Palliative care : an integrated approach

著者

    • Buckley, Jenny

書誌事項

Palliative care : an integrated approach

Jenny Buckley

Wiley-Blackwell, 2008

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注記

Includes bibliographical references (p. [288]-314) and index

内容説明・目次

内容説明

This evidence-based text brings together the theory and practice of palliative care. It examines at all aspects of palliative care i.e. psycho social, spiritual and physical in a highly practical way. The evidence base for cancer care has been developed within the Hospice Movement over the past 50 years and, in the main, it transfers across to patients dying of diseases other than cancer. The book addresses the palliative needs of any patient with any disease in any care setting, which gives it a generic approach. This is in line with current government directives. Contributions to care and treatment are considered in a multidisciplinary and complementary way.

目次

Foreword x Contributors' biographies xii Acknowledgements xv Dedications xvi 1 Historical and cultural perspectives on the evolution of palliative care 1 Key points 1 Introduction 2 Death in society 2 Dame Cicely Saunders and the origins of contemporary palliative care 3 An international perspective 6 Defi nitions 8 End-of-life care national programme 12 Culture 15 Service user involvement 18 Conclusion 19 Main implications for practice 19 Suggested further reading 19 2 Facing progressive disease and death 21 Key points 21 Psychosocial care 22 Partnership - maintaining the balance 23 Approaches to care 24 Giving the bad news 26 Denial/avoidance 29 Anger 32 Anxiety 33 Depression 33 Social pain 35 Conclusion 35 Main implications for practice 36 Suggested further reading 36 3 Communication skills 37 Key points 37 The impact of good communication 38 The impetus to teach communication skills 38 Facilitative styles 40 What Howard taught me about nursing dying people 45 Helpful strategies 46 Communicating with people with dementia 56 Conclusion 57 Main implications for practice 57 Suggested further reading 58 4 Self-awareness and self-care 59 Key points 59 Saving a life versus stealing a death 60 Facing death 62 Making space for decision-making 64 Self-awareness 66 How much did Nicky impact on my life? 68 Self-care 69 Main implications for practice 72 Suggested further reading 72 5 The sick role and partnership working 73 Key points 73 Introduction 73 Partnership care - what does it mean? 75 The sick role 76 Face-to-face partnership: attention to information giving 78 Written information 81 Decision aids 82 Special needs 83 Conclusion 83 Main implications for practice 83 Suggested further reading 84 6 Hope and spirituality 85 Key points 85 Introduction 86 Hope research 86 Spirituality 94 Religious practices concerned with death 100 Conclusion 104 Main implications for practice 104 Suggested further reading 105 7 Finding resilience together 106 Key points 106 Resilience in health care 107 Patient groups 108 Psychoneuroimmunology 108 The expert patient 111 Conclusion 114 Main implications for practice 115 Suggested further reading 115 8 Living with dying 116 Key points 116 Introduction 117 Social death 118 Vulnerable groups 119 Informational needs 121 Being heard and feeling supported 122 Companionship 123 Intimacy and caring 125 Health needs 125 Diffi cult thoughts and letting go 127 Conclusion 128 Main implications for practice 128 Suggested further reading 129 9 Bereavement 130 Key points 130 Defi nitions 131 Untimely deaths 131 Bereavement and health 132 Grief theorists 134 Mourning practices in different cultures 141 Bereaved children 143 Old age 143 Bereavement and dementia 143 Solitary grief 144 Bereavement services 145 Conclusion 148 Main implications for practice 149 Suggested further reading 149 10 Pain and other major symptoms: an integrated approach 150 Key points 150 Pain theories 152 Psychological approaches 154 Physical approaches 158 Complementary therapies 163 Creative therapies 170 Conclusion 172 Main implications for practice 172 Suggested further reading 172 11 The history of the use of strong opioids for cancer pain 173 Key points 173 Studies and narratives 174 WHO analgesia ladder 177 Side effects 182 Alternative routes for administration of strong opioids 184 Conclusion 187 Main implications for practice 188 Suggested further reading 188 12 Concordance and advance care planning 189 Key points 189 Patient-centred care: concordance 190 Advance care planning 192 The Mental Capacity Act 2005 196 Main implications for practice 196 Suggested further reading 197 13 Eleven prevalent symptoms 198 Key points 198 History 198 Pain 199 Nausea and vomiting 206 Constipation 212 Diarrhoea 216 Anorexia 218 Fatigue 223 Breathlessness 227 Confusion 232 Insomnia 236 Anxiety 238 Depression 240 Conclusion 244 Main implications for practice 244 Suggested further reading 245 Addendum: Doloplus 2 Scale 245 14 Palliative issues in some common diseases 248 Key points 248 Gold standard for all 248 Doing the right thing at the right time 249 Conclusion 280 Main implications for practice 280 Suggested further reading 280 Contents ix 15 Palliative emergencies 282 Key points 282 Palliative emergencies 282 Other symptoms 286 Main implications for practice 287 Suggested further reading 287 References 288 Index 315

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