Norwich Medical School, University of East Anglia, Norwich, UK
Department of Respiratory Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
BMJ Support Palliat Care. 2022 Dec;12(e6):e748-e751. doi: 10.1136/bmjspcare-2019-002148. Epub 2020 Jun 19.
Fibrotic interstitial lung disease is an incurable disease with poor prognosis. We aimed to understand factors affecting decisions regarding referrals to specialist palliative care services and to address barriers and facilitators to referrals from healthcare professionals' perspectives.
A survey study of healthcare professionals, including respiratory physicians, interstitial lung disease nurse specialists, respiratory nurse specialists and palliative care physicians, was conducted using a questionnaire, entailing 17 questions.
Thirty-six respondents, including 15 interstitial lung disease nurse specialists completed the questionnaire. Symptom control, psychological/spiritual support, general deterioration and end-of-life care were the most common reasons for referrals to specialist palliative care services. Most respondents felt confident in addressing palliative care needs and discussing palliative care with patients. A few participants emphasised that experienced respiratory nurse specialists are well placed to provide symptom management and to ensure continuity of patient care. Participants reported that access to palliative care could be improved by increasing collaborative work between respiratory and palliative care teams.
Most respondents felt that enhancing access to specialist palliative care services would benefit patients. However, palliative care and respiratory care should not be considered as mutually exclusive and multidisciplinary approach is recommended.
纤维化间质性肺疾病是一种无法治愈且预后不良的疾病。我们旨在了解影响将患者转介至专科姑息治疗服务的因素，并从医疗保健专业人员的角度解决转介的障碍和促进因素。
对医疗保健专业人员（包括呼吸科医生、间质性肺疾病护士专家、呼吸护士专家和姑息治疗医生）进行了一项问卷调查研究，共包含 17 个问题。
36 名受访者（包括 15 名间质性肺疾病护士专家）完成了问卷。症状控制、心理/精神支持、一般恶化和临终关怀是转介至专科姑息治疗服务的最常见原因。大多数受访者对满足姑息治疗需求并与患者讨论姑息治疗有信心。一些参与者强调，经验丰富的呼吸护士专家非常适合提供症状管理并确保患者护理的连续性。参与者报告说，增加呼吸和姑息治疗团队之间的协作可以改善姑息治疗的可及性。
大多数受访者认为，增加获得专科姑息治疗服务的机会将使患者受益。然而，姑息治疗和呼吸治疗不应被视为相互排斥的，建议采取多学科方法。
