Care at the Close of Life: Evidence and Experience - download pdf or read online
By Stephen McPhee, Margaret A. Winker, Michael W. Rabow, Steven Z. Pantilat, Amy J. Markowitz
From one of many world’s best clinical journals comes the definitive evidence-based, full-color consultant to end-of-life and palliative care "...represents a major milestone within the evolution of deal with individuals with complex disease—-for which its editors and authors and JAMA may be rightly proud. it's very good that JAMA had the foresight to post a sequence in this subject, which, as medication has develop into extra technologically complicated and subspecialized, is frequently missed and, occasionally worse, avoided....this booklet may be priceless for front-line clinicians, and certainly all health and wellbeing care practitioners—as care on the shut of existence is part of just about all of medicine’s specialties and settings."--Irene J. Higginson, BMBS, PhD, FPPHM, FRCP; Dept. of Palliative Care, coverage, & Rehabilitation; Cicely Saunders Institute; King's collage London (from the foreword) a brand new addition to the JAMAevidence sequence, Care on the shut of lifestyles: facts and adventure deals evidence-based and scientific professional tips on taking good care of sufferers with life-limiting ailment, incorporating the phrases and views of affected sufferers, their households, and treating clinicians. prepared by way of those real scientific circumstances, the ebook relies at the acclaimed 7-year sequence of forty two articles, initially released in JAMA as “Perspectives on Care on the shut of Life,” and now completely up to date as chapters and that includes vast never-before-published fabric. Care on the shut of existence covers are quite a lot of scientific syndromes, affliction methods, conversation demanding situations, health-care supply settings, and matters confronted by way of sufferers, together with withdrawal of dialysis and different life-sustaining measures, cross-cultural ways, and the position of chemotherapy. in the course of the ebook, emphasis is at the ideas of palliative care, with the sufferer and relations on the middle of care, and with realization given to all problems—physical, mental, social, and non secular. Reflecting this concentration, each one bankruptcy starts off with a sufferer case examine to introduce the medical challenge, through “perspectives” that draw on large, real-world discussion among clinicians, sufferers, and households. the world over popular authors then overview the common demanding situations illustrated by way of the case, supplying state of the art, evidence-based review and therapy methods. good points absolutely revised and up-to-date textual content with new proof and references, together with the hunt method for every chapter’s replace Evidence-based orientation provides the present nation of information within the care of terminally unwell sufferers and aid for his or her households and caregivers useful scientific suggestions and techniques from overseas specialists in palliative care Self-assessment Q&A, for boosting your wisdom of every chapter’s content material and for getting ready for tests an invaluable word list of acronyms, phrases, and checks up to date assets for every bankruptcy supply present, authoritative resources of diagnostic and therapy info which may assist you optimize palliative care Medline PubMed identification numbers facilitate speedy, handy entry to references
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For the studies in this review, clinician prediction of survival was more strongly correlated with actual survival than other traditional predictors of survival, such as performance status or symptoms, suggesting clinician prediction of survival is still a vital part of prognosticating provided clinicians are aware of their tendency to err on the optimistic side. This reluctance to relay unfavorable prognostic information results both from medicine’s inherent prognostic uncertainty21 and from clinicians’ fears that they will be perceived as “giving up” if they are pessimistic, thereby eliminating hope and depressing patients.
J Clin Oncol. 2007;25(6):715-723. [PMID: 17308275] 24. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008;300(14):1665-1673. [PMID: 18840840] 25. Block SD, Billings JA. Patient requests to hasten death: evaluation and management in terminal care. Arch Intern Med. 1994;154(18):2039-2047. [PMID: 7522432] 26. Quill TE. Doctor, I want to die: will you help me? JAMA. 1993;270(7):870873.
One week later, the patient returned to his primary care physician complaining of fatigue, anorexia, bloating, and worsening constipation. Concerned that he might be experiencing bowel obstruction, Dr W advised surgical consultation, and the patient said he would pursue that at his local hospital. Yet, this did not happen, and several days later he presented to Dr W’s hospital with increasing abdominal distension and pain and was admitted to the medical service. Abdominal radiographs showed no obstruction, and he was discharged after treatment with enemas, morphine, and steroids.
Care at the Close of Life: Evidence and Experience by Stephen McPhee, Margaret A. Winker, Michael W. Rabow, Steven Z. Pantilat, Amy J. Markowitz