Advances in Palliative Medicine and End-of-Life Care

被引:16
作者
Abrahm, Janet L. [1 ,2 ]
机构
[1] Brigham & Womens Hosp, Dana Farber Canc Inst, Dept Psychosocial Oncol & Palliat Care, Div Adult Palliat Care, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Boston, MA 02115 USA
来源
ANNUAL REVIEW OF MEDICINE, VOL 62, 2011 | 2011年 / 62卷
关键词
palliative care; quality of life; methadone; neuropathic pain; CINV; delirium; POLST; ADVANCED CANCER-PATIENTS; TREATMENT PREFERENCES; COMMUNICATION-SKILLS; AMERICAN-SOCIETY; MENTAL-HEALTH; NEAR-DEATH; PAIN; ASSOCIATIONS; QUALITY; UPDATE;
D O I
10.1146/annurev-med-050509-163946
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Palliative care improves the quality and cost-effectiveness of adult and pediatric patient care, and it decreases unwanted hospitalizations and aggressive care at the end of life. National palliative care quality standards and preferred practices can be used for benchmarking by institutions, health care systems, and accrediting bodies. Pain and symptom management and the management of delirium for patients is now possible for the vast majority of patients, even those with advanced disease. However, because of shortages of specialists providing "tertiary" palliative care, significant improvements are needed in generalist-level palliative care among oncologists, intensivists, and specialists caring for patients with advanced cardiac, pulmonary, renal, and hepatic diseases. POLST (Physician Orders for Life-Sustaining Treatment) forms are a major advance in end-of-life care. They enable patients' advance directives to be valid wherever they are cared for (home, hospital, or nursing facility).
引用
收藏
页码:187 / 199
页数:13
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