What are the guidelines for physicians for advising a patient that is cancer is !
Question: What are the guidelines for physicians for advising a patient that is cancer is terminal!?
In particular, if the patient is already experiencing extreme anxiety!.Www@Answer-Health@Com
Answers:
Evidence of this!. Also, have a hospital social worker, hospital pastor and family/friend present!. Guidelines are professionalism, integrity, facts on the doctor's part!. It's the choice of support networks that will be needed after the facts are delivered, along with the planned mode of 'best treatments' available!.Www@Answer-Health@Com
Specific recommendations addressed by the guidelines, the strength of each recommendation, and the accompanying level of evidence are as follows:
Patients with serious illness at the end of life should be regularly evaluated by clinicians for pain, dyspnea, and depression (grade: strong recommendation, moderate quality of evidence)!. Other significant concerns for patients, families, and clinicians are discontinuity in care and heavy caregiver burdens!. Individualized evaluation and care can best address these concerns, although most issues are common to all patients!.
Patients with serious illness at the end of life should be prescribed treatments proven to be effective in managing pain!. For patients with cancer, such therapies include nonsteroidal anti-inflammatory drugs, opioids, and bisphosphonates (grade: strong recommendation, moderate quality of evidence)!. In patients with breast cancer and myeloma, bisphosphonates are effective for relief of bone pain!.
Patients with serious illness at the end of life should be prescribed treatments proven to be effective in managing dyspnea!. These therapies include opioids in patients with unrelieved dyspnea, as well as oxygen for short-term relief of hypoxemia (grade: strong recommendation, moderate quality of evidence)!.
Patients with severe, unrelieved dyspnea due to end-of-life cancer or cardiopulmonary disease may require opioids, and those with advanced chronic obstructive pulmonary disease may require supplemental oxygen!. Although beta-agonists may be useful to treat dyspnea associated with chronic obstructive pulmonary disease, this indication has not been studied for end-of-life care!.
Clinicians should prescribe treatments of proven efficacy to treat depression in patients with serious illness at the end of life!. For patients with cancer, suitable therapies may include tricyclic antidepressants, selective serotonin reuptake inhibitors, or psychosocial intervention (grade: strong recommendation, moderate quality of evidence)!.
Clinicians should ensure that all patients with serious illness complete advance care planning, including advance directives (grade: strong recommendation, low quality of evidence)!. This planning should take place as soon as possible once a patient is identified as having a serious illness at end of life!. Specific issues that may be pertinent, depending on the diagnosis and other factors, include dementia management, tube feeding, continuation or discontinuation of chemotherapy in cancer patients, and whether to deactivate implantable cardioverter defibrillation in patients with end-stage congestive heart failure!.Www@Answer-Health@Com
Patients with serious illness at the end of life should be regularly evaluated by clinicians for pain, dyspnea, and depression (grade: strong recommendation, moderate quality of evidence)!. Other significant concerns for patients, families, and clinicians are discontinuity in care and heavy caregiver burdens!. Individualized evaluation and care can best address these concerns, although most issues are common to all patients!.
Patients with serious illness at the end of life should be prescribed treatments proven to be effective in managing pain!. For patients with cancer, such therapies include nonsteroidal anti-inflammatory drugs, opioids, and bisphosphonates (grade: strong recommendation, moderate quality of evidence)!. In patients with breast cancer and myeloma, bisphosphonates are effective for relief of bone pain!.
Patients with serious illness at the end of life should be prescribed treatments proven to be effective in managing dyspnea!. These therapies include opioids in patients with unrelieved dyspnea, as well as oxygen for short-term relief of hypoxemia (grade: strong recommendation, moderate quality of evidence)!.
Patients with severe, unrelieved dyspnea due to end-of-life cancer or cardiopulmonary disease may require opioids, and those with advanced chronic obstructive pulmonary disease may require supplemental oxygen!. Although beta-agonists may be useful to treat dyspnea associated with chronic obstructive pulmonary disease, this indication has not been studied for end-of-life care!.
Clinicians should prescribe treatments of proven efficacy to treat depression in patients with serious illness at the end of life!. For patients with cancer, suitable therapies may include tricyclic antidepressants, selective serotonin reuptake inhibitors, or psychosocial intervention (grade: strong recommendation, moderate quality of evidence)!.
Clinicians should ensure that all patients with serious illness complete advance care planning, including advance directives (grade: strong recommendation, low quality of evidence)!. This planning should take place as soon as possible once a patient is identified as having a serious illness at end of life!. Specific issues that may be pertinent, depending on the diagnosis and other factors, include dementia management, tube feeding, continuation or discontinuation of chemotherapy in cancer patients, and whether to deactivate implantable cardioverter defibrillation in patients with end-stage congestive heart failure!.Www@Answer-Health@Com