Lilley Elizabeth J, Cooper Zara, Schwarze Margaret L, Mosenthal Anne C
1 The Center for Surgery and Public Health at Brigham and Women's Hospital , Boston, Massachusetts.
2 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
J Palliat Med. 2017 Jul;20(7):702-709. doi: 10.1089/jpm.2017.0079. Epub 2017 Mar 24.
Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet, these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social, and spiritual well-being and quality of life. To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. The objective of this article was to describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. We propose a research agenda to address these gaps and provide a road map for future investigation.
鉴于外科疾病具有急性且往往危及生命的特点，以及治疗可能引发更多痛苦，外科患者有相当大的姑息治疗需求。然而，与内科患者相比，这些患者接受姑息治疗的可能性较小，而且姑息治疗会诊往往在死亡临近时才进行，这反映了临终关怀质量较差。外科患者可能会从与手术治疗同时提供的早期姑息治疗中受益，以促进目标一致的决策制定，并改善患者的身体、情感、社会和精神健康以及生活质量。迄今为止，支持姑息治疗在外科实践中作用的证据很少，外科领域的姑息治疗研究受到方法学挑战和根深蒂固的文化规范的阻碍，这些规范妨碍了姑息治疗的适当提供。本文的目的是描述外科姑息治疗在三个优先领域的现有科学，并揭示该领域内的具体差距。我们提出了一项研究议程来填补这些差距，并为未来的研究提供路线图。
