緩和ケアと医学

抽象的な

Building a Simple Way of Knowledge in Palliative Care

Antonio Rozzi and Margherita Salerno

The dramatic advances in clinical therapy and nutrition have produced a progressive increase in life expectancy. Due to the ageing of population, a growing proportion of persons may develop, during their life-time, progressive chronic illnesses (cancer, cardiovascular diseases, dementia, debilitating arthritis, infective diseases) with a consequential greater need for social and economic support. Palliative care recognizes the responsibility of attending to the needs of these patients with their families. Physicians involved in palliative care should relieve pain and the other symptoms: they have expertise in symptoms management and in the communication skills to improve discussion with patients and their families about treatment possibilities, preferences and goals of care. Palliative care focuses primarily in diagnosing and treating symptoms experienced by patients with progressive incurable diseases. The ultimate goal of palliative careis to improve quality of life for both the patient and the family, regardless of diagnosis. Moreover, palliative care reduces the need of hospitalization, diagnostic and treatment interventions and nonbeneficial intensive care [1]. The mandatory aim of palliative care is the relief of the “total pain” of a dying person and his family. What is the “total pain”? As firstly described by Cecily Saunders, total pain is the sum of patient’s physical, psychological, social and spiritual pain.