American family physician
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It has become increasingly obvious that traditional narcotic dosage schemes are not optimally effective in relieving pain. Inadequate relief of pain results in increased patient morbidity, probably due to adverse effects on the neurologic, endocrine, pulmonary and cardiovascular systems. ⋯ This analgesic technique is easy to use and is well accepted by patients, physicians and nurses. Significant benefits include earlier ambulation, decreased overall narcotic use, improved postoperative pulmonary function, shorter hospital stay and reduced health care costs.
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Psychosocial issues are a major factor in the quality of life of a patient with advanced human immunodeficiency virus infection. To provide effective, supportive care, the physician must assess the patient's psychosocial needs, with an understanding of the patient's sociocultural background. ⋯ Appropriate treatment of neuropsychiatric syndromes and debilitating physical symptoms also add significantly to the patient's quality of life. Most importantly, the patient must be given the opportunity to be an active participant in decisions about treatment and lifestyle.