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血液学中姑息治疗的早期整合:对患者而言是当务之急,对医生来说是一项挑战。

Early integration of palliative care in hematology: an urgency for patients, a challenge for physicians.

作者信息

Ferraz Laura Ferreira de Mesquita, Ferreira Amanda Pifano Soares, Guimarães Tânia Vannucci Vaz, de Melo Campos Paula

机构信息

Hospital de Base do Distrito Federal, Brasília, DF, Brazil.

OC Oncoclínicas Hematológica, Belo Horizonte, MG, Brazil.

出版信息

Hematol Transfus Cell Ther. 2022 Oct-Dec;44(4):567-573. doi: 10.1016/j.htct.2022.06.007. Epub 2022 Jul 30.

Abstract

INTRODUCTION

Early integration between palliative care and other medical specialties in the care of patients with serious illnesses is consolidating itself as good medical practice, based on scientific and ethical evidence. Despite this, palliative care is still not part of the routine care of patients with hematological diseases, even in specialized centers.

OBJECTIVE AND METHOD

In this article, we review the benefits and the main barriers described in the literature for early integration of hematology and palliative care. We also point out the challenges encountered in clinical practice, such as end-of-life prognosis assessment in patients with hematological diseases and management of the most common symptoms in hematology. Finally, we review models of integration between palliative care and oncology centers in outpatient and inpatient settings.

RESULTS AND CONCLUSION

Patients with hematological diseases can greatly benefit from early integration with palliative care, with improvement in symptom control, quality of life, reduction of emotional distress and the development of advanced care directives. It is necessary to make hematologists aware of the benefits of palliative care, provide adequate training for multidisciplinary teams and encourage specific studies of palliative care in patients with hematological diseases.

摘要

引言

基于科学和伦理证据,在重症患者的护理中,姑息治疗与其他医学专科的早期整合正逐渐成为一种良好的医疗实践。尽管如此,姑息治疗仍未成为血液疾病患者常规护理的一部分,即使在专科中心也是如此。

目的与方法

在本文中,我们回顾了文献中描述的血液学与姑息治疗早期整合的益处和主要障碍。我们还指出了临床实践中遇到的挑战,如血液疾病患者的临终预后评估以及血液学中最常见症状的管理。最后,我们回顾了门诊和住院环境中姑息治疗与肿瘤中心的整合模式。

结果与结论

血液疾病患者可从与姑息治疗的早期整合中大大受益,症状控制得到改善,生活质量提高,情绪困扰减轻,并制定了高级护理计划。有必要让血液科医生了解姑息治疗的益处,为多学科团队提供充分培训,并鼓励对血液疾病患者进行姑息治疗的具体研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d677/9605907/a6a94712b857/gr1.jpg

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