Howell Doris
Princess Margaret Cancer Research Centre, Toronto, ON, Canada.
Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Lung Cancer Manag. 2021 Jul 2;10(4):LMT52. doi: 10.2217/lmt-2020-0017. eCollection 2021 Dec.
Globally, engagement of patients in the self management of disease and symptom problems has become a health policy priority to improve health outcomes in cancer. Unfortunately, little attention has been focused on the provision of self-management support (SMS)in cancer and specifically for complex cancer symptoms such as breathlessness. Current management of breathlessness, which includes treatment of underlying disease, pharmacological agents to address comorbidities and opiates and anxiolytics to change perception and reduce the sense of breathing effort, is inadequate. In this perspective paper, we review the rationale and evidence for a structured, multicomponent SMS program in breathlessness including four components: breathing retraining, enhancing positive coping skills, optimizing exertional capacity and reducing symptom burden and health risks. The integration of SMS in routine lung cancer care is essential to improve breathlessness, reduce psychological distress, suffering and improve quality of life.
在全球范围内，让患者参与疾病和症状问题的自我管理已成为一项卫生政策重点，以改善癌症患者的健康结局。遗憾的是，很少有人关注癌症患者自我管理支持（SMS）的提供，尤其是针对诸如呼吸困难等复杂癌症症状的支持。目前对呼吸困难的管理，包括对基础疾病的治疗、用于治疗合并症的药物以及用于改变认知和减轻呼吸努力感的阿片类药物和抗焦虑药，都存在不足。在这篇观点论文中，我们回顾了针对呼吸困难的结构化、多组分SMS项目的基本原理和证据，该项目包括四个组成部分：呼吸再训练、增强积极应对技能、优化运动能力以及减轻症状负担和健康风险。将SMS纳入常规肺癌护理对于改善呼吸困难、减轻心理困扰、痛苦并提高生活质量至关重要。
