Goswami Poonam
The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Adv Pract Oncol. 2021 Jan-Feb;12(1):89-95. doi: 10.6004/jadpro.2021.12.1.7. Epub 2021 Jan 1.
Advance care planning discussions ensure patients' values and goals of care, including the freedom to choose their place of death, are respected. The benefits of advance care planning and early end-of-life care discussions are often delayed, as these discussions are not initiated early in patients' cancer trajectories. As a result, patients' wishes often remain unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which leads to higher resource utilization, decreased quality of life, and increased cost. The purpose of this article is to provide practical tips to the oncology advanced practitioner on initiating advance care planning and end-of-life care discussions with patients and their families or caregivers.
预先护理计划讨论可确保患者的护理价值观和目标，包括选择死亡地点的自由，得到尊重。预先护理计划和早期临终护理讨论的益处往往会延迟显现，因为这些讨论并未在患者的癌症病程早期启动。因此，患者的意愿往往直到生命的最后阶段才为人所知。有证据表明，许多患者在临终时接受了不适当的积极治疗，这导致了更高的资源利用、生活质量下降和成本增加。本文的目的是为肿瘤学高级从业者提供实用建议，以启动与患者及其家人或护理人员的预先护理计划和临终护理讨论。
