Pople Josephine
Staff Nurse Wythenshawe Hospital, Manchester University NHS Foundation Trust.
Int J Palliat Nurs. 2017 Oct 2;23(10):486-495. doi: 10.12968/ijpn.2017.23.10.486.
Twenty years ago, the case was made for people with life-limiting medical conditions other than cancer to receive specialist palliative care services. The recommendation came from the National Council for Hospice and Specialist Palliative Care Services ( Addington Hall, 1998 ). Since then, research and practice have developed to make this a reality. We now see people with non-curative medical conditions, often referred to as being in the end stages of their chronic condition, receiving care and treatment by palliative care practitioners. There is, however, a long way to go before the rhetoric of 'palliative care for all' becomes a reality. Few people with end-stage pulmonary disease have access to hospice and specialist palliative care services. This article focuses on end-stage pulmonary disease, a term that encompasses all non-malignant, chronic lung conditions that progress to end-of-life care. An overview of the pathophysiology of the condition is given. Focus is placed on the stages of the disease and common patient problems, using case studies to highlight how the disease processes develop to become end stage and require palliative care. The article highlights the need for care planning at the end of life and the palliative care measures required to ensure good quality care centred on both physical and psychosocial aspects.
二十年前，有人提出除癌症患者外，患有危及生命的疾病的人也应接受专科姑息治疗服务。这一建议来自国家临终关怀与专科姑息治疗服务委员会（阿丁顿厅，1998年）。从那时起，研究和实践不断发展，以使这一建议成为现实。我们现在看到，患有无法治愈疾病的人，通常被称为处于慢性病终末期的人，正在接受姑息治疗从业者的护理和治疗。然而，要让“全民姑息治疗”的口号成为现实，还有很长的路要走。很少有终末期肺病患者能够获得临终关怀和专科姑息治疗服务。本文聚焦于终末期肺病，这一术语涵盖了所有发展到临终护理阶段的非恶性慢性肺部疾病。文中给出了该病症病理生理学的概述。重点关注疾病阶段和常见的患者问题，并通过案例研究来突出疾病过程如何发展到终末期并需要姑息治疗。本文强调了临终护理规划的必要性以及为确保以身体和心理社会方面为中心的优质护理所需的姑息治疗措施。
