Evaluation and Assessment-FH assessment acronym Correct Answer-FRASER HEALTH ASSESSMENT ACRONYM
Onset
Palliate/Provoke
Quality
Region/radiate
Severity
Treatment
Understanding/impact on you
Values
Assess every symptom with this tool!
*palliative is not giving up, its changing the goal...
N304: Palliative and End of Life Care (EOL) - Part 2
questions with correct answers
Evaluation and Assessment-FH assessment acronym Correct Answer-
FRASER HEALTH ASSESSMENT ACRONYM
Onset
Palliate/Provoke
Quality
Region/radiate
Severity
Treatment
Understanding/impact on you
Values
Assess every symptom with this tool!
*palliative is not giving up, its changing the goal of care, changing the
treatment, want to give quality of life best we can for pt and family
i.e: maybe more psychosocial, managing symptoms
Palliative Performance Scale (PPS)
Provides a framework for what?
what are the 3 stages?
What are the 5 observable parameters in the assessment? Correct
Answer-provides a framework for measuring progressive decline over
,the course of illness. It also provides a "best guess" projection of length
of survival (i.e. suggests if patient is moving closer to death) and serves
as a communication tool for the team
can help as determine where EOL will happen: home, hospice
5 observable parameters included in the functional assessment:
1) Degree of ambulation
2) Ability to do activities
3) Ability to do self-care
4) Intake
5) Level of consciousness
Barriers to pain and symptom management
Health Care Professional barriers
System barriers
Patient/family barriers
,Societal barriers Correct Answer-Health Care Professional barriers
-education, knowledge levels about pain etiology/treatments/medications
-lack of autonomy/decision-making
-some feel they may have to influence how pain is treated; inconsistent
prescribing; poor pain assessment for a variety of reasons
-possibly bias towards patients; fear of opioids and
addiction/tolerance/side effects
-relationship/communication with patient
- attitudes of hcp ( it is argued that it is very difficult to know what pain
someone is experiencing, but studies show that hcp still make
judgements and assumptions about it which can significantly influence
care.)
System barriers
policy, accountability, education, interdisciplinary teams/communication
do we have the facilities for people to be in EOL unit/hospice
Patient/family barriers
-subjective nature of pain experiences
- lack of education/awareness re: side effects/tolerance etc;
communication with hcp/language used --expectations of pain: eg pain is
still expected as part of disease process esp with cancer and therefore to
be put up with (WIT DVD- said having pain reminded her she was still
alive)
, - environment, others around them, maybe think that curative treatments
might be stopped if c/o pain as could indicate disease progression so
keeps quiet.
-family not accepting pt @ EOL; want curative measures when not
realistic
Societal barriers
different cultures have different expectations (men should be tough!
Some express pain loudly etc), age, gender, level of education.
Differientiate between acute and chronic pain Correct Answer-Acute
pain <3 months
-sudden onset
-mild to severe
-caused by illness,surgery
-goes away as recovery occurs
-manifestations reflect sympathetic nervous system activation
-increased HR
-Increased RR
-Increased BP
-pallor
-anxiety, agitation,confusion
goal to eliminate pain
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