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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3090_Библиотеки_им_академика_М_И_Перельмана
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368 Index
medicines management (Continued )
unwanted medicines, 324
use of drugs, 307–308
medroxyprogesterone acetate
in cancer, 139
for increasing appetite and energy, 139
megestrol acetate
in cancer, 139
for increasing appetite and energy, 139
The Mental Capacity Act (2005), 107
mental capacity, assessment of, 107
mental health in UK, 270–271
metaethics, 68
metastatic cancer, 295
metoclopramide, 132, 147
micronutrients, 142
Midazolam, 295
mindfulness, 166
minority ethnic communities, 28
mirtazapine, 133
model for end-stage liver disease (MELD), 151
moral philosophy, ethics in palliative care, 68–69
morphine, 126–127, 130t
morphine-3-glucoronide (M3G), 127
morphine-6-glucoronide (M6G), 127
motor neurone disease (MND), 203, 209
mouth care, 142–144
dry mouth and, 142
management of, 143t
oral infections, 143–144
herpes simplex, 144
thrush, 143–144
painful mouth, 143
mucolytics, 210
multi-disciplinary team (MDT), 29, 42, 43,
63–64, 110, 123, 135, 203, 343
in cancer, 63
multi-morbidity, 236
people living and dying with, 237–238
muscle cramps, 208–209
musculoskeletal pain, 208, 224
myoclonic jerking, 263
Naloxone, 132
Naproxen, 125
nasogastric (NG) feeding tube, 140, 147
National Health Service (NHS), 28, 108
National Institute for Health and Care Excellence
(NICE) guidelines, 4, 12, 32, 203, 306, 350
National Palliative and End-of-Life Care
Partnership, 4
ambitions of, 6f
nausea and vomiting, 132, 144–148, 145f, 192,
294
advanced renal disease (ARD), 262
brain metastases, 182
malignant GI obstruction, 149
management of, 146–147, 146f, 302
persistent, 147–148
syndromes of, 146–147
needs
advance care planning, 110–111
assessment, 245–246
of families and unpaid carers, 42
in frailty, 231f
heart failure (HF), 243
heart failure, symptoms in, 244
holistic assessment of, 58
for oral care, 289
palliative care, 35
spiritual, 41
nephrotoxic medications, 184
nerve fibres transmitting pain, 118t
neuraxial (epidural/intrathecal analgesia), 123
neurolinguistic programming (NLP), 145
neurological disease, 203
neuro-palliative care, 207
neuropathic pain, 117, 120–121
next of kin (NOK), 350
NMDA antagonists, 224
nociceptive pain, 117, 119–120
nociceptor stimulation, 117
non-invasive ventilation (NIV), 170
non-maleficence, principle of, 70
non-malignant disease, 56
non-opioid drugs, 123, 125–126
advanced renal disease (ARD), 260–261
NSAIDs, 125, 126t
paracetamol, 125
non-pharmacological interventions, 135,
164–166, 248
non-steroidal anti-inflammatory drugs
(NSAIDs), 123–125, 154, 179, 261
adverse effects of, 126t
relative gastrointestinal toxicity of, 125t
non-verbal communication (NVC), 77, 196
North of England Cancer Network Palliative and
End-of-Life Care Guidelines, 132
nutrition, 210–211
nutritional supplements, 139
nutritional support
for GI symptoms, 139–142
jejunal feeding, 140
nasogastric tube feeding, 140
parenteral nutrition, 142
PEG feeding, 140, 141f, 142
obstructive nephropathy (ON), 185, 186
occupational therapy (OT), 354
oedema/ascites, 248
oesophageal problems, 144
oesophageal stents, 150
olanzapine, 263
opioids, 123, 126–133
advanced renal disease (ARD), 261
adverse effects, 132
alternatives to morphine, 130t
analgesics, 124, 124t, 129
for breathlessness, 166–167, 167t
and constipation, 132
for cough, 168–169, 168t
dose, 128–129
dry mouth, 132
fears and concerns related to use of, 132–133
initiation and titration, 127
nausea and vomiting, 132
oral, 131t
pain, 118–119
pharmacogenomics and, 129
response, 120t
side effects, 223
strong, 126–127, 128f, 129, 130t
titrating, 129
transdermal, 131–132
weak, 126, 127t
opioid switch, 129
oral opioids, 131t
