Maciver Jane, Ross Heather J
Ted Rogers Center for Heart Research and the Peter Munk Cardiac Center, University Health Network.
Lawrence S. Bloomberg Faculty of Nursing.
Curr Opin Cardiol. 2018 Mar;33(2):202-207. doi: 10.1097/HCO.0000000000000484.
The current review discusses the integration of guideline and evidence-based palliative care into heart failure end-of-life (EOL) care.
North American and European heart failure societies recommend the integration of palliative care into heart failure programs. Advance care planning, shared decision-making, routine measurement of symptoms and quality of life and specialist palliative care at heart failure EOL are identified as key components to an effective heart failure palliative care program. There is limited evidence to support the effectiveness of the individual elements. However, results from the palliative care in heart failure trial suggest an integrated heart failure palliative care program can significantly improve quality of life for heart failure patients at EOL.
Integration of a palliative approach to heart failure EOL care helps to ensure patients receive the care that is congruent with their values, wishes and preferences. Specialist palliative care referrals are limited to those who are truly at heart failure EOL.
本综述探讨将基于指南和证据的姑息治疗纳入心力衰竭临终（EOL）护理。
北美和欧洲心力衰竭学会建议将姑息治疗纳入心力衰竭项目。预先护理计划、共同决策、症状和生活质量的常规测量以及心力衰竭临终时的专科姑息治疗被确定为有效心力衰竭姑息治疗项目的关键组成部分。支持各个要素有效性的证据有限。然而，心力衰竭姑息治疗试验的结果表明，综合心力衰竭姑息治疗项目可显著提高心力衰竭患者临终时的生活质量。
将姑息治疗方法纳入心力衰竭临终护理有助于确保患者接受与其价值观、愿望和偏好相符的护理。专科姑息治疗转诊仅限于真正处于心力衰竭临终阶段的患者。
