The definitive Oxford Textbook of Palliative Medicine, now in its fifth edition, has again been thoroughly updated to offer a truly global perspective in this field of extraordinary talent and thoughtfulness. Updated to include new sections devoted to assessment tools, care of patients with cancer, and the management of issues in the very young and the very old, this leading textbook covers all the new and emerging topics since its original publication in 1993. In addition, the multi-disciplinary nature of palliative care is emphasized throughout the book, covering areas from ethical and communication issues, the treatment of symptoms and the management of pain. The printed book is complemented with 12 months free access to the online version, which includes expanded chapter information and links from the references to primary research journal articles, ensuring this edition continues to be at the forefront of palliative medicine. This fifth edition of the Oxford Textbook of Palliative Medicine is dedicated to the memory of Professor Geoffrey Hanks, pioneer in the field of palliative medicine, and co-editor of the previous four editions. A truly comprehensive text, no hospital, hospice, palliative care service, or medical library should be without this essential source of information.
LIST OF ABBREVIATIONS ; LIST OF CONTRIBUTORS ; SECTION 1: THE WORLDWIDE STATUS OF PALLIATIVE CARE ; 1.1 International progress in creating palliative medicine as a specialized discipline and the development of palliative care ; 1.2 Providing palliative care in economically disadvantaged countries ; 1.3 Essential medicines for palliative care ; 1.4 Policy in palliative care ; SECTION 2: THE CHALLENGE OF PALLIATIVE MEDICINE ; 2.1 The problem of suffering and the principles of assessment in palliative medicine ; 2.2 The epidemiology of death and symptoms: planning for population-based palliative care ; 2.3 Predicting survival in patients with advanced disease ; 2.4 Defining a 'good' death ; 2.5 Ethnic and cultural aspects of palliative care ; 2.6 The economic challenges of palliative medicine ; SECTION 3: SERVICE DELIVERY ISSUES IN PALLIATIVE CARE ; 3.1 Barriers to the delivery of palliative care ; 3.2 Palliative care delivery models ; 3.3 Palliative care in the emergency department ; 3.4 Palliative care in the nursing home ; SECTION 4: THE INTERDISCIPLINARY TEAM ; 4.1 The core team and the extended team ; 4.2 Teaching and training in palliative medicine ; 4.3 Nursing and palliative care ; 4.4 Social work in palliative care ; 4.5 The role of the chaplain in palliative care ; 4.6 Occupational therapy in palliative care ; 4.7 Music therapy in palliative care ; 4.8 The contribution of the dietitian and nutritionist to palliative medicine ; 4.9 Physiotherapy in palliative care ; 4.10 Speech and language therapy in palliative care ; 4.11 The contribution of art therapy to palliative medicine ; 4.12 Stoma therapy in palliative care ; 4.13 Clinical psychology in palliative care ; 4.14 The contribution of the clinical pharmacist in palliative care ; 4.15 Medical rehabilitation and the palliative care patient ; 4.16 Burnout, compassion fatigue, and moral distress in palliative care ; 4.17 Integrative oncology in palliative medicine ; SECTION 5: ETHICAL ISSUES ; 5.1 Human rights issues ; 5.2 Confidentiality ; 5.3 Neuro-palliative care and disorders of consciousness ; 5.4 Truth telling and consent ; 5.5 Ethics in paediatric palliative care ; 5.6 Dignity and palliative end-of-life care ; 5.7 Euthanasia and palliative care ; 5.8 Withholding and withdrawing life-sustaining treatment (including artificial nutrition and hydration) ; SECTION 6: COMMUNICATION AND PALLIATIVE MEDICINE ; 6.1 Communication with the patient and family ; 6.2 Talking with families and children about the death of a parent ; 6.3 Communication between professionals ; 6.4 Communication with the public, politicians, and the news media ; SECTION 7: ASSESSMENT TOOLS AND INFORMATICS ; 7.1 Palliative care needs assessment tools ; 7.2 The measurement of, and tools for, pain and other symptoms ; 7.3 Informatics and literature search ; 7.4 