Courteau C, Chaput G, Musgrave L, Khadoury A
Department of Family Medicine, McGill University, Montreal, QC.
Division of Supportive and Palliative Medicine, Royal Victoria Hospital of the McGill University Health Centre, Montreal, QC.
Curr Oncol. 2018 Dec;25(6):403-408. doi: 10.3747/co.25.4453. Epub 2018 Dec 1.
Palliative care (pc) is a fundamental component of the cancer care trajectory. Its primary focus is on "the quality of life of people who have a life-threatening illness, and includes pain and symptom management, skilled psychosocial, emotional and spiritual support" to patients and loved ones. Palliative care includes, but is not limited to, end-of-life care. The benefits of early introduction of pc services in the care trajectory of patients with advanced cancer are well known, as indicated by improved quality of life, satisfaction with care, and a potential for increased survival. In turn, early referral of patients with advanced cancer to pc services is strongly recommended. So when, how, and why should patients with advanced cancer be referred to pc services? In this article, we summarize evidence to address these questions about early pc referral: ▪ What are the known benefits?▪ What is the "ideal" pc referral timing?▪ What are the barriers?▪ Which strategies can optimize integration of pc into oncology care?▪ Which communication tools can facilitate skillful introduction of pc to patients?
姑息治疗（PC）是癌症治疗过程中的一个基本组成部分。其主要重点是“患有危及生命疾病的患者的生活质量，包括对患者及其亲人的疼痛和症状管理、专业的心理社会、情感和精神支持”。姑息治疗包括但不限于临终关怀。如提高生活质量、对护理的满意度以及可能延长生存期所示，在晚期癌症患者的治疗过程中尽早引入PC服务的益处是众所周知的。相应地，强烈建议将晚期癌症患者尽早转诊至PC服务。那么，晚期癌症患者应在何时、如何以及为何转诊至PC服务呢？在本文中，我们总结相关证据以解答这些关于早期PC转诊的问题：▪ 已知的益处有哪些？▪ “理想的”PC转诊时机是什么？▪ 存在哪些障碍？▪ 哪些策略可以优化PC与肿瘤学护理的整合？▪ 哪些沟通工具可以促进向患者巧妙介绍PC？
