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[大流行期间的一般姑息治疗]

[General palliative care during the pandemic].

作者信息

Schwartz J, Reuters M C, Schallenburger M, Meier S, Roch C, Ziegaus A, Werner L, Fischer M, van Oorschot B, Neukirchen M

机构信息

Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, 40225 Düsseldorf, Deutschland.

Klinik für Anästhesie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland.

出版信息

Onkologe (Berl). 2021;27(7):686-690. doi: 10.1007/s00761-021-00970-3. Epub 2021 May 12.

Abstract

BACKGROUND

The German healthcare system is facing unprecedented challenges due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. Palliative care for critically ill patients and their families was also severely compromised, especially during the first wave of the pandemic, in both inpatient and outpatient settings.

MATERIALS AND METHODS

The paper is based on our experience in routine inpatient palliative care and partial results of a study conducted as part of the collaborative project "National Strategy for Palliative Care in Pandemic Times (PallPan)". Based on our experience from the inpatient care of patients suffering from severe or life-limiting disease, best-practice examples for improving or maintaining care in the on-going pandemic are described.

RESULTS

Restrictive visitor regulations, communication barriers and insufficient possibilities to accompany dying patients or their grieving relatives continue to pose major challenges in general and specialized inpatient palliative care. In order to maintain high-quality palliative care, it is necessary to create structures that enable targeted therapy discussions and end-of-life care in the presence of relatives. Therefore, innovative communication methods like video calls or individualized exceptions from visitor restrictions are needed.

CONCLUSIONS

Adequate care for seriously ill and dying patients and their relatives must be guaranteed during the pandemic. Individual arrangements should be arranged and implemented. If available, earlier involvement of specialized palliative care teams can be beneficial.

摘要

背景

由于严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)大流行,德国医疗保健系统正面临前所未有的挑战。重症患者及其家属的姑息治疗也受到严重影响,尤其是在大流行的第一波期间,无论是住院还是门诊环境。

材料与方法

本文基于我们在常规住院姑息治疗方面的经验以及作为“大流行时期姑息治疗国家战略(PallPan)”合作项目一部分进行的一项研究的部分结果。根据我们在重症或临终疾病患者住院护理方面的经验,描述了在持续的大流行中改善或维持护理的最佳实践示例。

结果

限制性探视规定、沟通障碍以及陪伴临终患者或其悲伤亲属的可能性不足,在普通和专科住院姑息治疗中仍然构成重大挑战。为了维持高质量的姑息治疗,有必要建立能够在亲属在场的情况下进行有针对性的治疗讨论和临终护理的架构。因此,需要创新的沟通方式,如视频通话或对探视限制的个性化例外安排。

结论

在大流行期间,必须确保为重症和临终患者及其亲属提供充分的护理。应安排并实施个性化安排。如有可能,尽早让专业姑息治疗团队参与可能会有所帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/600e/8114191/ec10dd6851c4/761_2021_970_Fig1_HTML.jpg

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