Validated assessment tools for psychological, spiritual, and family issues ; SECTION 8: COMMON SYMPTOMS AND DISORDERS ; 8.1 Fatigue and asthenia ; 8.2 Dyspnoea and other respiratory symptoms in palliative care ; 8.3 Anaemia, cytopenias, and thrombosis in palliative medicine ; 8.4 Genitourinary aspects of palliative care ; 8.5 Oral care ; 8.6 Sleep disorders ; 8.7 The management of bleeding in palliative care ; 8.8 Sexual dysfunction: discussing patient sexuality and intimacy in palliative care ; SECTION 9: COMMON SYMPTOMS AND DISORDERS: PAIN ; 9.1 Principles of drug therapy: focus on opioids ; 9.2 Pathophysiology of pain in cancer and other terminal illnesses ; 9.3 Definition and assessment of chronic pain in advanced disease ; 9.4 Opioid therapy: optimizing analgesic outcomes ; 9.5 Opioid therapy: managing risks of abuse, addiction, and diversion ; 9.6 Non-opioid analgesics ; 9.7 Adjuvant analgesics ; 9.8 Interventional approaches for chronic pain ; 9.9 Neurostimulation in pain management ; 9.10 Rehabilitation medicine approaches to pain management ; 9.11 Psychological and psychiatric interventions in pain control ; 9.12 Complementary therapies in pain management ; 9.13 Paediatric pain control ; SECTION 10: COMMON SYMPTOMS AND DISORDERS: GASTROINTESTINAL SYMPTOMS ; 10.1 Dysphagia, dyspepsia, and hiccup ; 10.2 Palliation of nausea and vomiting ; 10.3 Constipation and diarrhoea ; 10.4 Jaundice, ascites, and encephalopathy ; 10.5 Aetiology, classification, assessment, and treatment of the anorexia-cachexia syndrome ; SECTION 11: COMMON SYMPTOMS AND DISORDERS: SKIN PROBLEMS ; 11.1 Skin problems in palliative care ; 11.2 Pruritus and sweating in palliative medicine ; 11.3 Lymphoedema ; SECTION 12: ISSUES IN POPULATIONS WITH CANCER ; 12.1 The oncologist's role in delivering palliative care ; 12.2 Disease-modifying therapies in advanced cancer ; 12.3 Radiotherapy in symptom control ; 12.4 The role of general surgery in the palliative care of patients with cancer ; 12.5 Orthopaedic surgery in the palliation of cancer ; 12.6 Interventional radiology in the palliation of cancer ; SECTION 13: CANCER PAIN SYNDROMES ; 13.1 Cancer pain syndromes: overview ; 13.2 Cancer-induced bone pain ; 13.3 Management issues in neuropathic pain ; 13.4 Visceral pain ; 13.5 Management issues in chronic pain following cancer therapy ; SECTION 14: CANCER-ASSOCIATED DISORDERS ; 14.1 Neurological problems in advanced cancer ; 14.2 Endocrine and metabolic complications of advanced cancer ; 14.3 Bowel obstruction ; 14.4 Skin problems in palliative medicine ; 14.5 Palliative issues in the care of patients with cancer of the head and neck ; SECTION 15: ISSUES IN POPULATIONS WITH NON-CANCER ILLNESSES ; 15.1 HIV/AIDS ; 15.2 Caring for the patient with advanced chronic obstructive pulmonary disease ; 15.3 Advanced heart disease ; 15.4 Dementia ; 15.5 Neurological disorders other than dementia ; 15.6 End-stage kidney disease ; 15.7 Palliative medicine in the intensive care unit ; SECTION 16: ISSUES OF THE VERY YOUNG AND THE VERY OLD ; 16.1 Talking with families and children about the death of a parent ; 16.2 Care of children with advanced illness ; 16.3 Palliative medicine and care of the elderly ; SECTION 17: PSYCHOSOCIAL AND SPIRITUAL ISSUES IN PALLIATIVE MEDICINE ; 17.1 Spiritual issues in palliative medicine ; 17.2 Coping in palliative medicine ; 17.3 Depression, demoralization, and suicidality ; 17.4 Anxiety and adjustment disorders ; 17.5 Delirium ; 17.6 The family perspective ; 17.7 Bereavement ; SECTION 18: THE TERMINAL PHASE ; 18.1 Management of the actively dying patient ; 18.2 Sedation at the end of life ; SECTION 19: RESEARCH IN PALLIATIVE MEDICINE ; 19.1 Research in palliative care ; 19.2 The principles of evidence-based medicine ; 19.3 Understanding clinical trials in palliative care research ; 19.4 Qualitative research ; 19.5 Research into psychosocial issues ; 19.6 Ethical issues in palliative care research ; 19.7 Quality of life in palliative care: principles and practice ; 19.8 Health services research in palliative care and end-of-life care ; 19.9 Clinical audit in palliative medicine ; INDEX