晚期慢性和末期病的支持性护理:一个回顾性队列研究
Angela Recchia1, Roberta Casazza2, Mario Cozzolino2,3
1Fondazione VIDAS, Via U. Ojetti 66, 20151, Milan, Italy. angela.recchia@vidas.it.
Journal of nephrology
|March 6, 2024
概括
将息治疗整合到病学中可以改善晚期慢性病 (CKD) 和末期病 (ESKD) 患者的治疗结果. 这种方法减少了住院和急诊室的访问,允许大多数患者在家中或宿舍接受护理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 抚慰性护理是一种缓解性护理.
- 老年医学 老年医学
背景情况:
- 支持性护理是一种以人为中心的模式,用于晚期慢性病 (CKD) 和末期病 (ESKD).
- 息护理的整合到标准科护理中是有限的,对常规实践的信息很少.
- 需要在脏病学环境中探索综合性息护理方法.
研究的目的:
- 描述将息护理方法整合到晚期CKD和ESKD患者的脏病护理中的经验.
- 评估多学科团队方法在科息护理中的可行性和影响.
主要方法:
- 对67名进入晚期CKD和ESKD患者的回顾性队列研究,这些患者被录取到息护理服务中.
- 从2017年6月到2020年12月收集的数据.
- 分析包括患者人口统计,治疗类型,护理环境和医疗保健利用情况.
主要成果:
- 患者的平均年龄为83.6岁,83.6%的患者患有5期慢性瘤.
- 近一半 (47.8%) 接受了脏替代疗法,52.2%接受了保守疗法.
- 大多数人 (77.6%) 接受了家庭息治疗,其中86.2%的人在家中或临终关怀中死亡. 住院和急救诊所的次数显著减少 (分别为85%和94%).
结论:
- 这项研究表明,在遵循意大利指导方针的情况下,将息治疗纳入脏病实践的初步步骤.
- 一个由脏病学家和息护理专家组成的多学科团队有效地分享了支持患者的技能.
- 综合方法促进了临终关怀或家庭护理,改善了晚期病患者的生活质量.
相关概念视频
01:27Dialysis
309
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
309
01:17Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
01:11Renal Failure: Dose Adjustments
88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
01:29Chronic Pancreatitis II: Collaborative Care
88
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
88
01:22Heart Failure Drugs: Diuretics
375
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
375
01:10Nephrons
2.4K
The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
2.4K