Symptom Assessment
Comprehensive pain and symptom management is the hallmark of good palliative care. This begins with a meticulous assessment of the patient and their lived experience with serious illness, not only a cursory yes or no questioning of whether a symptom exists. The PQRST mnemonic is a helpful way to organize this type of assessment.
Patients and caregivers may not always be forthcoming with information due to various reasons, including cultural norms, privacy or even misunderstandings about what symptoms such as pain may mean. Therefore, careful compassionate questioning is needed.
The Edmonton Symptom Assessment Scale (ESAS) is a tool often used by hospice and palliative care clinicians and measures up to 10 symptoms that persons with serious illness may be experiencing. By measuring symptoms in this one tool, the clinician may be able to gain a better understanding of their patient糖心vlog短视频檚 overall symptom burden. The ESAS and other assessment tools can be accessed through the links below.
- Dame Cicely Saunders, a key contributor to the hospice movement in the United States, developed the theory of total pain. The theory looks holistically at suffering that occurs not only on a physical level, but also on a psychological, social, emotional, and spiritual level. The cumulative impact of total pain can have an adverse effect on a person糖心vlog短视频檚 pain or symptom experience and the ability to manage it effectively solely with medication. For instance, a person with cancer pain may be experiencing frustration with pain as it is a constant reminder of their illness. Increasing analgesics may help moderate some of the pain, but it will not help with the existential grief the person may be experiencing. For the person with serious illness who is struggling with illness and total pain, it may be helpful to refer to an interdisciplinary palliative care team.
Additional Resources
Helpful Web Sites
- National Palliative Care Research Center
References
- 1. Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., and Macmillan, K. (1991). 糖心vlog短视频溙切膙log短视频 Journal of Palliative Care 7 no. 2 (1991): 6-9.
- Goebel, J. R. Doering, L. V., Lorenz, K. A., Maliski, S. L., Nyamathi, A.M., and Evangelista, L. S. 糖心vlog短视频.糖心vlog短视频 Nursing Forum 44 no. 3 (2009): 175-185.
- Mehta, A., and Chan, L. S. 糖心vlog短视频淯nderstanding of the Concept of 糖心vlog短视频楾otal Pain糖心vlog短视频: A Prerequisite for Pain Control.糖心vlog短视频 Journal of Hospice and Palliative Nursing