Moss Alvin H
Sections of Nephrology and Supportive Care, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
J Pain Symptom Manage. 2017 Mar;53(3):656-662.e1. doi: 10.1016/j.jpainsymman.2016.10.371. Epub 2017 Jan 6.
Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering. These patients would benefit from the integration of supportive care principles into their care. This article addresses how supportive care specialists can collaborate with nephrology clinicians to provide patient-centered supportive care and identifies resources to assist them in this endeavor.
尽管在透析前护理和透析技术方面取得了进展，但晚期慢性肾病和终末期肾病患者仍存在多种合并症、高症状负担、预期寿命缩短以及严重的身体、情感和精神痛苦。急性肾损伤和终末期肾病患者，尤其是老年患者，往往住院时间延长、更多地使用强化医疗治疗且生存率有限。不幸的是，大多数肾病学家未接受过进行共同决策对话以了解患者的价值观、偏好和治疗目标并解决患者多因素痛苦的培训。这些患者将受益于将支持性护理原则融入其护理中。本文探讨了支持性护理专家如何与肾病临床医生合作以提供以患者为中心的支持性护理，并确定有助于他们开展这项工作的资源。
