Oxford Textbook of Palliative Medicine-6판

This sixth edition of the Oxford Textbook of Palliative Medicine takes us now into the third decade for this definitive award-winning textbook. It has been rigorously updated to offer a truly global perspective, highlighting the best current evidence-based practices, and collective wisdom from more than 200 experts around the world.

This leading textbook covers all the new and emerging topics, updated and restructured to reflect major developments in the increasingly widespread acceptance of palliative medicine as a fundamental public health need.
The sixth edition includes new sections devoted to family and caregiver issues, cardio-respiratory symptoms and disorders, and genitourinary symptoms and disorders. In addition, the multi-disciplinary nature of palliative care is emphasized throughout the textbook, covering areas from ethical and communication issues, the treatment of symptoms, and the management of pain.

The Oxford Textbook of Palliative Medicine is a truly comprehensive text. No hospital, hospice, palliative care service, or medical library should be without this essential source of information.

This sixth edition of the Oxford Textbook of Palliative Medicine is dedicated to the memory of Professor Kenneth Fearon husband of Professor Marie Fallon and a surgeon who became a world leader in the research and management of anorexia and cachexia. He modeled a work-life balance that is so critical in our field, with devotion to both his patients and his family.

Section 1 The worldwide status of palliative care

1.1 International progress in the development of palliative medicine
1.2 Essential medicines for palliative care
1.3 Human rights issues
1.4 Policy in palliative care

Section 2 The challenge of palliative medicine

2.1 Building definitional consensus in palliative care
2.2 Core concepts in palliative care
2.3 The epidemiology of death and symptoms: planning for population-based palliative care
2.4 Barriers to the delivery of palliative care
2.5 Ethnic and cultural aspects of palliative and end of life care
2.6 Health economics for palliative care

Section 3 Service delivery issues in palliative care

3.1 Specialist palliative care along the trajectory of illness: issues in the early integration of
palliative care
3.2 Palliative care delivery models
3.3 Palliative medicine in the intensive care unit
3.4 Palliative care in the emergency department
3.5 Palliative care in the nursing home

Section 4 Healthcare professionals in palliative care

4.1 The core team and the extended team
4.2 Burnout, compassion fatigue, and moral distress in palliative care
4.3 Nursing education in palliative care
4.4 Social work in palliative care
4.5 The role of the chaplain in palliative care
4.6 Occupational therapy in palliative care
4.7 The role of the creative arts in palliative care
4.8 The role of the dietitian in palliative care
4.9 Physiotherapy in palliative care
4.10 Speech and language therapy in palliative care
4.11 Clinical psychology in palliative care
4.12 The contribution of the clinical pharmacist in palliative care
4.13 Medical rehabilitation and the palliative care patient

Section 5 Communication and palliative medicine

5.1 Communication with the patient and family
5.2 Practical considerations including difficult conversations
5.3 Advance care planning

Section 6 Family and caregiver issues

6.1 Family dynamics in the context of serious illness
6.2 Caregiver burden and distress

Section 7 Pain

7.1 Definition and assessment of chronic pain in advanced disease
7.2 Pathophysiology of pain in cancer and other terminal illnesses
7.3 Acute cancer pain syndromes
7.4 Chronic cancer pain syndromes
7.5 Principles of drug therapy
7.6 Opioid therapy: optimizing analgesic outcomes
7.7 Opioid therapy: managing risks of abuse, addiction, and diversion
7.8 Non-opioid analgesics
7.9 Adjuvant analgesics: principles of use
7.10 Interventional approaches for chronic pain
7.11 Neurostimulation in pain management
7.12 Behavioural and psychosocial interventions for pain management
7.13 Integrative medicine therapies in pain management
7.14 Management issues in bone pain
7.15 Management issues in neuropathic pain
7.16 Management issues in visceral pain
7.17 Management issues in chronic pain following cancer therapy
7.18 Paediatric pain control

Section 8 Gastrointestinal symptoms and disorders

8.1 Dysphagia, dyspepsia, and hiccups
8.2 Nausea and vomiting
8.3 Constipation and diarrhoea
8.4 Jaundice, ascites, and encephalopathy
8.5 Aetiology, classification, assessment, and treatment of the anorexia-cachexia syndrome
8.6 Parenteral nutrition