oral theophylline, 169
oropharyngeal wounds, 189
Ottawa Charter for Health Promotion, 18
outline local services, 48
overwhelmed reaction, 92
oxygen therapy, 168
paediatric palliative care (PPC), 218, 219
pain, 116
advanced renal disease (ARD), 260
assessment, 121–122, 223
background, 121
breakthrough, 121, 128–129
chronic, 122
definition, 116–117
domains of, 117f
elements, 118t
heart failure (HF), 248
IASP defines, 116
individualised and multi-modal approach, 116
management, 122–135
adjuvant analgesics, 133–134, 134t
breakthrough analgesia, 125
interventional analgesia, 134–135
last days of life for opioid, 299
non-opioids, 125–126
pharmacotherapeutic intervention, 123–124
principles, 122–123
WHO analgesic ladder, 124–125
nerve fibres transmitting, 118t
neuroanatomy, 117–119, 119f
neuropathic, 117, 120–121
nociceptive, 117, 119–120
non-pharmacological management of, 135,
224
opioids, 118–119, 126–133. see also opioids
in palliative care, 116
perception, 123
physiology, 117–119
progressive neurological diseases and, 208
somatic, 120
spontaneous, 121
syndromes, 119–121
temporality, 121
and tenesmus, 155
terminology, 116, 121
allodynia, 121
dysaesthesia, 121
hyperaesthesia, 121
hyperalgesia, 121
paraesthesia, 121
types, 119–121, 120t
visceral, 119
Pain Assessment in Advanced Dementia scale
(PAINAD), 122, 208
https://t.me/med1917
Index 369
palliative and end-of-life care (PEOLC), 348–349
palliative care
in advanced renal disease (ARD), 254–265
alleviate suffering and care for, 36
‘benign paternalism’ of, 16–17
of children and young people, 3
communication. see communication
definitions, 3, 26–27
in developed world, 8–9
disease-focused, 29–30
for dying person, priorities of, 7f
emotional complexity in, 339–340
and end-of-life care, 230–239
equity, 28–36
future, 324
gold standards for, in primary care, 9
in heart failure (HF), 246
hospice and, 3–4
in hospital. see hospital palliative care teams
impact of, 345–346
indicators guidance, 5f
individual well-being, 340–345
inequalities in, 25, 27
environment breeding, 27
principles, 28–34
integrating, 2f
international dimensions and integration,
34–36
issues for, 7–8
loss and grief in. see grief; loss
medical evolution of, 49
needs, 35
oncological interventions, side-effects of,
191–194
diarrhoea, 192
hair loss, 193
immunotherapy, 193–194
proctitis, 192
radiotherapy and chemotherapy, 192
skin, 192–193, 193t
organisational context, 346
pain in, 116
patient and public involvement in, 16–23
people with intellectual disabilities, 276–280
people with mental illness, 270–276
for people with neurological disease, 207f
practice, context of, 338–339
principle-based approach to, 28–36
principles of, 10–12. see also palliative care
principles
public health approach to, 41
quality in, 12–13
audit of quality, 13
role of, 203–207
scenarios in humanitarian crises, 35
Scottish Partnership for, 21
specialist, 4, 7
spirituality, 328–335
structures shaping, 27
in United Kingdom, 29, 32
WHO definition of, 53
palliative care for infants, children, and young
people
bereavement care, 226–227
delivery, 219–220
end-of-life care, 225–226
gastrointestinal symptoms, 224–225
pain, 223–224
recipients of, 218–219
routes of administration, 222–223
seizures, 225
significant discussions, 220–222
spiritual care, 227
staff support, 227–228
symptom management, 222
palliative care in community, 39–50
allied health professionals (AHPs), 47–48
Daffodil Standards for Community
Pharmacies, 45–47
district nurses and, 45–46
education and training, 48–49
general practitioner and, 43
healthy death, 39–43
by multidisciplinary team, 43
pastoral, spiritual, and religious support,
47–48
pharmacy teams and, 44–45
primary care networks (PCNs), 44–45
primary care team and, 42–43
support peer learning, 49
in UK, 39
Palliative Care in Humanitarian Aid Situations
