Marsaa Kristoffer, Guldin Mai-Britt, Marques Alda, Pinnock Hilary, Janssen Daisy J A
Steno Diabetes Center Copenhagen, Herlev, Aarhus, Denmark.
Research Unit for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark; Center for Grief and Existential Values, Aarhus, Denmark.
Chest. 2025 Jan;167(1):112-120. doi: 10.1016/j.chest.2024.09.003. Epub 2024 Oct 3.
This narrative review emphasizes the growing interest in palliative care for people with serious lung diseases such as COPD. It reflects on recent publications from the American Thoracic Society, the World Health Organization, and European Respiratory Society, with a focus on nonpharmacologic palliative care for people with COPD from both the health care professional and organizational perspective.
The concept of palliative care has changed over time and is now seen as applicable throughout the entire disease trajectory according to need, in conjunction with any disease-modifying therapies. Palliative care should pay attention to the needs of the person with COPD as well as the informal caregiver. Timely integration of palliative care with disease-modifying treatment requires assessment of needs at the individual level as well as organizational changes. High-quality communication, including advance care planning, is a cornerstone of palliative care.
Therefore, services should be based on the understanding that palliative care is not only specific standardized actions and treatments, but rather a holistic approach that includes compassionate communication, treatment, and care addressing the patient and informal and formal caregivers. Living with and dying of COPD is much more than objective measurements. It is the sum of relationships with others and the experience of living in the best possible harmony with one's own values and hopes, despite having a serious illness.
本叙述性综述强调了对慢性阻塞性肺疾病(COPD)等严重肺部疾病患者姑息治疗的兴趣日益增长。它回顾了美国胸科学会、世界卫生组织和欧洲呼吸学会最近的出版物,重点从医疗保健专业人员和组织的角度探讨了COPD患者的非药物姑息治疗。
姑息治疗的概念随时间而变化,现在根据需要,与任何疾病改善疗法相结合,被视为适用于整个疾病轨迹。姑息治疗应关注COPD患者以及非正式照护者的需求。将姑息治疗与疾病改善治疗及时整合需要在个体层面进行需求评估以及组织变革。高质量的沟通,包括预先护理计划,是姑息治疗的基石。
因此,服务应基于这样的理解,即姑息治疗不仅是特定的标准化行动和治疗,而是一种整体方法,包括富有同情心的沟通、治疗以及针对患者、非正式和正式照护者的护理。与COPD共存和死于COPD远不止客观测量。它是与他人关系的总和,以及尽管患有重病但仍尽可能与自己的价值观和希望和谐相处的生活体验。