Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; James J. Peters Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center, Bronx, New York, USA.
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC Heart Fail. 2024 Jun;12(6):973-989. doi: 10.1016/j.jchf.2024.01.010. Epub 2024 Mar 6.
Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. These needs are particularly acute in advanced HF, a leading cause of death in the United States. Palliative care, when offered alongside HF disease management, offers improved symptom control, quality of life, communication, and caregiver satisfaction as well as reduced caregiver anxiety. The dynamic nature of the clinical trajectory of HF presents distinct symptom patterns, changing functional status, and uncertainty, which requires an adaptive, dynamic model of palliative care delivery. Due to a limited specialty-trained palliative care workforce, patients and their caregivers often cannot access these benefits, especially in the community. To meet these needs, new models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.
心力衰竭（HF）患者常伴有症状控制不佳、生活质量下降以及与医疗保健提供者沟通不畅等问题。这些需求在晚期 HF 中尤为突出，晚期 HF 是美国的主要致死原因之一。姑息治疗与 HF 疾病管理同时提供可改善症状控制、生活质量、沟通和护理人员满意度，并降低护理人员焦虑。HF 临床轨迹的动态性质呈现出明显的症状模式、不断变化的功能状态和不确定性，这需要姑息治疗提供一种适应性强、动态的模式。由于专业姑息治疗人员的数量有限，患者及其护理人员往往无法获得这些益处，尤其是在社区中。为了满足这些需求，需要采用新的模式，这些模式需要更好地利用高质量数据，使初级姑息治疗原则能够被广泛应用于各类医疗保健提供者，并明确引入专业姑息治疗的触发因素，针对患者的疾病轨迹和不断变化的需求提供具体的姑息干预措施。
