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全球视角下的癌症患者姑息治疗:并非所有国家都一样。

Global Perspectives on Palliative Care for Cancer Patients: Not All Countries Are the Same.

机构信息

Billings Clinic, 2651 North Bridger Drive, Billings, MT, 59102, USA.

Middle Eastern Cancer Consortium, Haifa, Israel.

出版信息

Curr Oncol Rep. 2021 Apr 8;23(5):60. doi: 10.1007/s11912-021-01044-8.

Abstract

PURPOSE OF THE REVIEW

The integration of cancer-related palliative care is essential to holistic, quality cancer care. While some similarities exist between countries, this manuscript will focus on five differences that impact palliative care for cancer patients including the epidemiology of cancer and related symptoms, cancer-specific integration into care, palliative care education, economic development of the country, and cultural and religious differences.

RECENT FINDINGS

The epidemiology of cancer varies around the world resulting in variable symptoms and the need for individualized approaches to palliative care. While palliative care is integrated in some countries, it is lacking in over half of the world, and specific integration into cancer care is virtually absent. Education and training are the key to expansion, and yet oncology-focused palliative care education is lacking or is not well-reported in the literature. To complicate this global lens even further are the economic disparities that exist. Low-to-middle-income countries (LMICs) are resource poor and have the fewest resources and least amount of integration, and yet patients with advanced cancer are over-represented in these countries. Essential to cancer-related palliative care is a tailored approach that addresses cultural and religious differences around the globe. Palliative care is developing around the globe and yet palliative care specific for cancer patients is in its infancy. Cancer care professionals should (1) understand the epidemiologic differences that exist globally and the impact this has on palliative care, (2) integrate palliative care into the cancer care arena, (3) provide cancer-specific palliative education focused on the cancer trajectory from diagnosis through survivorship and end of life, (4) advocate for LMICs, which suffer from a lack of resources and services, and (5) understand cultural and religious differences that exist to provide holistic and sensitive cancer-related palliative care.

摘要

审查目的

将癌症相关姑息治疗纳入整体癌症护理至关重要。虽然各国之间存在一些相似之处,但本文将重点介绍五个影响癌症患者姑息治疗的差异,包括癌症的流行病学和相关症状、癌症特定的治疗整合、姑息治疗教育、国家的经济发展以及文化和宗教差异。

最近的发现

癌症的流行病学在全球范围内存在差异,导致症状各异,需要采用个体化的姑息治疗方法。虽然在一些国家姑息治疗已经整合,但在全球超过一半的国家中还缺乏这种治疗,癌症治疗中几乎没有特定的姑息治疗整合。教育和培训是扩大服务范围的关键,但肿瘤学重点的姑息治疗教育在文献中缺乏或报道不佳。使这一全球性问题更加复杂的是存在的经济差距。中低收入国家资源匮乏,资源最少,整合程度最低,但这些国家的晚期癌症患者却最多。癌症相关姑息治疗的关键是采用一种针对全球文化和宗教差异的量身定制的方法。姑息治疗在全球范围内不断发展,但针对癌症患者的姑息治疗仍处于起步阶段。癌症护理专业人员应(1)了解全球存在的流行病学差异及其对姑息治疗的影响,(2)将姑息治疗纳入癌症护理领域,(3)提供专注于癌症轨迹的癌症特异性姑息治疗教育,从诊断到生存和生命末期,(4)倡导中低收入国家,这些国家缺乏资源和服务,(5)了解存在的文化和宗教差异,以提供整体和敏感的癌症相关姑息治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f2c/8026388/0af7033aa6c3/11912_2021_1044_Fig1_HTML.jpg

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