Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY, 10029, USA.
Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.
Heart Fail Rev. 2017 Sep;22(5):611-620. doi: 10.1007/s10741-017-9604-9.
Heart failure (HF) is a chronic and progressive illness, which affects a growing number of adults, and is associated with a high morbidity and mortality, as well as significant physical and psychological symptom burden on both patients with HF and their families. Palliative care is the multidisciplinary specialty focused on optimizing quality of life and reducing suffering for patients and families facing serious illness, regardless of prognosis. Palliative care can be delivered as (1) specialist palliative care in which a palliative care specialist with subspecialty palliative care training consults or co-manages patients to address palliative needs alongside clinicians who manage the underlying illness or (2) as primary palliative care in which the primary clinician (such as the internist, cardiologist, cardiology nurse, or HF specialist) caring for the patient with HF provides the essential palliative domains. In this paper, we describe the key domains of primary palliative care for patients with HF and offer some specific ways in which primary palliative care and specialist palliative care can be offered in this population. Although there is little research on HF primary palliative care, primary palliative care in HF offers a key opportunity to ensure that this population receives high-quality palliative care in spite of the growing numbers of patients with HF as well as the limited number of specialist palliative care providers.
心力衰竭（HF）是一种慢性且进行性疾病，影响着越来越多的成年人，与高发病率和死亡率相关，并且对 HF 患者及其家属的身体和心理症状都带来了巨大负担。姑息治疗是一个多学科专业，专注于优化生活质量并减轻患有严重疾病的患者和家庭的痛苦，无论预后如何。姑息治疗可以分为以下两种形式：（1）专科姑息治疗，由接受过专科姑息治疗培训的姑息治疗专家咨询或共同管理患者，以解决临床医生治疗潜在疾病的同时所产生的姑息需求；（2）初级姑息治疗，由负责 HF 患者的初级临床医生（如内科医生、心脏病专家、心脏病护士或 HF 专家）提供基本的姑息治疗领域。本文描述了 HF 患者初级姑息治疗的关键领域，并提供了一些在该人群中提供初级姑息治疗和专科姑息治疗的具体方法。尽管 HF 初级姑息治疗的研究较少，但 HF 初级姑息治疗为确保该人群获得高质量的姑息治疗提供了一个关键机会，尽管 HF 患者数量不断增加，而专科姑息治疗提供者数量有限。