and Emergencies (PallCHASE), 36
palliative care principles, 10–12
rights and needs of patients and carers, 10
information, 10
quality of life, 10
support for carers, 10
symptom control limits, 12
symptom management, 11
anticipation, 11
attention to detail, 12
continuity of care, 12
evaluation and assessment, 11
explanation and information, 11–12
individualised treatment, 12
re-evaluation and supervision, 12
paracentesis, 153
paracetamol (Acetaminophen), 123, 125
paraesthesia, 121
“parallel planning,” concept of, 226
parenteral nutrition (PN), 142
participatory research methods, 22
patient and public involvement, in palliative care,
16–23
asset-based community development, 21
‘benign paternalism,’ 16–17
community engagement, 20–21
gatekeeping, 17
hard to reach, 17–18
involvement in care, 19
Public Health Palliative Care, 18–19
research methods, 22
services, 21–22
patients, 349
communication with, 244
fever in cancer, 190, 191t
holistic assessment, 56–59, 58f
with non-malignant disease, 56
support, 123
using handheld fan, advice for, 165t
people living with mental illnesses, 269
barriers to palliative care, 273, 273t
experiences, 271–272
health inequalities and, 271
individual level, 274
risk, 272–273
stigma and, 271
system level, 275–276
in UK, 270–271
people with intellectual disabilities, 276–280
advance care planning with, 278
bereavement care, 279
disadvantage, 276–277
end-of-life care for, 277t, 279–280
impairment level, 277t
reasonable adjustments, 277–278
PEPSICOLA mnemonic, 57, 58f
perception, 118
percutaneous endoscopic gastrostomy (PEG)
tube, 140, 141f, 142, 210
percutaneous nephrostomy, 186
percutaneous radiological gastrostomy (PRG),
210
percutaneous transhepatic cholangiography
(PTC), 151
peritoneal dialysis (PD), 255
person-centred approach, 82, 97
person-centred outcome measures (PCOMs),
108
pharmacists, 307
pharmacogenomics, 129
pharmacy teams, 44–45
in palliative care, 306–307
phenotype, 230
physiotherapist, 352–353
pilocarpine, 143
plan, do, check, act cycle, 60, 60f
pleural effusions, 159–160
pneumonitis, 161, 194
polymorphisms, 129
polypharmacy, 260
portosystemic encephalopathy, 153
“post-thrombotic panic,” 160
practicalities, 131
prednisolone, 321
pressure sores, 289, 289t
pressure ulcers, 290t
primary care networks (PCNs), 39, 44–45
primary care services, 42–43
and community teams, 44–45
Primary Palliative Care Research Group, 30
principle-based approach, 25
principlism, 69–70
proctitis, 192
progesterones, for increasing appetite and
energy, 139
“prognostic paralysis,” 169, 243
progressive neurological disorders, 203–215,
204t–206t
carer support, 213–214
end-of-life care, 214–215
https://t.me/med1917
370 Index
psychological, social, and spiritual distress,
213
symptom management, 208–213
breathlessness and respiratory issues,
209–210
cognitive change, 212–213
constipation, 211
drooling, 211
insomnia, 211–212
nutrition and dysphagia, 210–211
pain, 208–209
restlessness and agitation, 212
speech and communication, 212
weakness and mobility, 212
Project ECHO, 49
prostate cancer, 179
pruritus, 154, 224, 263, 264
psychological flexibility, 341
public health approach, 112, 279
Public Health Palliative Care (PHPC), 18–19
public participation, 17, 22
pulmonary embolism (PE), 160
pulmonary rehabilitation (PR), 166
quality improvement (QI), 59–60
quality standards
for adults care, 13
for end-of-life care, 13
range of response to loss model (RRL), 89,
92–94, 93f, 97–100, 100f
rapid-onset opioids (ROOs), 129
rashes, 194
“realistic utopia,” principles of, 28
rectal bleeding, 156
reflexology, 355–356
“reformist agenda,”21
refractory ascites, 151
Reiki principles, 356
relational approach, ACP as, 112
relaxation, 166
renal cancer, 179
renal replacement therapy (RRT), 255
renal system, 126t
renal transplantation, 256
