经病学：是时候进行范式转变了。
Palliative care and neurology: time for a paradigm shift.
作者信息
Boersma Isabel, Miyasaki Janis, Kutner Jean, Kluger Benzi
机构信息
From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada.
出版信息
Neurology. 2014 Aug 5;83(6):561-7. doi: 10.1212/WNL.0000000000000674. Epub 2014 Jul 2.
Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research.
姑息治疗是一种针对面临进行性和慢性疾病的患者及其家属的护理方法，其重点是缓解因身体症状、心理社会问题和精神痛苦而产生的痛苦。由于神经科医生负责照料患有慢性、进行性、危及生命和致残性疾病的患者，因此他们理解并学会应用姑息医学的原则非常重要。在本文中，我们旨在通过回答以下问题，为神经科医生提供姑息医学的一个实用起点：（1）什么是姑息治疗，什么是临终关怀？（2）神经科患者的姑息治疗需求有哪些？（3）神经科患者是否有独特的姑息治疗需求？以及（4）如何将姑息治疗融入神经科实践？我们涵盖了与神经科医生相关的几项基本姑息治疗技能，包括坏消息的告知、症状评估与管理、预先护理计划、照顾者评估以及适当转介至临终关怀和其他姑息治疗服务。我们最后提出了未来教育工作和研究的方向。
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