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目标关怀与 COVID-19:应对不确定性的良好框架。

Goals of care and COVID-19: A GOOD framework for dealing with uncertainty.

机构信息

Harvard Medical School, Harvard University, Boston, MA.

New England Geriatric Research, Education, and Clinical Center (GRECC), Boston, MA.

出版信息

Palliat Support Care. 2020 Aug;18(4):379-381. doi: 10.1017/S1478951520000474.

Abstract

As the COVID-19 pandemic continues, more patients will require palliative and end-of-life care. In order to ensure goal-concordant-care when possible, clinicians should initiate goals-of-care conversations among our most vulnerable patients and, ideally, among all patients. However, many non-palliative care clinicians face deep uncertainty in planning, conducting, and evaluating such interactions. We believe that specialists within palliative care are aptly positioned to address such uncertainties, and in this article offer a relevant update to a concise framework for clinicians to plan, conduct, and evaluate goals-of-care conversations: the GOOD framework. Once familiar with this framework, palliative care clinicians may use it to educate their non-palliative care colleagues about a timely and critical component of care, now and beyond the COVID-19 era.

摘要

随着 COVID-19 大流行的持续,将会有更多的患者需要姑息治疗和临终关怀。为了在可能的情况下确保目标一致的治疗,临床医生应该在我们最脆弱的患者中,理想情况下在所有患者中开展治疗目标的对话。然而,许多非姑息治疗的临床医生在规划、进行和评估此类互动时面临着深深的不确定性。我们相信,姑息治疗专家能够恰当地应对这些不确定性,在本文中,我们为临床医生提供了一个相关的更新,即一个用于规划、进行和评估治疗目标对话的简明框架:GOOD 框架。一旦熟悉了这个框架,姑息治疗的临床医生就可以用它来教育他们的非姑息治疗同事,让他们了解现在和 COVID-19 时代之后医疗护理中一个及时而关键的组成部分。

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