期刊
CA-A CANCER JOURNAL FOR CLINICIANS
卷 68, 期 5, 页码 356-376出版社
WILEY
DOI: 10.3322/caac.21490
关键词
access; delivery of health care; integration; neoplasms; palliative care
类别
资金
- National Institutes of Health [1R01CA214960-01A1, R21NR016736]
- American Cancer Society [MRSG-14-1418-01-CCE]
- Andrew Sabin Family Fellowship Award
- Ontario Ministry of Health and Long-Term Care [152996]
- Canadian Institutes of Health Research [152996]
- Rose Family Chair in Palliative Medicine and Supportive Care
Over the past decade, a large body of evidence has accumulated supporting the integration of palliative care into oncology practice for patients with advanced cancer. The question is no longer whether palliative care should be offered, but what is the optimal model of delivery, when is the ideal time to refer, who is in greatest need of a referral, and how much palliative care should oncologists themselves be providing. These questions are particularly relevant given the scarcity of palliative care resources internationally. In this state-of-the-science review directed at the practicing cancer clinician, the authors first discuss the contemporary literature examining the impact of specialist palliative care on various health outcomes. Then, conceptual models are provided to support team-based, timely, and targeted palliative care. Team-based palliative care allows the interdisciplinary members to address comprehensively the multidimensional care needs of patients and their caregivers. Timely palliative care, at its best, is preventive care to minimize crises at the end of life. Targeted palliative care involves identifying the patients most likely to benefit from specialist palliative care interventions, akin to the concept of targeted cancer therapies. Finally, the strengths and weaknesses of innovative care models, such as outpatient clinics, embedded clinics, nurse-led palliative care, primary palliative care provided by oncology teams, and automatic referral, are summarized. Moving forward, more research is needed to determine how different health systems can best personalize palliative care to provide the right level of intervention, for the right patient, in the right setting, at the right time. (C) 2018 American Cancer Society.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据