Palliative and Serious Illness Patient Management for Physician Assistants最新文献

筛选
英文 中文
Assessment and Management of Pain 疼痛的评估和管理
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0014
R. Portenoy, Ebtesam I. Ahmed, C. Krom
{"title":"Assessment and Management of Pain","authors":"R. Portenoy, Ebtesam I. Ahmed, C. Krom","doi":"10.1093/med/9780190059996.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0014","url":null,"abstract":"The management of pain associated with serious chronic illness is a core objective of palliative care. Successful therapy depends on individualization of the therapy. Management begins with a comprehensive assessment that characterizes the pain and describes it in terms of the biopsychosocial context, which includes the etiology, pathophysiology, and condition or syndrome. Nonpharmacological approaches should be considered, many of which are implemented by other interdisciplinary team members. In some cases, disease-modifying therapies may be used for analgesic purposes. The nonopioids, particularly the nonsteroidal anti-inflammatory drugs, are often adequate for initial pain management. Patients with moderate or severe pain usually are also offered an opioid, and widely accepted guidelines are available to inform safe and effective prescribing. Dose titration is usually necessary, and breakthrough pain may warrant concurrent use of fixed-schedule and “as-needed” therapy. Side effects must be anticipated and managed, and a “universal precautions” approach is prudent to mitigate the risk of abuse and addiction. If a favorable balance between analgesia and adverse effects is not realized, the patient may be poorly responsive and requires reevaluation. Opioid rotation is commonly used in this situation, as is cotreatment with one or more adjuvant analgesics, such as a glucocorticoid, antidepressant, or gabapentinoid. With guideline-based pharmacotherapy and other readily available integrative medical approaches, most patients with pain associated with serious chronic illness can obtain satisfactory relief throughout the course of their illness.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130506701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethical and Legal Issues 道德及法律问题
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0026
Bonnie K. Cole-Gifford, Kathlyn F. Wohlrabe
{"title":"Ethical and Legal Issues","authors":"Bonnie K. Cole-Gifford, Kathlyn F. Wohlrabe","doi":"10.1093/med/9780190059996.003.0026","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0026","url":null,"abstract":"The sections of this chapter discuss both evaluation and management of legal and ethical aspects of the physician assistant (PA) profession, taking into consideration that the PA practice flows out of an interconnected relationship between the PA, the physician, and the patient. PAs are called to fulfill not only the law when practicing but also rise to uphold ethical principles. There are a variety of situations a provider can encounter throughout a career. Some topics are present in every patient encounter, such as confidentiality and informed consent. Some topics may only be present in certain cases, such as advanced directives and futile treatment. Nevertheless, the provider should be knowledgeable about each of these legal and ethical situations and understand the evaluation and management of them.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132379373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiopulmonary System 心肺系统
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0012
K. Curseen, Jabeen Taj
{"title":"Cardiopulmonary System","authors":"K. Curseen, Jabeen Taj","doi":"10.1093/med/9780190059996.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0012","url":null,"abstract":"The broad range of palliative care needs are similar in cardiopulmonary disease as in other forms of serious illness. As new interventions reshape their clinical course and prognosis, palliative care has become the new standard of care for patients with serious cardiac/pulmonary diseases. Palliative care providers, including physician assistants, will need to be adept in advanced symptom management and communication skills that are unique to this for both patients and caregivers. This specialty provides opportunities for more nuanced advance care planning and goals-of-care discussions. In addition, earlier primary palliative care will provide more time to address end-of-life issues that are inherent to the care of this population—leading to a smoother transition to hospice.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128072345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Whole-Person Assessment of the Patient 病人的全人评估
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0004
B. Ferrell, V. Battista
{"title":"Whole-Person Assessment of the Patient","authors":"B. Ferrell, V. Battista","doi":"10.1093/med/9780190059996.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0004","url":null,"abstract":"Comprehensive assessment provides the foundation for enhancing the quality of life of a seriously ill patient, forms the basis of care, and helps in the coordination of care across disciplines. A whole-person assessment in palliative care extends beyond basic patient evaluation by recognizing the unique needs of patients who face serious illness and the needs of their family members. It provides additional information on symptoms and physical and psychological concerns often present in advanced disease and assists in the evaluation of social factors such as family caregiver needs and the assessment of spirituality, which is recognized as an important aspect of patient and family support in serious illness.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132000289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Veteran Population 经验丰富的人
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0020
Holly Pilewski
{"title":"Veteran Population","authors":"Holly Pilewski","doi":"10.1093/med/9780190059996.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0020","url":null,"abstract":"The Department of Veterans Affairs is a large, multilayered administration providing veterans healthcare, numerous medical and caregiver benefits, and cemetery and burial services. Veterans account for a large portion of the population and have unique physical, psychological, spiritual, and social needs that are shaped by veterans’ perceptions of military experience and injuries or medical conditions related to their service. Many veterans receive their care outside the VA. This makes it imperative for everyone to have a basic understanding of the VA, military culture, and veterans’ multifaceted needs. Hospice and palliative care in and outside the VA setting are essential in order to provide veterans with improved quality of life and high-quality end-of-life care.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123949684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Genitourinary Issues in Palliative Care 姑息治疗中的泌尿生殖系统问题
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0013
Min Ji Kim, Kimberson Tanco
{"title":"Genitourinary Issues in Palliative Care","authors":"Min Ji Kim, Kimberson Tanco","doi":"10.1093/med/9780190059996.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0013","url":null,"abstract":"Genitourinary problems in palliative care can be very distressing to patients and require prompt management and alleviation of symptoms. Examples include urinary tract obstruction, which can lead to pain and kidney injury, as well as infection, hematuria, renal colic, and bladder spasm-related pain. This chapter addresses relevant aspects of palliative care in patients with genitourinary issues, including consideration for context of symptoms and subsequent practical management. Options for symptom management may range from medications to procedural interventions. In deciding between treatment options, factors such as the patient’s preexisting comorbidities, performance status, goals of care, and anticipated benefit in symptom control and in quality of life versus potential burden of treatment must be considered.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123557266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Palliative Models of Care Delivery 姑息治疗模式的提供
Palliative and Serious Illness Patient Management for Physician Assistants Pub Date : 2021-08-01 DOI: 10.1093/med/9780190059996.003.0002
Britni Lookabaugh, C. Gunten
{"title":"Palliative Models of Care Delivery","authors":"Britni Lookabaugh, C. Gunten","doi":"10.1093/med/9780190059996.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780190059996.003.0002","url":null,"abstract":"In caring for patients with chronic complex and life-limiting illness, models of palliative care delivery have developed across the care continuum. While many palliative care services are provided by hospital-based consult teams, palliative care is also delivered in the home, including independent living, assisted living, and group homes; in skilled nursing facilities; and in the outpatient office setting. While high variability exists for delivery of palliative care across the globe, there have been many studies reflecting the value of palliative care across these settings, for quality of end-of-life care as well as for the financial implications in the complex medical care for patients with palliative care needs.","PeriodicalId":423010,"journal":{"name":"Palliative and Serious Illness Patient Management for Physician Assistants","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127231254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信