PALLIATIVE CARE NURSING

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Introduction to Part One Bridget Johnston Palliative care as a discipline and concept has grown exponentially in the last few years The Global Atlas of Palliative Care 2014 identifies that palliative care is an essential part of all healthcare systems Despite this it is widely acknowledged that there is still inadequate access to hospice and palliative care worldwide With an ageing population who are going to be living and dying with more complex and often co morbid conditions the demand for care is only going to increase in the future The atlas provides data that each year around 20 million people need end of life palliative care 6 per cent of whom are children The estimates are that there are still a large number of people globally with unmet palliative and end of life care needs More than ever therefore there is a need for palliative nursing that is patient centred and informed by appropriate evidence In Chapter 1 Stuart P Milligan introduces us to the concept of palliative care He considers the three main criteria by which the palliative patient might be defined namely diagnosis prognosis and level nature of need He also explores other important criteria such as suffering and consensus Stuart also discusses how we identify people with palliative care needs He explores the issue of whether it is helpful for nurses to use tools to aid prognostication at the end of life as opposed to using clinical judgement alone Stuart concludes by posing a challenge that due to the rising numbers of people in need of palliative care solutions could include the extension of the responsibility for the provision of palliative care to a much wider range of professionals agencies and services than previously He also considers an increasing emphasis on a public health approach to palliative care that recognises that the latter stages of life are often associated with high symptom burden challenges to dignity and personhood and a huge burden of suffering and suggests that we should develop population level solutions in response to need Chapter 2 by Josie Dixon discusses issues of access and referral to palliative care and in particular inequity of access Inequity issues related to gender age ethnicityIntroduction to Part One Bridget Johnston Palliative care as a discipline and concept has grown exponentially in the last few years The Global Atlas of Palliative Care 2014 identifies that palliative care is an essential part of all healthcare systems Despite this it is widely acknowledged that there is still inadequate ...access to hospice and palliative care worldwide With an ageing population who are going to be living and dying with more complex and often co morbid conditions the demand for care is only going to increase in the future The atlas provides data that each year around 20 million people need end of life palliative care 6 per cent of whom are children The estimates are that there are still a large number of people globally with unmet palliative and end of life care needs More than ever therefore there is a need for palliative nursing that is patient centred and informed by appropriate evidence In Chapter 1 Stuart P Milligan introduces us to the concept of palliative care He considers the three main criteria by which the palliative patient might be defined namely diagnosis prognosis and level nature of need He also explores other important criteria such as suffering and consensus Stuart also discusses how we identify people with palliative care needs He explores the issue of whether it is helpful for nurses to use tools to aid prognostication at the end of life as opposed to using clinical judgement alone Stuart concludes by posing a challenge that due to the rising numbers of people in need of palliative care solutions could include the extension of the responsibility for the provision of palliative care to a much wider range of professionals agencies and services than previously He also considers an increasing emphasis on a public health approach to palliative care that recognises that the latter stages of life are often associated with high symptom burden challenges to dignity and personhood and a huge burden of suffering and suggests that we should develop population level solutions in response to need Chapter 2 by Josie Dixon discusses issues of access and referral to palliative care and in particular inequity of access Inequity issues related to gender age ethnicity

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