临终时对接受腹膜透析的老年患者的护理。
Caring for Older Patients on Peritoneal Dialysis at End of Life.
作者信息
Meeus Frédérique, Brown Edwina A
机构信息
Nephrology Departement, Clinique Edouard Rist, Paris, France.
Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK
出版信息
Perit Dial Int. 2015 Nov;35(6):667-70. doi: 10.3747/pdi.2015.00054.
End of life is the last phase of life, not merely the last few days. For many older patients on peritoneal dialysis (PD), the end-of-life phase commences with the start of dialysis. The principal aim of management of this phase should be optimizing the quality of life of the patient. Evidence suggests that patients on dialysis mostly want involvement in decisions at this stage, but most do not have the opportunity to do so. Management should therefore include discussions with the patient and their family to determine lifestyle goals, treatment wishes, and ceilings of care (including resuscitation and dialysis withdrawal). Care should also include symptom identification and management, psychosocial support, and adaptation of dialysis to the ability and needs of the patient. By doing this, quality of life at end of life is achievable.
生命末期是生命的最后阶段，而不仅仅是最后几天。对于许多接受腹膜透析（PD）的老年患者来说，生命末期阶段始于透析开始之时。这一阶段管理的主要目标应该是优化患者的生活质量。有证据表明，透析患者大多希望在这个阶段参与决策，但大多数人没有这样的机会。因此，管理应包括与患者及其家人进行讨论，以确定生活方式目标、治疗意愿和护理上限（包括心肺复苏和停止透析）。护理还应包括症状识别与管理、心理社会支持，以及根据患者的能力和需求调整透析。通过这样做，生命末期的生活质量是可以实现的。
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