Articles: palliative-care.
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Given modern techniques of pain assessment and management, it is now possible to be optimistic about cancer pain control. Assessment of cancer pain must include information about the site(s) of pain, pathophysiology, pain severity, and quantification of analgesic responses. Correct diagnosis of common pain patterns including breakthrough and incident pain are essential. ⋯ Misunderstandings about opioids are common and patient and family education paramount. Adjuvant analgesics are necessary for good pain control, but have important differences in indications, usage, and side effects compared with opioids. First-rate pain management is a basic professional and humanitarian responsibility of the skilled clinical oncologist.
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Seminars in oncology · Feb 2000
Organization of services and nursing care: hospice and palliative medicine.
The health care industry is changing and nursing case management is an integral part of restructured care in many institutions. Health care organizations must evaluate services and outcomes. The terminally ill comprise a large portion of patients in any health care delivery system. ⋯ Shifts in patient care will be evident due to changes in demographics, payor initiatives, and technological advances. Providing care for patients with advanced disease and the role of nursing have evolved over the past 10 years. One important area that has not changed is the passion and caring evident in the nurse's everyday practice.
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The American Board of Hospice and Palliative Medicine (ABHPM) was formed in 1995 to establish and implement standards for certification of physicians practicing hospice and palliative medicine and, ultimately, accreditation of physician training in this discipline. The ABHPM has created a certification process that parallels other member boards of the American Board of Medical Specialties (ABMS). After 3(1/2) years and the administration of seven examinations, 623 physicians have achieved board certification in hospice and palliative medicine. ⋯ There is significant physician interest in seeking professional recognition of expertise in caring for terminally ill persons and their families through creation of a specialty in hospice and palliative medicine. Certification of physicians and accreditation of training programs are key elements in this process. This process will encourage more physicians to enter this field and provide needed expertise in the management of patients with progressive disease for whom the prognosis is limited, and the focus of care is quality of life.