我对早期原发性进行性失语症以人为本的个性化护理的体会。

Joanne T Douglas
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摘要

原发性进行性失语症(PPA)是一种以语言能力下降为特征的脑神经退行性疾病。它是一种罕见的、通常在年轻时发病的痴呆症,对患者的工作和个人活动具有毁灭性影响。目前,PPA 尚无治愈或改变病情的疗法,也没有办法阻止或减缓潜在的渐进性脑退化。因此,在整个病程中,任何治疗都必须是姑息性的,旨在控制症状并改善患者的生活质量。大多数患者在确诊后很少或根本得不到后续治疗,尤其是在疾病的早期阶段。在医学文献中,很少有从 PPA 患者的角度出发,旨在改善患者生活质量的以人为本的护理信息。在影像学的支持下,我得到了 PPA 非流利/语义变异型的早期准确临床诊断。我很幸运,在我开始出现语言障碍时,就得到了一个多学科医疗团队提供的模范个性化护理。在本文中,我将讨论我在这种以人为本的个性化医疗服务中的方方面面的亲身经历,描述这种医疗服务是如何建立在共同决策的基础上,以及如何采用一种全面、包容痴呆症的方法,涵盖了与一种无法治愈的神经退行性疾病共存的身体、心理、情感、社会心理和精神层面。
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My experience of person-centered and personalized care in early-stage primary progressive aphasia.

Primary progressive aphasia (PPA) is a neurodegenerative brain disorder characterized by declining language ability. It is a rare, often young-onset dementia with a devastating impact on the work and personal activities of those affected. At present there is no cure or disease-modifying therapy for PPA nor any way to arrest or slow the underlying progressive brain degeneration. Throughout the course of the condition any treatment must therefore be palliative-designed to manage symptoms and improve the quality of life of the affected person. The majority of those affected receive little or no follow-up care after diagnosis, particularly in the early stage of the disease. There is very little information in the medical literature about person-centered care designed to improve the quality of life of people with PPA written from the perspective of those living with this condition. I received an early and accurate clinical diagnosis of the nonfluent/agrammatic variant of PPA, supported by imaging. I am fortunate to have benefited from exemplary individualized care from a multidisciplinary medical team from the onset of my difficulties with language. In this paper, I discuss my lived experience of all aspects of this personalized and person-centered care, describing how it was founded on shared decision-making and a holistic, dementia-inclusive approach encompassing the physical, mental, emotional, psychosocial and spiritual dimensions of living with an incurable neurodegenerative disease.

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