Palliative Care Unit and Competence Centre, Department of Internal Medicine, Spital Schwyz, Waldeggstrasse 10, 6430 Schwyz, Switzerland.
Department of Palliative Medicine, University Medical Center Göttingen Georg August University, Robertkochstrasse 40, 37075 Göttingen, Germany.
Cardiovasc Res. 2020 Jan 1;116(1):12-27. doi: 10.1093/cvr/cvz200.
Contrary to common perception, modern palliative care (PC) is applicable to all people with an incurable disease, not only cancer. PC is appropriate at every stage of disease progression, when PC needs emerge. These needs can be of physical, emotional, social, or spiritual nature. This document encourages the use of validated assessment tools to recognize such needs and ascertain efficacy of management. PC interventions should be provided alongside cardiologic management. Treating breathlessness is more effective, when cardiologic management is supported by PC interventions. Treating other symptoms like pain or depression requires predominantly PC interventions. Advance Care Planning aims to ensure that the future treatment and care the person receives is concordant with their personal values and goals, even after losing decision-making capacity. It should include also disease specific aspects, such as modification of implantable device activity at the end of life. The Whole Person Care concept describes the inseparability of the physical, emotional, and spiritual dimensions of the human being. Addressing psychological and spiritual needs, together with medical treatment, maintains personal integrity and promotes emotional healing. Most PC concerns can be addressed by the usual care team, supported by a PC specialist if needed. During dying, the persons' needs may change dynamically and intensive PC is often required. Following the death of a person, bereavement services benefit loved ones. The authors conclude that the inclusion of PC within the regular clinical framework for people with heart failure results in a substantial improvement in quality of life as well as comfort and dignity whilst dying.
与普遍认知相反，现代姑息治疗（PC）适用于所有患有不治之症的人，而不仅仅是癌症患者。PC 在疾病进展的每个阶段都适用，当出现 PC 需求时。这些需求可能是身体、情感、社会或精神方面的。本文件鼓励使用经过验证的评估工具来识别这些需求，并确定管理的效果。PC 干预措施应与心脏病学管理同时提供。当心脏病学管理得到 PC 干预措施的支持时，治疗呼吸困难的效果更好。治疗疼痛或抑郁等其他症状则需要主要的 PC 干预措施。预先护理计划旨在确保在失去决策能力后，患者未来接受的治疗和护理符合其个人价值观和目标。它还应包括疾病特定方面，例如在生命末期修改可植入设备的活动。全人关怀概念描述了人类身体、情感和精神维度的不可分割性。解决心理和精神需求，与医疗治疗一起，维护个人完整性并促进情感康复。大多数 PC 问题可以由常规护理团队解决，如果需要，还可以由 PC 专家提供支持。在临终期间，患者的需求可能会动态变化，通常需要强化 PC。在患者死亡后，丧亲服务会使亲人受益。作者得出结论，将 PC 纳入心力衰竭患者的常规临床框架内，可以显著提高生活质量以及临终时的舒适度和尊严。
