在脏息护理中的透析接入考虑因素
Samantha L Gelfand1, Dirk M Hentschel2
1Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston MA; Department of Medicine, Division of Palliative Care, Brigham and Women's Hospital, Boston, MA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Interventional Nephrology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Seminars in nephrology
|August 14, 2023
概括
计划透析接入涉及老年或重病患者的复杂决策. 了解潜在的并发症和益处对于明智地选择置换疗法与保守护理至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医学伦理 医学伦理
- 抚慰性护理是一种缓解性护理.
背景情况:
- 透析接入计划需要对寿命有限的患者进行仔细考虑.
- 中心静脉导管虽然可以立即使用,但其风险比或移植更高.
- 早期准入安置的好处必须与潜在的过早或不必要的程序进行权衡.
研究的目的:
- 审查透析准入规划,预后和以患者为中心的决策方面的挑战.
- 突出了解透析并发症对患者和家人的重要性.
- 探索脏息护理在复杂的生命终结决策中的作用.
主要方法:
- 对透析准入规划方面的挑战的文献综述.
- 讨论影响透析决策的预后因素.
- 分析以患者为中心的决策框架.
主要成果:
- 早期接入安置提供了好处,但在一些老年/生病患者中存在不必要的手术风险.
- 有知情的决策需要明确沟通关于访问并发症和预后.
- 脏息护理可以促进对护理目标的讨论.
结论:
- 共同决策对于弱势群体的透析接入至关重要.
- 整合息治疗改善了复杂治疗选择的导航.
- 预后和患者价值应该指导透析接入计划.
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