Topics in Palliative Care Volume 5

by Bruera, Eduardo; Portenoy, Russell

• ISBN13: 9780195132205
• ISBN10: 0195132203
• Format: Hardcover
• Copyright: 2001-02-22
• Publisher: Oxford University Press

Summary

The rapidly evolving field of Palliative Care focuses on the management of phenomena that produce discomfort and that undermine the quality of life of patients with incurable medical disorders. The interdisciplinary clinical purview includes those factors - physical, psychological, social, andspiritual - that contribute to suffering, undermine the quality of life, and prevent a death with comfort and dignity. Palliative Care is a fundamental part of clinical practice, the "parallel universe" to therapies directed at cure or prolongation of life. All clinicians who treat patients withchronic life threatening diseases are engaged in palliative care, continually attempting to manage complex symptomatology and functional disturbances. The scientific foundation of palliative care is advancing, and similarly, methods are needed to highlight, for practitioners at the bedside, thefindings of empirical research. Topics in Palliative Care Series is divided into sections that address a range of issues. Addressing aspects of sumptom control, psyshocsoical functioning, spiritual or existential concerns, ethics, and other topics, the chapters in each section review the given areaand focus on a small number of salient issues for analysis. The authors present and evaluate existing data, provide a context drawn from clinical and research settings, and integrate knowledge in a manner that is both practical and readable. The specific topics covered in Volume 5 are Culturalissues in Palliative Care, Palliative Care in Geriatrics, Communication Issues in Palliative Care, Outcomes Research in Palliative Care, Opiod Tolerance; Reality of Myth?, and Pain and other symptoms: Treatment Challenges.

Table of Contents

Contributors	xi
I Cultural Issues in Palliative Care
Models for the Delivery of Palliative Care: The Canadian Model	3	(22)
Carleen Brenneis
Eduardo Bruera
Models for the Delivery of Palliative Care: The Spanish Model	25	(14)
Carlos Centeno
Marcos Gomez-Sancho
Models for the Delivery of Palliative Care in Developing Countries: The Argentine Model	39	(16)
Roberto Wenk
Mariela Bertolino
II Palliative Care in Geriatrics
Exploring the Need for a Special Model of Geriatric Care	55	(8)
R. Sean Morrison
Diane E. Meier
Care of the Elderly with Advanced Diseases: Caregiver Issues	63	(18)
Tami Borneman
Betty Ferrell
III Communication Issues in Palliative Care
Truth-Telling and Reciprocity in the Doctor---Patient Relationship: A North American Perspective	81	(14)
Joseph J. Fins
Truth-Telling in Cancer Care: The Japanese Perspective	95	(12)
Yosuke Uchitomi
Advance Directives in Different Cultures	107	(16)
Akira Akabayashi
Raymond Voltz
Assessment of Symptoms in the Cognitively Impaired	123	(14)
Wendy M. Stein
IV Research Outcomes in Palliative Care
Defining and Measuring Quality of Life in Palliative Care	137	(20)
S. Robin Cohen
Economic Outcomes and Palliative Care	157	(20)
Thomas J. Smith
Laurie Lyckholm
Symptom Assessment Outcomes in Home-Based Palliative Care	177	(20)
Franco De Conno
Cinzia Martini
V Opioid Tolerance: Reality or Myth?
Opioid Tolerance: A Clinical Perspective	197	(16)
Leia Phioanh Nghiemphu
Russell K. Portenoy
Problems with Opioid Dose Escalation in Cancer Pain: Differential Diagnosis and Management Strategies	213	(34)
Sebastiano Mercadante
VI Pain and Other Symptoms: Treatment Challenges
Dose Ratios Among Different Opioids: Underlying Issues and an Update on the Use of the Equianalgesic Table	247	(30)
Peter Lawlor
Jose Pereira
Eduardo Bruera
Intraspinal Pain Therapy in Palliative Care	277	(26)
Magnus Sjoberg
Narinder Rawal
Diagnosis and Management of Delirium in the Terminally Ill	303	(20)
William Breitbart
Index	323