Palliative Treatment : From Cure to Care

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Palliative Treatment From Cure to
Care Psychological Support in Terminal
Illness ?????? ?????? ??????????????????? ?????
?????????????????????
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Emotional Reaction - E. Kübler - Ross - shock
- denial - anger - bargain - depression -
despair - acceptance
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Fear in chronic - living dying phase Holland et
al. - Six Ds - Death - Dependency -
Disfigurement - Disability - Disruption -
Discomfort
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Fear in chronic - living dying phase Garfield.
- fear of the unknown - fear of
loneliness - fear of sorrow - fear of loss
of family, friends - fear of loss of body -
fear of loss of self - control - fear of
loss of identity - fear of suffering and
pain - fear of regression
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Psychiatric Comorbidities -
bereavement - depression - adjustment
disorder with depressed mood - dysthymia -
secondary depression - anxiety - organic
mental disorders - delirium - confusional
state - organic personality - substance
abuse/addict - insomnia - psychosomatic
disorders
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Psychological Support - patient - family 1.
Hope 2. Caring 3. Sharing
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Caring - pain free (physical, psychological,
social, spiritual) - comfort - fully mental
alert (sense of control)
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Sharing - attitude - communication -
experiences - environment - responsibilities
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Essential Treatment Recommendation in Terminal
Illness Cassem Stewart - competence -
concern - comfort - communication -
children - family cohesion and integration -
cheerfulness - consistency perseverance -
equanimity (calmness of mind and temper) Add -
professional sexual rehabilitation
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???? ??????????????????????????????????
?????????????????? 1. ?????????????
???????????????????????? multimodal treatment
regimens 2. ???????????????????????????????????
??????????????????????? ??????
??????????????????????????????????????????????? 3.
?????????????? coping mechanisms
????????????????? 4. ????????????????????????????
?????????? silent grief ??? anticipatory grief 5.
???????????????????? preterminal phase
????????????????????????? good death 6.
?????????????? guilt after death
??????????????????????????????????????
????????????????????? 7. ???????????
mental support ??????????????????????????
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Thank You