在社区提供临终关怀:马来西亚面临的挑战是什么?

Yoke Yeng Leong, Ednin Hamzah, Sylvia McCarthy, Zee Nee Lim
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摘要

一位72岁的妇女,患有骨和脑转移性肺癌,左髂外静脉血栓形成,在社区姑息治疗提供者的护理下。她经历了急性疼痛危机由于急性肢体缺血左下肢。与患者及其家属讨论了护理目标;她优先考虑在家中控制症状和临终关怀。家属和病人都知道她预后不佳。她的复杂疼痛由社区姑息治疗小组处理,她的家人被授权进行皮下注射。我们举例说明了社区卫生服务与姑息治疗支持的重要性,在整个生命限制疾病的过程中提供症状管理和支持病人和家庭照顾者。它还强调了家庭护理人员在家中为患者提供晚期护理时皮下注射的潜在心理困扰。
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Providing End-of-Life Care in the Community: What Are the Challenges in Malaysia?
A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers’ potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.
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