“rescue medication,” 312
research, hospital palliative care, 61–62
resilience, 91–92
resources, communication, 82, 82f–84f
respiratory secretions, 294
management, 301
respiratory symptoms, management of, 159–171
COPD, 159, 169–170
cough, 168–169
COVID-19, 170–171
dyspnoea, 162–168
interstitial lung disease (ILD), 170
joint specialty MDT approach, 171
problems associated with malignancy,
159–162
respiratory system, 126t
restlessness, 212
Royal Pharmaceutical Society, 45
Scottish Partnership, for palliative care, 21
seizures, 182, 225, 295
management of, 305
and myoclonic jerking, 263
selective serotonin reuptake inhibitors (SSRIs),
125, 248
self-awareness, 82
self-compassion, 341–342
sense of coherence, 342
serious health-related suffering (SHS), 25–26
serious illness, truth-telling narratives in, 28
Short Form McGill Pain Questionnaire for pain
assessment in PC (SF-MPQ), 122
short-term integrated palliative and supportive
care (SIPS), 237
skeletal-related events (SREs), 180
skin, 192–193, 193t, 263
social care teams, 45–46
social determinants of health, 27
social workers, 353–354
SOCRATES mnemonic, 121, 122
somatic pain, 120
somatosensory system, 120
specialist palliative care, 3, 4, 7, 54
speech, 212
Sphere Handbook, The, 35
sphincter dysfunction, 175
spinal cord compression, 177t
spirituality, 328–335
assessment, 329–331, 329t
conceptual building blocks, 334f
models, 331–333, 332f
and spiritual care, 333–335
transcendence, 333
transcultural approach, 334–335
transformation, 333
wholeness and hope, 333
spontaneous bacterial peritonitis (SBP), 153
stents, 150–151
biliary, 150–151
colorectal, 151
gastroduodenal, 150
oesophageal, 150
stereotactic radiosurgery (SRS), 182
steroids, 139
medicines management, 321–322
note on, 162
stigma, 270
stoma care, 156–157
stridor, 161
structured non-biased process, 48
suffering, 26
superior vena cava obstruction (SVCO),
160–161, 177–178, 178t
Supportive and Palliative Care Indicators Tool
(SPICT), 5f, 9, 29, 111
swallowing, 144
sweating, 191
sympathy, 78f
syringe driver
combining drugs in, 318
compatibility and stability, 318–319
for CSI, 311–319
drugs used in, 313t–317t
and explanation to patient and carers, 312
infusion site, choice of, 319
management of subcutaneous infusion, 320
medications used in, 312
patient and carers, 312
telemedicine, 81
terminal agitation, 182, 294
management of, 303
terminal care, 4, 56
thalidomide, 169
thrombocytopenia, 193
thrush, 143–144
tissue necrosis, 225
titrating opioids, 129
tracheostomy, 196–198
transcendence, 333
transcultural approach, 334–335
transcutaneous electrical nerve stimulation, 11
transdermal opioids, 131–132
transformation, 333
transjugular intrahepatic portosytemic shunt
(TIPSS), 153
truth-telling narratives, in serious illness, 28
T34 syringe pump, 312f
tumour necrosis, 187
UK Medicines Act (1968), 318
unauthorised (unlicensed) medicinal product,
307
uncovered stents, 150
unintentional discriminating factors, 26
United Kingdom
mental health in, 270–271
palliative care in, 29, 32
universal healthcare coverage (UHC), 26
Universal Principles of Advance Care Planning,
105
upper urinary tract obstruction, 185, 185t
urinary retention, 288
urinary tract obstruction, 185–186, 185t
utilitarianism, 69
Value of Death Commission, 28
values history, 106
variceal bleeding, 153
vascular embolisation, 187
verbal communication, 77
vertebroplasty, 181
virtual communication, 81–82
virtue theory, 69
visceral pain, 119
vomiting. see nausea and vomiting
weight gain, drugs for
progesterones, 139
steroids, 139
Welfare Powers of Attorney, 107
WHO analgesic ladder, 124–125, 124f, 209, 223
whole brain radiotherapy (WBRT), 182–183
wounds. see malignant wounds; pressure ulcers
xerosis, 264
xerostomia management, 143
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