癌症晚期/生命有限患者的姑息性镇静治疗（五）

Palliative sedation therapy for patients in advanced cancer and in life limitation （5）

一旦作出镇静治疗的决定,还要进一步考虑诊断逼近死亡,尝试应用预后指数作为指导.患者逼近死亡时必须同时对家属提供支持,“给死亡以机会”是理性的.后事的关怀包括出具死亡证明书等,以及对家属的难题提供专业化的帮助.照护者也需要支持,对各种照护者都必须提供相同心理的对待;要与他们进行优良的交流,指导他们,为他们提供反映事件发生的机会.患者死亡之后帮助他们回顾反省完整的经过,分析和找出能够提高的地方,从而提升整体的关怀质量.

Once the decision has made, further diagnosing imminent death should be consid ered and attempts should be made to produce a prognostic index as a general guidance. The patient＇s family must also be offered support as the patient approaches death. It is appropriate to ＂give death a chance＂, aftercare includes the filling out of the death certificate and there will often be good profes sional help to problems experienced by the family themselves. The professional carers also need to be cared and supported. The different carers who are involved in the patient＇s situation must be dealt with sympathetically; caring for carers means communicating well with them, guiding them, and offering them the opportunity to reflect on what is happening. Taking time to think back and reflect on the entire situation after the patient＇s death in order to clarify and identify areas that could be im proved, for improving the overall quality of care.