Pain in Palliative Care and Thee Importance of Interdisciplinary Team Work

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Introduction: Pain is one of the most common and distressing symptoms described by patients with life-limiting illnesses (Ferrell and Coyle, 2008). However, it is not purely a physical experience but involves various other components of human functioning, including personality, mood, behaviour, and social relations (Bruera and Portenoy, 2003). In an attempt to describe the all-encompassing nature of pain within a “wholeperson” framework, Dame Cicely Saunders coined the concept of “total pain” (Saunders, 1978). She suggested that pain has physical, psychological, social, emotional, and spiritual components that make up the “total pain” experience. Yet the contribution of each component will be specific to each individual and his or her situation. Palliative care utilizes an interdisciplinary approach to patient care, relying on input from doctors, pharmacists, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve total pain and suffering in all areas of a patient's life (Krouse, 2008). In this essay I will discuss the impact that the interdisciplinary team may have on total pain in a patient suffering from a life limiting illness. Total Pain: Pain is a common symptom of end-stage illness, affecting between 70 and 90 percent of patients with advanced cancer and large numbers of patients experiencing other life-threatening illnesses (Hospice of the Western Reserve, 2003). It is a complex and individual experience, often requiring creative approaches to identify causes and seek solutions for relief (Middleton-Green, 2008). As previously mentioned the concept of “total” pain was first described by hospice founder Dame Cicely Saunders in the late 1960s, following her extensive work with terminally ill patients in London (Saunders, 1978). Total pain encompasses physical, social,
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