Palliative Nursing Care ~ Pain & Symptom Management and Quality of Life

palliative care
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What is palliative nursing care?

An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

WHO, n.d.

Palliative care is not only available for patients with cancer, but also for patients with no possible recovery, such as patients with end-stage organ failure.

palliative nursing care
Retrieved from https://online.stanford.edu/courses/som-xche0017-palliative-care-always-capstone on 18th January 2022

What is suffering in palliative care?

A multidimensional and dynamic experience of severe stress that occurs when there is a significant threat to the whole person and regulatory processes (which would normally enable adaptation) are insufficient.

Krikorian & Limonero, 2012
palliative nursing care
Retrieved from https://ezgif.com/webp-to-jpg/ezgif-7-4e0210900f.webp on 18th January 2022

Promoting Quality of Life in Palliative Nursing Care

Palliative Nursing Care should aim to provide quality of life, which in other words refers to care in all aspects that palliative patients deem necessary for what they perceive quality of life to be. Such aspects include:

  • emotional needs
  • autonomy
  • healthcare
  • cognitive aspects
  • physical aspects
  • social aspects
  • spiritual aspects
  • preparatory aspects

A primary assessment aims to point out all current issues as well as potential ones. Palliative Nursing Care should include the following domains when it comes to patient assessment:

  • symptoms
  • function
  • interpersonal
  • well-being
  • transcendent

These should be measured through assessment, satisfaction and importance…

palliative nursing care
Retrieved from https://www.semanticscholar.org/paper/Measuring-quality-of-life-for-patients-with-the-of-Byock-Merriman/db4f292e8c6c3d301fdaf2cb4735a9e72e7ca7b0/figure/1 on 18th January 2022

Palliative Nursing Care Systematic Symptom Assessment

A systematic symptom assessment provides a deeper insight when compared to a primary assessment…

palliative nursing care
Retrieved from https://www.sciencedirect.com/science/article/pii/S0885392416312131 on 18th January 2022
palliative nursing care
Retrieved from https://www.tomwademd.net/assessing-your-patients-symptoms-with-the-edmonton-symptom-assessment-scale/ on 18th January 2022
palliative nursing care
Retrieved from https://www.tomwademd.net/assessing-your-patients-symptoms-with-the-edmonton-symptom-assessment-scale/ on 18th January 2022

Symptomatic Pain Management

Symptomatic Pain Management needs to be applied through the nursing process:

  1. ASSESSMENT of the pain
  2. PLANNING pain management
  3. IMPLEMENTATION of medical and non-medical regimen
  4. EVALUATION of applied pain management and its effectiveness
palliative nursing care
Retrieved from https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/nursing-documentation-principles/ on 18th January 2022

Detailed information about the pain being experienced by the patient, such as location, intensity, quality, effect, and impact (even including the patient’s own descriptive words about experienced pain), leads to an accurate diagnosis and thus, better pain management strategies.

Pain can be classified as either Neuropathic Pain or Nociceptive Pain. Nociceptive Pain is a combination of Somatic Pain and Visceral Pain…

Retrieved from https://edu.glogster.com/glog/acutechronic-pain/2afxqocdhjg?=glogpedia-source on 18th January 2022

Medical Pain Management Strategies

Retrieved from https://www.researchgate.net/figure/New-adaptation-of-the-analgesic-ladder_fig2_258112804 on 18th January 2022

(‘weak opioids’ include Codeine)

Retrieved from https://www.uspharmacist.com/article/special-considerations-for-opioid-use-in-elderly-patients-with-chronic-pain on 18th January 2022

Non-Medical Pain Management Strategies

Non-medical pain management strategies may help in conjunction with medical pain management methods. Helpful methods may include:

  • complementary therapy
  • transcutaneous electrical nerve stimulation (TENS)
  • acupuncture
  • music therapy
  • hypnosis
  • reflexology
  • mind-body therapy
  • art therapy

The Nurse’s Role in Pain Management

  • pain assessment
  • pain management
  • evaluation
  • palliative approach
  • patient education
  • support
  • research
  • patient inclusion in pain management choices through provision of information, enabling informed consent for intervention choices

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Claire

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Author: Claire

Claire Galea is a mum of three currently in her final year following a Degree in Nursing at the Faculty of Health Sciences, University of Malta, as a mature student. Claire is keen about public education on health-related subjects as well as holistic patient-centered care. She is also passionate about spreading awareness on the negative effects that domestic abuse leaves on its victims’ mental, emotional, social and physical wellbeing. Claire aspires to continue studying following completion of her Nursing Degree, because she truly believes in lifelong education.