A CLINICAL GUIDE
TO SUPPORTIVE AND PALLIATIVE CARE FOR HIV/AIDS
Joseph F. O’Neill, Peter A. Selwyn, and Helen Schietinger (Eds)
 |
HIV/AIDS Bureau, Health Resources and Services Administration, US Department of Health and Human Services, 2003
602pp Available Free (Click Here) |
The need to incorporate the principles and practices of palliative care into the management of patients with advanced HIV infection
and AIDS has been obvious to those who work in the field of palliative care for a long time. But HIV/AIDS and palliative care have had a chequered history. In the early days, accepting palliative
care was equated with "giving up". Then as the death rates increased in the early 1990s, palliative care became a little more acceptable. But then protease inhibitors arrived and now
the major textbooks on HIV/AIDS again have no mention of the management of advanced disease or death and dying. There has been a great need for a textbook detailing the multidisciplinary symptomatic
and supportive care of patients with HIV/AIDS and this Clinical Guide goes a long way to filling the gap.
The Table of Contents reads like a palliative care text. There are a number of chapters on the medical management of pain and other
physical symptoms. The coverage is good, although a little more about degenerative neurological disease would have been appropriate. Then there are chapters about the cultural, spiritual, social,
and ethical aspects of care, as well as grief and bereavement. There are chapters on communication and caring for the caregiver. And not one, but two, chapters on the management of advanced disease
and terminal care. There is a comprehensive list of Internet resources and a 37-page chapter detailing clinically significant drug interactions. Which all adds up to a fairly comprehensive treatise
on palliative care and HIV/AIDS.
Dr. O’Neill and his collaborators are to be congratulated on the production of this excellent Clinical Guide, which will be a valuable
resource to any palliative care workers who treat patients with HIV/AIDS. The fact that it is being made available free of charge means that this information on how to provide better care for
these patients will be more readily available in the developed world, as well as in the developing world where HIV/AIDS is rampant.
Roger Woodruff,
Director of Palliative Care, Austin Health, Melbourne, Australia
Former Chairman, IAHPC
May 2003
Author Information
Joseph F. O’Neill is Director of the White House Office of National
AIDS Policy.
Peter A. Selwyn is Director of the Palliative Care Program at Montefiore Medical Center, New York, USA
Helen Schietinger is HIV Policy Analyst, Domestic and International Program Development and Evaluation, Washington, DC, USA.
Table of Contents
Part I – Introduction
1. HIV and Palliative Care 1 O’Neill and Barini-Garcia
2. Overview of Clinical Issues 5 Selwyn and Rivard
Part II – Management of Advanced HIV Disease
3. Assessment of Physical Symptoms 37 Ingham and Farooqi
4. Pain 85 Breitbart
5. Constitutional Symptoms 123 Hurtado and Krakauer
6. Pulmonary Symptoms 135 Beehler
7. Gastrointestinal Symptoms 157 Wohlfeiler
8. Oral Problems 167 Rosenstein and Chiodo
9. Dermatological Problems 177 Kouba and Martins
10. Psychiatric Problems 207 Forstein
11. Substance Abuse Problems 253 O’Neill and Selwyn
12. The Care of Children and Adolescents 267 Hutton and Oleske
Part III – Psychosocial, Cultural and Ethical Issues
13. Spiritual Care 289 Puchalski and Sandoval
14. Culture and Care 301 Sandoval
15. Special Populations 315 Alexander and Schietinger
16. Grief and Bereavement 329 Reder
17. Ethical Issues 349 Jansen, Johnston and Sulmasy
18. Legal and Financial Issues 365 Greenwald and Eshghi
19. Palliative Care in Resource-poor Settings 387 Foley, Aulino and Stjernsward
20. Care for the Caregiver 409 O’Neill and McKinney
Part IV – Care at the End-of-Life
21. Patient-Clinician Communication 431 Curtis
22. Facilitating the Transition to Home-based and Hospice care 447 Kutzen
23. Medical Care in Advanced AIDS 479 Meyers and Linder
24. Medical Care at the end-of-life. Alexander, Back and Perrone
25. Prevention of Skin Breakdown 505 Tuthill and Garnier
Part V – References for the Clinician
26. Resources 515 Barini-Garcia & Sundra
27. Pharmacologic Interactions of Clinical Significance Edmunds-Ogbuokiri
Index 587
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