RESUMO
Pain assessment and management of pain at the end of life require a good knowledge of pain pathophysiology and of the connections between pain and facing death related suffering. Pain is a multidimensional experience. Only an interdisciplinary team is able to provide a compassionate care with a comprehensive approach.
Assuntos
Analgésicos/uso terapêutico , Manejo da Dor , Medição da Dor , Cuidados Paliativos , Terapia por Acupuntura , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Atitude Frente a Morte , Humanos , Dor/tratamento farmacológico , Dor/fisiopatologia , Psicoterapia , Assistência TerminalAssuntos
Neoplasias/terapia , Dor Intratável/terapia , Adulto , Analgésicos não Narcóticos/classificação , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/classificação , Analgésicos Opioides/uso terapêutico , Criança , Relação Dose-Resposta a Droga , Esquema de Medicação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Neoplasias/fisiopatologia , Medição da Dor , Dor Intratável/fisiopatologia , Dor Intratável/psicologia , Cuidados Paliativos , Qualidade da Assistência à Saúde , Qualidade de VidaAssuntos
Neoplasias Gastrointestinais/terapia , Cuidados Paliativos , Analgésicos/uso terapêutico , Família , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/tratamento farmacológico , Mão de Obra em Saúde , Humanos , Obstrução Intestinal/tratamento farmacológico , Relações Médico-PacienteRESUMO
This prospective multidisciplinary survey started in October 1994. The survey assessed the modalities of care of hospitalized patients with advanced AIDS in an Infectious and Tropical Diseases Unit with regards to the practices of palliative care in a Palliative Care Unit. Seventy-eight (78) AIDS patients with CD4 < or = 30/mm3 who had 102 consecutive hospitalizations were recruited. Types (symptomatic or curative) and number of drugs administered to the patients, as well as biological and radiological investigations performed were recorded. Symptoms were concomitantly assessed on a weekly basis by self-evaluation of the patients themselves and by physicians. The results showed that the practices of care were different in the two units according to the specific goals and norms of each unit. A higher density of care was delivered at the Infectious and Tropical Diseases Unit. Symptoms assessed by both patients and physicians were underestimated by physicians in frequency and in intensity. In conclusion, an integrated approach including objective and subjective criteria should enable a better adjustment of the palliative and curative therapeutic strategies in advanced AIDS. These would concomitantly take into account the wishes of the patient and the goals regarding care in the unit where the patient is hospitalized.