Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities.
Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities.
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DOI：
10.1016/j.jacc.2017.08.036
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发表时间：
2017-10-10
影响因子：
24
通讯作者：
Arnold RM
中科院分区：
文献类型：
--
作者：
Kavalieratos D;Gelfman LP;Tycon LE;Riegel B;Bekelman DB;Ikejiani DZ;Goldstein N;Kimmel SE;Bakitas MA;Arnold RM
心力衰竭（HF）患者及其家属在心力衰竭患病过程中会因多种原因而承受压力和痛苦。姑息治疗是一种跨学科的服务以及一种整体的护理方法，它能提高重症患者的生活质量并减轻其痛苦，无论预后如何。在这篇综述中，我们综合了心力衰竭姑息治疗干预的随机临床试验的证据。虽然心力衰竭姑息治疗的证据基础很有前景，但它仍处于起步阶段，需要更多高质量、方法学合理的研究来明确阐明姑息治疗对承受心力衰竭负担的患者及其家属的作用。然而，由初级医疗和心脏病学临床医生提供的对初级姑息治疗（例如基本的身体和情绪症状管理、预先护理计划）的关注度增加，可能是一种在疾病早期以及整个病程中解决未满足的姑息治疗需求的途径。
Patients with HF and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.
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