Section 9 Cardiorespiratory symptoms and disorders

9.1 Breathlessness and other respiratory symptoms in palliative care
9.2 Cough and other pulmonary symptoms

Section 10 Skin and oral symptoms and disorders

10.1 Skin problems in palliative care
10.2 Palliative wound and ostomy care
10.3 Lymphoedema and oedema of advanced disease
10.4 Oral care

Section 11 Genitourinary symptoms and disorders

11.1 Dysuria, frequency, and bladder spasm
11.2 Obstructive urinary disorders

Section 12 Constitutional symptoms and related disorders

12.1 Fatigue
12.2 Sexuality in palliative care: discussing patient sexuality and intimacy in palliative care
12.3 Sleep disorders
12.4 Assessment and management of thrombotic complications
12.5 Assessment and management of bleeding complications in the medically ill

Section 13 Psychiatric and psychological symptoms and disorders

13.1 Coping and resilience in palliative medicine
13.2 Depression, demoralization, and suicidality
13.3 Fear, anxiety, and adjustment disorder in palliative care
13.4 Delirium
13.5 Bereavement

Section 14 Palliative care in cancer

14.1 The oncologist’s role in delivering palliative care
14.2 Disease-modifying therapies in advanced cancer: medical treatment
14.3 Radiotherapy in symptom management
14.4 The role of general surgery in the palliative care of patients with cancer
14.5 Orthopaedic surgery in the palliation of cancer
14.6 Integrative oncology in palliative medicine
14.7 Interventional radiology in the palliation of cancer
14.8 Neurological problems in advanced cancer
14.9 Endocrine and metabolic complications of advanced cancer
14.10 Malignant bowel obstruction
14.11 Palliative care issues in head and neck cancers
14.12 Palliative care issues in populations with haematological malignancies
14.13 Anaemia, cytopenias, and thrombosis in palliative medicine

Section 15 Issues in populations with non-cancer illnesses

15.1 HIV/AIDS
15.2 Advanced diseases of the lung
15.3 Advanced heart disease
15.4 Dementia
15.5 Neurological disorders other than dementia
15.6 Palliative care and end-stage liver disease
15.7 End-stage kidney disease
15.8 Palliative care in catastrophic disasters and humanitarian crises

Section 16 Issues of the very young and the very old

16.1 Involving children and families when someone important is dying or has died
16.2 Care of children with advanced illness
16.3 Palliative medicine and care of the elderly

Section 17 Spiritual issues in palliative medicine

17.1 Spiritual issues in palliative medicine
17.2 Integration of spiritual care into palliative care service delivery models

Section 18 The terminal phase

18.1 Predicting survival in patients with advanced disease
18.2 Physiology of dying
18.3 Management of the actively dying patient

Section 19 Ethical issues

19.1 Practical bioethics in the care of patients with advanced illness
19.2 Requests for futile or inappropriate interventions near the end of life
19.3 Autonomy and shared decision-making in a multicultural world
19.4 Truth telling and consent
19.5 Ethics in paediatric palliative care
19.6 Ethical issues in physician aid-in-dying
19.7 Withholding and withdrawing life-sustaining treatment (including artificial nutrition and hydration)
19.8 Medical and ethical considerations in palliative sedation at the end of life

Section 20 Assessment tools and informatics

20.1 Palliative care needs assessment tools
20.2 Informatics and literature search
20.3 Validated assessment tools for psychological, spiritual, and family issues

Section 21 Teaching and training in palliative medicine

21.1 Physicians
21.2 Nurses
21.3 Teaching and training in palliative social work, chaplaincy, and pharmacy

Section 22 Research in palliative medicine

22.1 Research in palliative care
22.2 The principles of evidence-based medicine
22.3 Understanding clinical trials in palliative care research
22.4 Qualitative research
22.5 Research into psychosocial issues
22.6 Ethical issues in palliative care research
22.7 Quality of life and patient-reported outcome measures
22.8 Health services research in palliative and end of life care
22.9 Clinical audit, quality improvement, and safety in palliative medicine

Index