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协作性康复目标设定在姑息治疗中的应用:病例报告

Collaborative goal setting in palliative rehabilitation: a case report.

机构信息

HCA Hospice, Singapore, Singapore.

出版信息

BMC Palliat Care. 2024 Jul 19;23(1):179. doi: 10.1186/s12904-024-01506-3.

Abstract

BACKGROUND

Palliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients' quality of life by optimizing physical function and maximizing autonomy despite advancing illness. Alongside providing non-pharmacological symptom management, it emphasizes personalized goal-setting tailored to individual needs. This case illustrates the transformative impact targeted physiotherapy interventions can have on patients' physical function, morale and motivation in spite of their expected deterioration.

CASE PRESENTATION

An 85-year-old male with angioimmunoblastic T cell lymphoma was admitted to home hospice care. He was referred for physiotherapy to optimize his function and mobility despite his short prognosis. A conversation guide was used throughout the duration of therapy to identify personal goals, prescribe and review the use of appropriate interventions, and discuss future therapeutic plans. Within a month he achieved his functional goals, experienced reduced physical dependency, and had increased satisfaction in his ability to participate more actively in self-care. This also resulted in significant improvements in his confidence, mood, and overall well-being. Engaging the patient actively in his care and management journey provided him with significant motivation and hope.

CONCLUSION

The case study highlights the vital role of physiotherapists in facilitating transparent communication among patients, healthcare providers, and caregivers throughout palliative rehabilitation. Through open dialogue and utilizing conversation guides, physiotherapists help understand patient preferences, goals, and motivation. This patient-centred approach ensures that therapeutic interventions align with individual needs, enhancing overall patient care and the provision of holistic palliative care.

摘要

背景

姑息康复将姑息治疗和康复的原则相结合,通过优化身体功能并最大限度地提高自主性,从而提高患者的生活质量,尽管疾病在进展。除了提供非药物症状管理外,它还强调针对个人需求制定个性化目标。本案例说明了有针对性的物理治疗干预可以如何改变患者的身体功能、士气和动力,尽管他们的预期会恶化。

病例介绍

一位 85 岁男性患有血管免疫母细胞性 T 细胞淋巴瘤,被收住家庭临终关怀护理。他被转介接受物理治疗,以优化他的功能和活动能力,尽管他的预后很短。在整个治疗过程中使用了对话指南,以确定个人目标、规定和审查适当干预措施的使用,并讨论未来的治疗计划。在一个月内,他实现了他的功能目标,减少了身体依赖,对自己更积极参与自我护理的能力的满意度也有所提高。这也导致他的信心、情绪和整体幸福感显著改善。让患者积极参与他的护理和管理之旅为他提供了巨大的动力和希望。

结论

该病例研究强调了物理治疗师在姑息康复过程中促进患者、医疗保健提供者和护理人员之间透明沟通的重要作用。通过开放对话和使用对话指南,物理治疗师可以帮助了解患者的偏好、目标和动机。这种以患者为中心的方法确保治疗干预措施与个人需求保持一致,从而提高整体患者护理和提供整体姑息治疗。

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