____________________________________________ Assessment and Management of Pain at the End of Life
Patients who are following a methadone maintenance program may also fear effective pain management as a risk for recurrent abuse. Two approaches may be followed for these patients: they may receive an increased dose of methadone as the pain reliever or they may be given other opioids along with the same methadone dose, with the dose of the opioid titrated for effective pain relief [12; 33]. Again, involvement of the drug counselor is important. CONCLUSION As many as 96% of people with a life-limiting disease have pain at the end of life, and unrelieved pain is a great fear in this population. However, experts estimate that 75% to 90% of end-of-life pain can be effectively managed. Healthcare professionals should strive to enhance their knowledge of key strategies to achieve high-quality pain management at the end of life through open communication, frequent assessment, and the use of evidence-based pharmacologic and nonpharmaco- logic interventions that are individualized to each patient’s specific situation. Implicit Bias in Health Care The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, profes- sionals’ attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients’ trust and comfort with their provider, leading to earlier termina- tion of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health profes- sionals’ implicit biases can further exacerbate these existing disadvantages. Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control- based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual’s behaviors. These strategies include increas- ing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.
WORKS CITED https://qr2.mobi/Assessment_Pain_EOL
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MDNJ1525
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