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Palliative care〔(【引用サイトリンク】title= NCI Dictionary of Cancer Terms )〕 is a multidisciplinary approach to specialised medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. The goal of such therapy is to improve quality of life for both the patient and the family.〔 PMID 17531914〕〔(【引用サイトリンク】title=Get Palliative Care )〕 Palliative care is provided by a team of physicians, nurses, and other health professionals who work together with the primary care physician and referred specialists (or, for patients who don't have those, hospital or hospice staff) to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment. Physicians sometimes use the term ''palliative care'' in a sense meaning palliative therapies without curative intent, when no cure can be expected (as often happens in late-stage cancers). For example, tumor debulking can continue to reduce pain from mass effect even when it is no longer curative. A clearer usage is ''palliative, noncurative therapy'' when that is what is meant, because palliative care can be used along with curative or aggressive therapies. Starting in 2006 in the United States, palliative medicine is now a board certified sub-speciality of internal medicine with specialised fellowships for physicians who are interested in the field. Palliative care utilises a multidisciplinary approach to patient care, relying on input from pharmacists, nurses, chaplains, social workers, psychologists and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life. This multidisciplinary approach allows the palliative care team to address physical, emotional, spiritual and social concerns that arise with advanced illness. Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease or cause. This can include treating nausea related to chemotherapy or something as simple as morphine to treat the pain of broken leg or ibuprofen to treat aching related to an influenza (flu) infection. Although the concept of palliative care is not new, most physicians have traditionally concentrated on trying to cure patients. Treatments for the alleviation of symptoms were viewed as hazardous and seen as inviting addiction and other unwanted side effects. The focus on a person's quality of life has increased greatly since the 1990s. In the United States today, 55% of hospitals with more than 100 beds offer a palliative-care program,〔Center to Advance Palliative Care, www.capc.org〕 and nearly one-fifth of community hospitals have palliative-care programs. A relatively recent development is the palliative-care team, a dedicated health care team that is entirely geared toward palliative treatment. ==Medical uses== Immediate palliative care is indicated for patients with any serious illness and who have physical, psychological, social, or spiritual distress as a result of the treatment they are seeking or receiving.〔, which cites * * * * * * * * 〕 Palliative care increases comfort by lessening pain, controlling symptoms, and lessening stress for the patient and family, and should not be delayed when it is indicated.〔 Evidence shows that end-of-life communication interventions decrease utilization (such as length of stay), particularly in the intensive care unit setting, and that palliative care interventions (mostly in the outpatient setting) are effective for improving patient and caregiver perceptions of care. Palliative care is not reserved for patients in end-of-life care and can increase quality of life and lengthen the patient's life.〔 If palliative care is indicated for a person in an emergency department, then that care should begin in the emergency department immediately and with referral to additional palliative care services.〔, which cites: * * 〕 Emergency care physicians have a unique and critical position to begin discussions with patients and caregivers about palliative care and hospice services as they see persons in difficult times of life.〔 In some cases, medical specialty professional organizations recommend that patients and physicians respond to an illness only with palliative care and not with a therapy directed at the disease. The following items are indications named by the American Society of Clinical Oncology as characteristics of a patient who should receive palliative care but not any cancer-directed therapy.〔 * The American Society of Clinical Oncology made this recommendation based on various cancers. See * for lung cancer, see and * for breast cancer, see * for colon cancer, see * for other general statements see and 〕 # patient has low performance status, corresponding with limited ability to care for oneself〔 # patient received no benefit from prior evidence-based treatments〔 # patient is ineligible to participate in any appropriate clinical trial〔 # the physician sees no strong evidence that treatment would be effective〔 These characteristics may be generally applicable to other disease conditions besides cancer. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Palliative care」の詳細全文を読む スポンサード リンク
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