Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician.
Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician.
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DOI：
10.1186/s44201-022-00010-9
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发表时间：
2022
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81%的癌症患者在生命的最后6个月内曾到急诊科(ED)就诊。急症室的癌症病人很多都是晚期，症状负担高，需要复杂，过半是住院病人。开发了创新的护理模式，为患有严重、限制生命的疾病(如晚期癌症)的患者提供高质量的门诊和居家护理。新的护理模式可以根据预后(例如，大于或少于6个月)、护理水平(例如，低强度需求与高强度需求，如静脉注射疼痛/恶心药物或频繁监测)以及护理目标(例如，针对癌症的治疗与仅针对症状的护理)分为若干类别。我们进行了叙述性回顾，以(1)比较急诊科重症癌症患者的护理模式，以及(2)检查可能加速或阻碍这些模式更广泛传播的因素。
Eighty-one percent of persons living with cancer have an emergency department (ED) visit within the last 6 months of life. Many cancer patients in the ED are at an advanced stage with high symptom burden and complex needs, and over half is admitted to an inpatient setting. Innovative models of care have been developed to provide high quality, ambulatory, and home-based care to persons living with serious, life-limiting illness, such as advanced cancer. New care models can be divided into a number of categories based on either prognosis (e.g., greater than or less than 6 months), or level of care (e.g., lower versus higher intensity needs, such as intravenous pain/nausea medication or frequent monitoring), and goals of care (e.g., cancer-directed treatment versus symptom-focused care only). We performed a narrative review to (1) compare models of care for seriously ill cancer patients in the ED and (2) examine factors that may hasten or impede wider dissemination of these models.