心臟衰竭病人的安寧療護
 
陳冠綸¹　黃獻樑²

 
安寧緩和醫療在腫瘤醫學領域已經融入許久，提供許多末期病人身心靈全方位照護，將安寧緩和醫療應用至其他領域例如非癌症的心臟衰竭疾病，將能幫助更多病人提升照護品質。心衰竭最常發生在大於65歲的老年族群，65歲以上老年人約6-10%患有心衰竭；社區調查顯示三至四成心衰竭病人在診斷後一年內死亡，六至七成在五年內死亡，可見病況起伏變化快速；心衰竭對於病人生活影響甚巨，末期心衰竭病人因病況與治療，會產生許多身心靈困擾，如何建立團隊模型，在治療心衰竭的同時，應用安寧緩和醫療根據此疾病的特性，適切的提升照護品質、增加靈性安適感並解決倫理困境，是未來努力的方向。
（台灣家醫誌2021; 31: 87-95）DOI: 10.3966/168232812021063102002
 
關鍵詞：安寧緩和醫療、心臟衰竭
 

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¹國立台灣大學醫學院醫學系、²國立台灣大學醫學院附設醫院家庭醫學部
受理日期：109年8月2日　　修改日期：109年9月30日　　　 同意刊登：109年11月12日
通訊作者：黃獻樑　　　　 通訊地址：台北市中山南路7號　E-mail：tennishuang@gamil.com

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 Hospice Palliative Care for Patients with Heart Failure

Kuan-Lun Chen1 and Hsien-Liang Huang2

 
Hospice palliative care (HPC) has offered terminal patients soothing spiritual comfort for years. Extending and integrating HPC into advanced disease care such as heart failure (HF) is essential. Heart failure occurs mostly among people aged over 65 as around 6-10 % of them are diagnosed with heart failure. A community survey showed that 30-40% of HF patients died within a year after diagnosis, and 60-70% within 5 years. This indicates the susceptibility of HF patients to rapid and unpredictable changes. HF poses a drastic impact on patients’ quality of life. Spiritual burden of end-stage HF patients arises from illness and medication. Establishing a hospice palliative team care model for HF to promote the life quality and spiritual wellbeing of patients facing ethical dilemmas should be considered a major goal in the future of advanced HF care.
(Taiwan J Fam Med 2021; 31: 87-95) DOI: 10.3966/168232812021063102002
 
Key words: heart failure, hospice palliative care, palliative care
 

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¹Department of Medicine, College of Medicine, National Taiwan University; ²Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Received: August 2, 2020; September 30, 2020; Accepted: November 12, 2020.