Yoyoyoy
INTRODUCTION
Symptom management is a fundamental aspect of palliative care (WHO 2003). It is the primary therapeutic goal of service delivery and is aimed at subjective wellbeing (De Canno & Martini 2001). Although it is estimated that 90% of patients who access palliative care services have a diagnosis of cancer (Bruera % Portenoy 2001), governments worldwide are now committed to ensuring that palliative care is available to all who need it, including patients diagnosed with incurable non-malignant diseases (Armstrong 2001, Scottish Executive 2001, World Health Organization 2003). The aims and principle of symptom management can be applied to all patients requiring palliative care services regardless of diagnosis. Irrespective of the symptom, a generic framework can be utilized in symptom management in advanced disease. The large and diverse number of symptoms that occur within palliative care cannot be addressed in a book chapter of this length, so we have decided to focus on those symptoms that, in our professional experience, have caused significant problems for patient and have adequate evidence base underpinning the management plan.
The aims of this chapter are to enable the reader to: * Appreciate the value of adopting a miltiprofessional approach to the management of symptoms * Recognize contributory factors that determine the impact of the symptoms on the individual patient * Identify appropriate nursing interventions that contribute to the comfort of the patient and family * Explain the pharmacological management of symptoms discussed on this chapter
KEY PRINCIPLES OF SYMPTOM MANAGEMENT
When considering symptom management, Regnard & Kindlen (2002) remind us that several key issues should influence any decision. 1. Implementing any intervention or treatment related to the management of symptoms, the preferred choice of the patient should be at the forefront of the minds of practitioners. This includes agreeing to
Symptom management is a fundamental aspect of palliative care (WHO 2003). It is the primary therapeutic goal of service delivery and is aimed at subjective wellbeing (De Canno & Martini 2001). Although it is estimated that 90% of patients who access palliative care services have a diagnosis of cancer (Bruera % Portenoy 2001), governments worldwide are now committed to ensuring that palliative care is available to all who need it, including patients diagnosed with incurable non-malignant diseases (Armstrong 2001, Scottish Executive 2001, World Health Organization 2003). The aims and principle of symptom management can be applied to all patients requiring palliative care services regardless of diagnosis. Irrespective of the symptom, a generic framework can be utilized in symptom management in advanced disease. The large and diverse number of symptoms that occur within palliative care cannot be addressed in a book chapter of this length, so we have decided to focus on those symptoms that, in our professional experience, have caused significant problems for patient and have adequate evidence base underpinning the management plan.
The aims of this chapter are to enable the reader to: * Appreciate the value of adopting a miltiprofessional approach to the management of symptoms * Recognize contributory factors that determine the impact of the symptoms on the individual patient * Identify appropriate nursing interventions that contribute to the comfort of the patient and family * Explain the pharmacological management of symptoms discussed on this chapter
KEY PRINCIPLES OF SYMPTOM MANAGEMENT
When considering symptom management, Regnard & Kindlen (2002) remind us that several key issues should influence any decision. 1. Implementing any intervention or treatment related to the management of symptoms, the preferred choice of the patient should be at the forefront of the minds of practitioners. This includes agreeing to