Bangerter Lauren R, Griffin Joan M, Eagan Arielle, Mishra Manish, Lunde Angela, Roger Véronique, Mulley Albert, Lotherington Jon
Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 200 First Street SW Rochester, Minnesota, USA.
Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, Massachusetts, USA.
Int J Qual Health Care. 2018 Jun 1;30(5):408-413. doi: 10.1093/intqhc/mzy029.
In December 2016, 66 health leaders from 14 countries convened at the Salzburg Global Seminar (SGS) to engage in cross-cultural and collaborative discussions centered on 'Rethinking Care Toward the End of Life'. Conversations focused on global perspectives on death and dying, challenges experienced by researchers, physicians, patients and family caregivers. This paper summarizes key findings and recommendations from SGS.
Featured sessions focused on critical issues of end of life care led by key stakeholders, physicians, researchers, and other global leaders in palliative care. Sessions spanned across several critical themes including: patient/family/caregiver engagement, integrating health and community-based social care, eliciting and honoring patient preferences, building an evidence base for palliative care, learning from system failures, and delivering end of life care in low-resource countries. Sessions were followed by intensive collaborative discussions which helped formulate key recommendations for rethinking and ultimately advancing end of life care.
Prominent lessons learned from SGS include learning from low-resource countries, development of evidence-based quality measures, implementing changes in training and education, and respecting the personal agency of patients and their families.
There is a global need to rethink, and ultimately revolutionize end of life care in all countries. This paper outlines key aspects of end of life care that warrant explicit improvement through specific action from key stakeholders.
2016年12月，来自14个国家的66位卫生领域领导者齐聚萨尔茨堡全球研讨会（SGS），围绕“重新思考临终关怀”展开跨文化合作讨论。对话聚焦于全球对死亡和临终的看法、研究人员、医生、患者及家庭护理人员所面临的挑战。本文总结了SGS的关键发现和建议。
专题会议聚焦于临终关怀的关键问题，由关键利益相关者、医生、研究人员及其他姑息治疗领域的全球领导者主持。会议涵盖多个关键主题，包括：患者/家庭/护理人员参与、整合卫生与社区社会护理、引出并尊重患者偏好、建立姑息治疗证据基础、从系统故障中吸取教训以及在资源匮乏国家提供临终关怀。会议之后进行了深入的合作讨论，有助于为重新思考并最终推进临终关怀制定关键建议。
从SGS汲取的突出经验教训包括向资源匮乏国家学习、制定基于证据的质量衡量标准、在培训和教育方面实施变革以及尊重患者及其家庭的个人自主权。
全球都需要重新思考并最终彻底变革所有国家的临终关怀。本文概述了临终关怀的关键方面，需要关键利益相关者采取具体行动进行明确改进。
