The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Dec 2007
ReviewHelping patients, families, caregivers, and physicians, in the grieving process.
Physical experiences of the body and those that are emotional, cognitive, and spiritual are inextricably related. The author, a hospice bereavement coordinator and counselor, discusses how medical professionals can become personally prepared to assist in the often intense and intimate passage of life into death and later through both didactic and personal preparation. She also describes the major models of grief processes and illustrates the power a caring professional can have during the dying process and in the aftermath of a patient's death by relating personal case scenarios.
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J Am Osteopath Assoc · Dec 2007
ReviewManaging cancer pain with nonpharmacologic and complementary therapies.
Nonpharmacologic interventions are important adjuncts to treatment modalities for patients with cancer pain. A variety can be used to reduce pain and concomitant mood disturbance and increase quality of life. Physicians may feel relatively uninformed about which modalities have been used for patients with cancer and have scientific support. ⋯ It focuses on those having empirical support or promising preliminary evidence, with the goal of familiarizing physicians with therapies that may complement regular oncologic care. This review updates an article published in November 2005. An anecdotal case study has been added to illustrate incorporation of nonpharmacologic and complementary therapies in the treatment of a patient with cancer-related pain.
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Cancer remains the second most common cause of death in the United States despite advances in prevention, early detection, and newer treatment protocols. Pain continues to be the most feared complication of this diagnosis. ⋯ Although clinical evidence is convincing that opioids are effective in treating patients for cancer pain, physician reluctance to prescribe them and patient unwillingness to take such medication continue. Barriers to opioid use are multifactorial, but with education of healthcare providers and patients, pharmacotherapy for pain management will be more effective.
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Management of cancer pain is still a significant problem in healthcare today despite the fact that such discomfort can be controlled in approximately 90% of patients. Emotional, psychosocial, and spiritual suffering associated with this disease complicates the problem. ⋯ Pain intensity scales, complementary and alternative methods, and the role of an interdisciplinary care team, as well as a need to provide spiritual support to both patient and family, are included in this discussion. A case vignette describes management of cancer pain in a typical patient admitted to hospice.