Consultant, Assistant Professor, Medical University of South Carolina, Charleston, South Carolina.
Assistant Professor, Division of Hematology/Medical Oncology, School of Medicine, Oregon Health & Science University, Portland, Oregon; Knight Cancer Institute, Beaverton, Oregon.
Pain Manag Nurs. 2024 Aug;25(4):327-329. doi: 10.1016/j.pmn.2024.03.020. Epub 2024 May 1.
Fundamental to the quality of life is assisting patients in relieving pain including at the end of life. Compassionate, effective, evidence-based pain care for the dying improves the quality of life for patients and may reduce distress and complicated bereavement in the loved ones witnessing this death. However, efforts designed to mitigate the consequences of the opioid epidemic have seriously compromised pain care at the end of life. This has created an urgent need to focus on the barriers to relief, and solutions necessary to provide safe and effective pain and symptom management in this population. To that end, a committee of experts was convened by the American Society for Pain Management Nursing and the Hospice and Palliative Nursing Association. These experts reviewed the current literature, developed a draft position statement which underwent consecutive revisions. This statement was then endorsed by the respective organizations. Elucidation of barriers to effective pain control in advanced disease allows targeted interventions; including those related to clinical care, education, accessibility, and research. As nurses, we must continuously advocate for humane and dignified care, promoting ethical, effective pain and symptom management at the end of life for all.
提高生活质量的基础是帮助患者缓解疼痛，包括临终时的疼痛。对临终患者进行富有同情心、有效且基于证据的疼痛护理，可以提高患者的生活质量，并可能减轻目睹亲人死亡的亲友的痛苦和复杂的丧亲之痛。然而，旨在减轻阿片类药物泛滥后果的努力严重影响了临终关怀的疼痛护理。这就迫切需要关注缓解疼痛的障碍，以及为这一人群提供安全有效的疼痛和症状管理所需的解决方案。为此，美国疼痛管理护理学会和姑息护理护理协会召集了一个专家委员会。这些专家审查了当前的文献，制定了一份立场声明草案，并进行了多次修订。该声明随后得到了相关组织的认可。阐明晚期疾病中有效疼痛控制的障碍，可以进行有针对性的干预；包括与临床护理、教育、可及性和研究相关的干预。作为护士，我们必须不断倡导人道和有尊严的护理，促进所有人在生命末期都能得到人道和有尊严的护理，进行伦理、有效的疼痛和症状管理。
