Palliative Care and Cardiovascular Disease and Stroke A Policy Statement From the American Heart Association/American Stroke Association

被引：164

作者：

Braun, Lynne T. ^{[1
]}

Grady, Kathleen L. ^{[2
]}

Kutner, Jean S. ^{[3
]}

Adler, Eric ^{[4
]}

Berlinger, Nancy ^{[5
]}

Boss, Renee ^{[6
]}

Butler, Javed ^{[7
,8
]}

Enguidanos, Susan ^{[10
]}

Friebert, Sarah ^{[12
]}

Gardner, Timothy J. ^{[13
]}

Higgins, Phil

Holloway, Robert ^{[15
]}

Konig, Madeleine ^{[8
]}

Meier, Diane ^{[16
,17
]}

Morrissey, Mary Beth ^{[18
,19
]}

Quest, Tammie E. ^{[20
,21
]}

Wiegand, Debra L. ^{[23
]}

Coombs-Lee, Barbara ^{[9
]}

Fitchett, George ^{[11
]}

Gupta, Charu ^{[14
]}

Roach, William H., Jr. ^{[22
]}

机构：

[1] Rush Univ, Coll Nursing, Chicago, IL 60612 USA

[2] Northwestern Univ, Evanston, IL 60208 USA

[3] Univ Colorado, Sch Med, Boulder, CO 80309 USA

[4] Univ Calif San Diego, La Jolla, CA 92093 USA

[5] Hastings Ctr, Garrison, NY USA

[6] Johns Hopkins Univ, Baltimore, MD 21218 USA

[7] SUNY Stony Brook, Stony Brook, NY 11794 USA

[8] Amer Heart Assoc, Dallas, TX USA

[9] Compass & Choices, Denver, CO USA

[10] Univ Southern Calif, Los Angeles, CA USA

[11] Rush Univ, Med Ctr, Chicago, IL 60612 USA

[12] Akron Childrens Hosp, Akron, OH USA

[13] Christiana Care Hlth Syst, Newark, DE USA

[14] Univ Calif San Francisco, San Francisco, CA 94143 USA

[15] Univ Rochester, Rochester, NY 14627 USA

[16] Mt Sinai Med Ctr, New York, NY 10029 USA

[17] Hertzberg Palliat Care Inst, New York, NY USA

[18] Fordham Univ, Bronx, NY 10458 USA

[19] Collaborat Palliat Care, New York, NY USA

[20] Emory Univ, Sch Med, Atlanta, GA 30322 USA

[21] Atlanta VAMC, Dept Vet Affairs, Decatur, GA USA

[22] McDermott Will & Emery LLP, Chicago, IL USA

[23] Univ Maryland, Sch Nursing, College Pk, MD 20742 USA

来源：

CIRCULATION | 2016年 / 134卷 / 11期

关键词：

AHA Scientific Statements; palliative care; quality of life; treatment outcome; QUALITY-OF-LIFE; VENTRICULAR ASSIST DEVICE; MECHANICAL CIRCULATORY SUPPORT; INTERMACS ANNUAL-REPORT; FAILURE PATIENTS; AMBULATORY PATIENTS; FAMILY CAREGIVER; CARDIAC TRANSPLANTATION; INTERNATIONAL SOCIETY; DEPRESSIVE SYMPTOMS;

D O I：

10.1161/CIR.0000000000000438

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions. Palliative care, defined as patient-and family-centered care that optimizes health-related quality of life by anticipating, preventing, and treating suffering, should be integrated into the care of all patients with advanced cardiovascular disease and stroke early in the disease trajectory. Palliative care focuses on communication, shared decision making about treatment options, advance care planning, and attention to physical, emotional, spiritual, and psychological distress with inclusion of the patient's family and care system. Our policy recommendations address the following: reimbursement for comprehensive delivery of palliative care services for patients with advanced cardiovascular disease and stroke; strong payer-provider relationships that involve data sharing to identify patients in need of palliative care, identification of better care and payment models, and establishment of quality standards and outcome measurements; healthcare system policies for the provision of comprehensive palliative care services during hospitalization, including goals of care, treatment decisions, needs of family caregivers, and transition to other care settings; and health professional education in palliative care as part of licensure requirements.

引用

页码：E198 / E225

页数：28

共 150 条

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