Trinity College of Arts and Sciences, Duke University, Durham, NC.
Duke Cancer Institute, Duke University Medical Center, Durham, NC.
JCO Oncol Pract. 2020 Dec;16(12):803-809. doi: 10.1200/OP.20.00309. Epub 2020 Nov 13.
Patients with advanced cancer and their families frequently encounter clinical and logistical challenges related to end-of-life care. Hospice provides interdisciplinary and holistic care to meet patients' biomedical, psychosocial, and spiritual needs in the last phases of life. Despite increasing general acceptance and use among patients with cancer, hospice remains underused. Underuse stems from ongoing misconceptions regarding hospice and its purpose, coupled with the rapid development of novel anticancer treatments, such as immunotherapies and targeted therapies, that have changed the landscape of possibilities. Furthermore, rapid evolutions in how end-of-life care is structured and reimbursed for will affect how oncology patients will intersect with hospice care. In this review, we explore the current and future challenges to greater integration of hospice care in the care of patients with advanced cancer and propose five recommendations as part of the path forward.
晚期癌症患者及其家属经常在临终关怀方面面临临床和后勤方面的挑战。临终关怀提供跨学科的整体护理,以满足患者在生命最后阶段的生物医学、心理社会和精神需求。尽管临终关怀在癌症患者中的接受度和使用率不断提高,但它的使用仍然不足。使用率低的原因是人们对临终关怀及其目的存在持续的误解,再加上新型抗癌治疗方法(如免疫疗法和靶向疗法)的快速发展,改变了治疗的可能性。此外,临终关怀的结构和报销方式的快速演变将影响肿瘤患者与临终关怀的交叉情况。在这篇综述中,我们探讨了在晚期癌症患者的护理中更大程度地整合临终关怀所面临的当前和未来挑战,并提出了作为前进道路一部分的五项建议。