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Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment - Article

ABSTRACT: The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patient's spirituality or religious commitment and health outcomes, and that patients would like physicians to consider these factors in their medical care. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process. The HOPE concepts for discussion are as follows: H--sources of hope, strength, comfort, meaning, peace, love and connection; O--the role of organized religion for the patient; P--personal spirituality and practices; E--effects on medical care and end-of-life decisions.

Challenges in Pain Management at the End of Life - Article

ABSTRACT: Effective pain management in the terminally ill patient requires an understanding of pain control strategies. Ongoing assessment of pain is crucial and can be accomplished using various forms and scales. It is also important to determine if the pain is nociceptive (somatic or visceral pain) or neuropathic (continuous dysesthesias or chronic lancinating or paroxysmal pain). Nociceptive pain can usually be controlled with nonsteroidal antiinflammatory drugs or corticosteroids, whereas neuropathic pain responds to tricyclic antidepressants or anticonvulsants. Relief of breakthrough pain requires the administration of an immediate-release analgesic medication. If a significant amount of medication for breakthrough pain is already being given, the baseline dose of sustained-release analgesic medication should be increased. If pain does not respond to one analgesic medication, physicians should use an equianalgesic dose chart when changing the medication or route of administration. Opioid rotation can be used if pain can no longer be controlled on a specific regimen. The impact of unresolved psychosocial or spiritual issues on pain management may need to be addressed.

Predicting Benefit of Spinal Manipulation for Low Back Pain - Point-of-Care Guides

Electronic Medical Records: The FPM Vendor Survey - Feature

Focus on the Family, Part 1: What Is Your Family Focus Style? - Improving Patient Care

Providing Basic Spiritual Care for Patients: Should It Be the Exclusive Domain of Pastoral Professionals? - Medicine and Society

Spiritual Assessment in Medical Practice - Editorials

Women in Medicine - Resident and Student Voice

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse - Putting Prevention into Practice

Monitoring Therapy for Patients with Alzheimer's Disease - FPIN's Clinical Inquiries

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