Department of Research & Development, CIRO, Horn.
Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Curr Opin Support Palliat Care. 2021 Dec 1;15(4):199-204. doi: 10.1097/SPC.0000000000000567.
The purpose of this paper is (1) to provide insight in the palliative care needs of patients with COVID-19; (2) to highlight the challenges of COVID-19 for palliative care; and (3) to highlight developments in COVID-19 palliative care.
Patients with serious COVID-19 have palliative care needs in all domains: physical, psychological, social and spiritual. COVID-19 palliative care is confronted with many challenges, including: the uncertain prognosis, resource limitations, challenges regarding advance care planning, lack of guidance, limited multidisciplinary collaboration, need for remote communication, restrictions in family visits, and burden for clinicians. Palliative care responded with many developments: development of services; integration of palliative care with other services; tools to support advance care planning, (remote) communication with patients and families, or spiritual care; and care for team members.
Palliative care has an important role in this pandemic. Palliative care rapidly developed services and opportunities were found to support patients, families and clinicians. Further developments are warranted to face future demands of a pandemic, including integrated palliative care and education in palliative care skills across all specialties. Intervention studies are needed to enable evidence-based recommendations for palliative care in COVID-19.
本文旨在(1)深入了解 COVID-19 患者的姑息治疗需求;(2)强调 COVID-19 对姑息治疗的挑战;以及(3)强调 COVID-19 姑息治疗的新进展。
患有严重 COVID-19 的患者在所有领域都有姑息治疗需求:身体、心理、社会和精神。COVID-19 姑息治疗面临着许多挑战,包括:不确定的预后、资源限制、预先护理计划方面的挑战、缺乏指导、多学科合作有限、远程沟通需求、家庭探视限制以及临床医生的负担。姑息治疗作出了许多发展回应:服务的发展;姑息治疗与其他服务的整合;支持预先护理计划、(远程)与患者和家属沟通或精神关怀的工具;以及对团队成员的关怀。
姑息治疗在这场大流行中发挥了重要作用。姑息治疗迅速发展了服务,并找到了支持患者、家庭和临床医生的机会。需要进一步发展,以应对未来大流行的需求,包括姑息治疗的综合服务以及所有专业的姑息治疗技能教育。需要干预研究,为 COVID-19 中的姑息治疗提供循证建议。