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 areasfrom 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; International progress in the development of palliative medicine; Essential medicines for palliative care; Human rights issues; Policy in palliative care; Section 2: The challenge of palliative medicine; Building definitional consensus in palliative care; Core concepts in palliative care; The epidemiology of death and symptoms: Planning for population-based palliative care; Barriers to the delivery of palliative care; Ethnic and cultural aspects of palliative and end of life care; Health economics for palliative care; Section 3: Service delivery issues in palliative care; Specialist palliative care along the trajectory of illness: Issues in the early integration of palliative care; Palliative care delivery models; Palliative medicine in the intensive care unit; Palliative care in the emergency department; Palliative care in the nursing home; Section 4: Healthcare professionals in palliative care; The core team and the extended team; Burnout, compassion fatigue, and moral distress in palliative care; Nursing Education in palliative care; Social work in palliative care; The role of the chaplain in palliative care; Occupational therapy in palliative care; The role of the creative arts in palliative care; The role of the dietitian in palliative care; Physiotherapy in palliative care; Speech and language therapy in palliative care; Clinical psychology in palliative care; The contribution of the clinical pharmacist in palliative care; Medical rehabilitation and the palliative care patient; Section 5: Communication and palliative medicine; Communication with the patient and family; Practical considerations including difficult conversations; Advance care planning; Section 6: Family and caregiver issues; Family dynamics in the context of serious illness; Caregiver burden and distress; Section 7: Pain; Definition and assessment of chronic pain in advanced disease; Pathophysiology of pain in cancer and other terminal illnesses; Acute cancer pain syndromes; Chronic cancer pain syndromes; Principles of drug therapy; Opioid therapy: Optimizing analgesic outcomes; Opioid therapy: Managing risks of abuse, addiction, and diversion; Non-opioid analgesics; Adjuvant analgesics: principles of use; 7.10 Interventional approaches for chronic pain; Neurostimulation in pain management; Behavioral and psychosocial interventions for pain management; Integrative medicine therapies in pain management; Management issues in bone pain; Management issues in neuropathic pain; Management issues in visceral pain; Management issues in chronic pain following cancer therapy; Paediatric pain control; Section 8: Gastrointestinal symptoms and disorders; Dysphagia, dyspepsia, and hiccups; Nausea and vomiting; Constipation and diarrhoea; Jaundice, ascites, and encephalopathy; Aetiology, classification, assessment, and treatment of the anorexia-cachexia syndrome; Parenteral nutrition; Section 9: Cardio-respiratory symptoms and disorders; Breathlessness and other respiratory symptoms in palliative care; Cough and other pulmonary symptoms; Section 10: Skin and oral symptoms and disorders; Skin problems in palliative care; Palliative wound and ostomy care; Lymphoedema and oedema of advanced disease; Oral care; Section 11: Genitourinary symptoms and disorders; Dysuria, frequency, and bladder spasm; Obstructive urinary disorders; Section 12: Constitutional symptoms and related disorders; Fatigue; Sexuality in palliative care: Discussing patient sexuality and intimacy in palliative care; Sleep disorders; Assessment and management of thrombotic complications; Assessment and management of bleeding complications in the medically ill; Section 13: Psychiatric and psychological symptoms and disorders; Coping and resilience in palliative medicine; Depression, demoralization, and suicidality; Fear, anxiety, and adjustment disorder in palliative care; Delirium; Bereavement; Section 14: Palliative care in cancer; The oncologist s role in delivering palliative care; Disease-modifying therapies in advanced cancer-medical treatment; Radiotherapy in symptom management; The role of general surgery in the palliative care of patients with cancer; Orthopaedic surgery in the palliation of cancer; Integrative oncology in palliative medicine; Interventional radiology in the palliation of cancer; Neurological problems in advanced cancer; Endocrine and metabolic complications of advanced cancer; Malignant Bowel obstruction; Palliative care issues in head and neck cancers; Palliative care issues in populations with haematological malignancies; Anaemia, cytopenias, and thrombosis in palliative medicine; Section 15: Issues in populations with non-cancer illnesses; HIV/AIDS; Advanced diseases of the lung; Advanced heart disease; Dementia; Neurological disorders other than dementia; Palliative care and end-stage liver disease; End-stage kidney disease; Palliative care in catastrophic disasters and humanitarian crises; Section 16: Issues of the very young and the very old; Involving children and families when someone important is dying or has died; Care of children with advanced illness; Palliative medicine and care of the elderly; Section 17: Spiritual issues in palliative medicine; Spiritual issues in palliative medicine; Integration of spiritual care into palliative care service delivery models; Section 18: The terminal phase; Predicting survival in patients with advanced disease; Physiology of dying; Management of the actively dying patient; Section 19: Ethical issues; Practical bioethics in the care of patients with advanced illness; Requests for futile or inappropriate interventions near the end of life; 3 Autonomy and shared decision making in a multi-cultural world; Truth-telling and consent; Ethics in paediatric palliative care; Ethical issues in physician aid-in-dying; Withholding and withdrawing life-sustaining treatment (including artificial nutrition and hydration); Medical and ethical considerations in palliative sedation at the end of life; Section 20: Assessment tools and Informatics; Palliative care needs assessment tools; Informatics and literature search; Validated assessment tools for psychological, spiritual, and family issues; Section 21: Teaching and training in palliative medicine; Physicians; Nurses; Teaching and training in palliative social work, chaplaincy, and pharmacy; Section 22: Research in palliative medicine; Research in palliative care; The principles of evidence-based medicine; Understanding clinical trials in palliative care research; Qualitative research; Research into psychosocial issues; Ethical issues in palliative care research; Quality of life and patient-reported outcome measures; Health services research in palliative and end-of-life care; Clinical audit in palliative medicine;