Sabo Brenda, Johnston Grace
Can J Neurosci Nurs. 2016;38(1):48-55.
Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care.
An exploration of extant literature over the past 10 years.
The current literature demonstrates that timely referrals to palliative care consult teams and access to community-based resources have been associated with fewer hospitalizations and visits to emergency departments and a decrease in the initiation of invasive, aggressive treatment at end of life. Timely referral to palliative care has also been shown to reduce distress, enhance quality of life and, in some cases, increase life expectancy.
Earlier referral to palliative care has yet to become a reality for many patients diagnosed with life-limiting illnesses and, in particular, those with a PMBT. More research is needed to uncover and challenge the barriers to early transition including communication issues among professionals, patients and families around palliative care.
报告强调，姑息治疗适用于所有癌症，其未满足的需求日益增长，但医疗系统和医护人员的响应似乎迟缓。以下讨论文件突出了原发性恶性脑肿瘤（PMBT）患者群体中姑息治疗的现状，并主张改变当前医疗系统的方法，该方法仍然更强调治愈而非护理。
对过去10年的现有文献进行探索。
当前文献表明，及时转诊至姑息治疗咨询团队并获得社区资源，与住院次数减少、急诊就诊次数减少以及临终时侵入性积极治疗的启动减少相关。及时转诊至姑息治疗还被证明可以减轻痛苦、提高生活质量，在某些情况下还能延长预期寿命。
对于许多被诊断患有危及生命疾病的患者，尤其是患有PMBT的患者，早期转诊至姑息治疗尚未成为现实。需要更多研究来发现并挑战早期过渡的障碍，包括专业人员、患者和家属围绕姑息治疗的沟通问题。
