Palliative care has evolved over the past five decades as an interprofessional specialty to improve quality of life and quality of care for patients with cancer and their families. Existing evidence supports that timely involvement of specialist palliative care teams can enhance the care delivered by oncology teams. This review provides a state-of-the-science synopsis of the literature that supports each of the five clinical models of specialist palliative care delivery, including outpatient clinics, inpatient consultation teams, acute palliative care units, community-based palliative care, and hospice care. The roles of embedded clinics, nurse-led models, telehealth interventions, and primary palliative care also will be discussed. Outpatient clinics represent the key point of entry for timely access to palliative care. In this setting, patient care can be enhanced longitudinally through impeccable symptom management, monitoring, education, and advance care planning. Inpatient consultation teams provide expert symptom management and facilitate discharge planning for acutely symptomatic hospitalized patients. Patients with the highest level of distress and complexity may benefit from an admission to acute palliative care units. In contrast, community-based palliative care and hospice care are more appropriate for patients with a poor performance status and low to moderate symptom burden. Each of these five models of specialist palliative care serve a different patient population along the disease continuum and complement one another to provide comprehensive supportive care. Additional research is needed to define the standards for palliative care interventions and to refine the models to further improve access to quality palliative care.

中文翻译：

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癌症患者姑息治疗模式

在过去的五年中，姑息治疗已经发展成为一个跨专业的专业，以提高癌症患者及其家人的生活质量和护理质量。现有证据支持专家姑息治疗团队的及时参与可以增强肿瘤团队提供的护理。本综述提供了最新的文献概要，支持专科姑息治疗提供的五种临床模型中的每一种，包括门诊、住院咨询团队、急性姑息治疗病房、基于社区的姑息治疗和临终关怀关心。还将讨论嵌入式诊所、护士主导模式、远程医疗干预和初级姑息治疗的作用。门诊是及时获得姑息治疗的关键入口。在这个设定中，通过无可挑剔的症状管理、监测、教育和预先护理计划，可以纵向加强患者护理。住院咨询团队提供专家症状管理，并为有急性症状的住院患者提供出院计划。具有最高水平痛苦和复杂性的患者可能会受益于进入急性姑息治疗病房。相比之下，以社区为基础的姑息治疗和临终关怀更适合那些体力状况较差、症状负担低至中度的患者。这五种专业姑息治疗模式中的每一种都为疾病连续体中的不同患者群体服务，并相互补充以提供全面的支持性护理。