Problems Faced by Patients and Relatives in Coping With Illness

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· It is important to deal with the illness on a physical, emotional &

spiritual level.

Compliance with Rx

· Problems identified as causing failure of adherence to clinical

advice:

o No named doctor being in charge of patients care.

o No named nurse being in charge of patients care.

o Being in pain most or all of the time.

o Not being told on discharge when to resume their normal activities.

· Factors in communication which improve patients’ adherence to

clinical advice:

o Clinician understands the patient.

o Clinician’s tone of voice.

o Clinician elicits all the patient’s health concerns.

o Patient is comfortable asking questions.

o Patient perceives that sufficient time is spent with the clinician.

· Health outcomes depend on the extent to which patients adhere to

their clinical advice.

· Correctable factors are all matters of communication: letting

patients know why their Rx is being given & what benefits they stand

to gain, what pros & cons there may be, what options exist, & doing so

in a ways which builds trust & collaboration.

Adjustment to loss & bereavement

· Phases of bereavement – shock, distress, adjustment, moving on.

Legal & ethical issues relating to consent to Rx

· Doctors seeking consent for a particular procedure must be competent

in the knowledge of how the procedure is performed & its problems.

· For agreement to Rx to be legally accepted it must meet 3

conditions:

o Consent must be informed to an adequate standard.

o Patients must be competent to consent to Rx.

o Patients must not be coerced into accepting Rx against their wishes.

· It i...

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...of

the chest cavity. Most commonly used to examine lymph nodes in

patient with lung cancer for disease staging.

· Thoracoscopy – endoscopic procedure to inspect the pleural cavity.

Allows examination & biopsy of pleural lesions, drainage of pleural

effusions & talc pleurocesis.

Indications for mechanical ventilation of patients with respiratory

failure

· Significant respiratory acidosis resulting from increased PaCO2.

· Arterial hypoxaemia that is refractory to supplemental oxygen via an

aerosol mask.

Domiciliary oxygen & nebuliser therapy in lung disease

· Domiciliary oxygen – home oxygen therapy.

· Nebulisers – instrument used to apply liquid in form of fine spray.

Additional therapies for cancer

· Immunotherapy – BCG inoculation & monoclonal Ab

· Hyperthermia

· Sensitisers
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