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在帕金森病中采用姑息治疗理念是一项未得到满足的需求。

Adopting a palliative care mindset is an unmet need in Parkinson's disease.

作者信息

Kundrick Avery, Hogue Olivia, Namrow Sarah, Samala Renato, Walter Ellen, Walter Benjamin, Fernandez Hubert, Margolius Adam

机构信息

Center for Neurological Restoration, Neurological Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, United States.

Washington University, St. Loius, MO 63130, USA.

出版信息

Clin Park Relat Disord. 2023 Jun 20;9:100206. doi: 10.1016/j.prdoa.2023.100206. eCollection 2023.

Abstract

INTRODUCTION

Parkinson's disease (PD) affects multiple facets of patients' lives, many of which may not be recognized or addressed by their healthcare team. A growing body of evidence has shown that palliative care improves patients' quality of life with PD; however, little is currently known about how patients with PD perceive palliative care.

METHODS

An 8-question multiple choice survey was created and given to patients with established care for PD at a movement disorders clinic in a quaternary care center. Patients with less than two years of follow-up or that had atypical features of PD were excluded from the survey.

RESULTS

There were 106 respondents to the survey. A third of patients reported having never heard of palliative care and an additional 25% had heard of it but did not know what it was. Eighty-eight percent reported being familiar with or very knowledgeable about hospice, though 50% of respondents did not know the difference between hospice and palliative care. 93% had never been offered either service. 37.7% thought their neurologist should discuss advance care planning early in the course of their disease.

CONCLUSION

Even among established patients with Parkinson's disease in a quaternary center, over half were not familiar with palliative care, and the majority had never been offered palliative or hospice services despite growing evidence that it could improve their quality of life. Additionally, patients would like to be introduced to advanced care planning early in the course of their disease.

摘要

引言

帕金森病(PD)会影响患者生活的多个方面,而其中许多方面可能未被其医疗团队认识到或予以处理。越来越多的证据表明,姑息治疗可改善帕金森病患者的生活质量;然而,目前对于帕金森病患者如何看待姑息治疗知之甚少。

方法

设计了一份包含8个问题的多项选择题调查问卷,并将其发放给一家四级医疗中心运动障碍诊所中已确诊为帕金森病的患者。随访时间不足两年或具有帕金森病非典型特征的患者被排除在调查之外。

结果

共有106名患者参与了此次调查。三分之一的患者表示从未听说过姑息治疗,另有25%的患者听说过但不知道其具体内容。88%的患者表示熟悉或非常了解临终关怀,不过50%的受访者不知道临终关怀与姑息治疗之间的区别。93%的患者从未接受过这两种服务中的任何一种。37.7%的患者认为他们的神经科医生应该在其疾病进程早期就讨论预先护理计划。

结论

即使在四级医疗中心已确诊的帕金森病患者中,超过半数的患者不熟悉姑息治疗,并且尽管越来越多的证据表明姑息治疗可以改善他们的生活质量,但大多数患者从未接受过姑息治疗或临终关怀服务。此外,患者希望在其疾病进程早期就了解预先护理计划。

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