Finding Peace Beyond the Pain: Sunder's Journey in the Hospice

Rao, Seema Rajesh

doi:10.1080/15360288.2016.1204408

Cited by 3 publications

(2 citation statements)

References 6 publications

(4 reference statements)

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“…This finding was also consistent with studies of Japanese and Taiwanese individuals ( Cheng et al, 2012 ; Miyashita, Sanjo, Morita, Hirai, & Uchitomi, 2007 ). Pain at the EOL represents not only physical discomfort but a combination of symptoms from physical, psychosocial, and spiritual distress ( Rao, 2016 ; Saunders & Sykes, 1993 ).…”

Section: Discussionmentioning

confidence: 99%

What Matters Most at the End-of-Life for Chinese Americans?

Lee

Hinderer

Alexander

2018

Gerontology and Geriatric Medicine

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Background: To provide optimal end-of-life (EOL) care in the Chinese American population, we need to have a better understanding of what matters most at EOL from their perspective. Experiencing a “good death” at the EOL is the optimal goal of palliative care. Studies show that the meaning and description of good death varies across cultures in different populations. In the United States, Chinese Americans comprise the largest Asian demographic. Aim: To describe EOL wishes, which define a good death for Chinese Americans. Method: Qualitative study using focus groups. A convenience sample of 60 Chinese Americans was recruited from a community organization in Maryland. Ten focus group discussion sessions were conducted. Results: Wishes at the EOL that defined a good death for the participants in this study included being pain-free, not being a burden to family, being with family, having a trusted physician, maintaining dignity, and prayer. Conclusion: A good death is a complex concept. What matters most to patients at the EOL differs depending on their cultural background. When caring for Chinese Americans, a comprehensive EOL care plan should include cultural considerations in addition to physical, psychosocial, and spiritual needs.

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Section: Discussionmentioning

confidence: 99%

What Matters Most at the End-of-Life for Chinese Americans?

Lee

Hinderer

Alexander

2018

Gerontology and Geriatric Medicine

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“…We believe that the care of this small patient population lies at the intersection between that of chronic non-cancer pain patients and those who are experiencing Total Pain, a concept more commonly used in palliative care to describe multidimensional suffering related to serious or terminal illness (Figure 1). 1,2 In this scenario, the patient’s chronic non-cancer pain worsens with mandated opioid tapering, contributing to increased Total Pain. Appropriate, monitored use of opioids in the context of a multidisciplinary treatment plan alleviates the physical pain and reduces the patient’s suffering, allowing the patient to achieve functional goals and improve his quality of life, thereby addressing the Total Pain.…”

Section: Case Descriptionmentioning

confidence: 99%

End Stage Chronic Pain (ESCP): Naming Complex Suffering in the Opioid Crisis Era

Comerci

Marr

Finlay

2020

Am J Hosp Palliat Care

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The “opioid crisis” stemming from overprescribing of prescription opioids describes an iatrogenic situation which has resulted in a rise in opioid use disorder (OUD) and overdose deaths. Many of these patients suffer from chronic non-cancer pain syndromes (CNCP) who have been injudiciously treated with opioids. Some patients with CNCP are treated successfully with opioids in accordance with modern guidelines. There is a very complex, small group of patients with CNCP who require higher than recommended dosages of opioids when other modalities and treatments have failed. We describe such a patient and believe that there is a subset of patients with unremitting suffering from chronic pain which we have called end-stage chronic pain (ESCP). These patients, despite receiving expert chronic pain care, often require high doses of opioids and suffer a dramatic decline in quality of life (QOL), function and an increase in their suffering when their opioids are tapered or discontinued. We have responded to the treatment of this group of patients by critically examining our approach to the use of opioids for their pain and attempting to reconcile high dose opioids in the setting of the Center for Disease Control (CDC) guidelines. We describe a patient with severe chronic pain from congenital spinal disease who experienced increased pain and suffering when his opioids were tapered. We will discuss our approach to this patient and in doing so discuss the concept of ESCP and proposed criteria for the use of high dose opioids in such patients.

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Triggers and markers of skin aging in women with menopausal syndrome

Mamontova¹,

Усольцева

Pisklakova

et al. 2022

Medicinskij sovet

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Introduction. External manifestations of aging, and especially skin aging are the most important for modern women.Aim. The aim of our study was to identify a set of adverse factors that effect on the skin of women in menopausal transition (MP) and in postmenopause (PM), and to identify markers of skin aging in this category of women.Materials and methods. The study included 36 women in MP and PM suffering from MS. At the first stage, anamnesis was collected, anthropometric data and severity of MS were evaluated, and the hormonal profile of patients was determined. At the second stage, computer mapping of the skin was performed using the digital video camera Aramo SG with the skin XPpro program. Statistic analysis was performed using the SPSS v13.0 program. Spearman’s analysis was used to determine the relationship between anthropometric, clinical and anamnestic data and the measurements of skin condition of women in MP and PM. Results. According to the obtained data, the main triggers of skin aging of women in MP and PM are: the presence of metabolic disorders (obesity, metabolic syndrome), decrease of estradiol and progesterone levels in blood serum as well as increase of prolactin level and rhythm disturbance of melatonin secretion. Markers of skin aging in women with menopausal syndrome are decreased moisture, increased oiliness in T-zone, increased of skin pigmentation and enlarged pore size.Conclusions. The obtained data are useful for management involuting skin changes of women in PM and MP suffering from MS. The data justifies the relevancy to normalization not only the estradiol level, but other sex steroids, melatonin, as well as correction of metabolic endocrine processes, and treatment of MS.

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Finding Peace Beyond the Pain: Sunder's Journey in the Hospice

Cited by 3 publications

References 6 publications

What Matters Most at the End-of-Life for Chinese Americans?

What Matters Most at the End-of-Life for Chinese Americans?

End Stage Chronic Pain (ESCP): Naming Complex Suffering in the Opioid Crisis Era

Triggers and markers of skin aging in women with menopausal syndrome

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