中国大陆应该大力发展安宁缓和医疗事业——北京协和医院的经验体会
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摘要
在中国大陆地区,治愈性治疗的理念处于主导地位,死亡质量需要改善,迫切需要缓和医疗理念的推广和实践,这一理念不仅可以改善死亡质量,而且可以实现医方、患方、政府、社会多赢的目的。在分析北京协和医院对缓和医疗理念的认识、实践和推广方面的实际工作的基础上,分享经验与体会:关于死亡和死亡质量、善终的内涵,医护团队有义务主动介绍;面对死亡话题,必须学会相应的沟通方法;必须有"总疼痛"的概念,具有"全人"的视角,从身心社灵全方位照顾到临终的患者。
In mainland China, the concept of curative treatment is dominant, and the quality of death needs to be improved. It is urgent to promote and practice the concept of palliative care. This concept can not only improve the quality of death, but also achieve the goal of win-win for doctors, patients, government and society. This paper shared some experience based on the analysis of the understanding, practice and promotion of palliative care concept in Peking Union Medical College Hospital. Regarding the connotation of death, quality of death and good death, the medical and nursing team had the obligation to introduce them actively. Faced the topic of death, it is necessary to learn the corresponding communication methods. Meanwhile, it is necessary to have the concept of "total pain", with the perspective of " holistic care", thus we can take care of the dying patients from physical, social, psychological and spiritual aspect.
In mainland China, the concept of curative treatment is dominant, and the quality of death needs to be improved. It is urgent to promote and practice the concept of palliative care. This concept can not only improve the quality of death, but also achieve the goal of win-win for doctors, patients, government and society. This paper shared some experience based on the analysis of the understanding, practice and promotion of palliative care concept in Peking Union Medical College Hospital. Regarding the connotation of death, quality of death and good death, the medical and nursing team had the obligation to introduce them actively. Faced the topic of death, it is necessary to learn the corresponding communication methods. Meanwhile, it is necessary to have the concept of "total pain", with the perspective of " holistic care", thus we can take care of the dying patients from physical, social, psychological and spiritual aspect.
引文
[1] Strengthening of palliative care as a component of comprehensive care throughout the life course.SIXTY- SEVENTH WORLD HEALTH ASSEMBLY[EB/OL].(2014- 05-24)[2018-02-15].http://www.who.int/cancer/palliative/zh/.
[2] Economist intelligence unit. The 2015 quality of death index. Ranking palliative care across the world[EB/OL]. (2018-01-16)[2018-03-10].http://www.pallnetz.ch/cm_ data/2015_Quality_of_Death_Index_Infographic.pdf.
[3] 国家卫生计生委.安宁疗护实践指南(试行) [EB/OL]. (2017-02-09)[2018-03-20].http://www.moh.gov.cn/yzygj/s3593/201702/83797c0261a947 81b158dbd76666 b717.shtml.
[4] Cummings JE, Hughes SL, Weaver FM, et al.Cost-effectiveness of Veterans Administration hospital-based home care[J]. A randomized clinical trial, 1990,150 (6):1274-1280.
[5] Gomes B, Calanzani N, Curiale V, et al.Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers[J]. Cochrane Database Syst Rev, 2013 6 (6):CD007760.
[6] Kastbom L,Milberg A,Karlsson MA good death from the perspective of palliative cancer patients [J].Support Care Cancer [J].2017,25(3):933-939.
[7] Hales S,Zimmermann C,Rodin G. The quality of dying and death[J]. Arch intern Med, 2008 ,168(9):912-918.
[2] Economist intelligence unit. The 2015 quality of death index. Ranking palliative care across the world[EB/OL]. (2018-01-16)[2018-03-10].http://www.pallnetz.ch/cm_ data/2015_Quality_of_Death_Index_Infographic.pdf.
[3] 国家卫生计生委.安宁疗护实践指南(试行) [EB/OL]. (2017-02-09)[2018-03-20].http://www.moh.gov.cn/yzygj/s3593/201702/83797c0261a947 81b158dbd76666 b717.shtml.
[4] Cummings JE, Hughes SL, Weaver FM, et al.Cost-effectiveness of Veterans Administration hospital-based home care[J]. A randomized clinical trial, 1990,150 (6):1274-1280.
[5] Gomes B, Calanzani N, Curiale V, et al.Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers[J]. Cochrane Database Syst Rev, 2013 6 (6):CD007760.
[6] Kastbom L,Milberg A,Karlsson MA good death from the perspective of palliative cancer patients [J].Support Care Cancer [J].2017,25(3):933-939.
[7] Hales S,Zimmermann C,Rodin G. The quality of dying and death[J]. Arch intern Med, 2008 ,168(9):912-918.