The management of constipation in palliative care: clinical practice recommendations
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- PJ Larkin
- Senior Lecturer in Nursing (Palliative Care), School of Nursing and Midwifery, Aras Moyola, The National University of Ireland, Galway
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- NP Sykes
- Medical Director and Consultant in Palliative Medicine, St Christopher’s Hospice, London
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- C Centeno
- Consultant in Palliative Care, Clínica Universitaria, University of Navarra, Pamplona
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- JE Ellershaw
- Professor of Palliative Medicine, University of Liverpool, Liverpool; Director, Marie Curie Palliative Care Institute, Liverpool
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- F Elsner
- Assistant Professor and Assistant Medical Director, Department of Palliative Medicine, University Hospital Aachen, Aachen
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- B Eugene
- Palliative Care Nurse, Hospices Civils de Lyon, Lyon
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- JRG Gootjes
- Care Manager, Hospice Kuria, Amsterdam
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- M Nabal
- Consultant in Palliative Medicine, Palliative Care Supportive Team, Hospital Universitario Arnau de Vilanova, Lleida
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- A Noguera
- Clinical Research Fellow, Palliative Care Unit, Clínica Universitaria, University of Navarra, Pamplona
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- C Ripamonti
- Specialist in Oncology Medicine and Clinical Pharmacology, Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation, National Cancer Institute of Milan, Milan
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- F Zucco
- Director of the Department of Anaesthesia, Hospice Garbagnate, Cure Palliative AO Salvini, Milan
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- WWA Zuurmond
- Professor of Palliative Care and Pain Relief, Vrije Universiteit Medical Centre Amsterdam, Hospice Kuria, Amsterdam
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説明
<jats:p> Constipation is one of the most common problems in patients receiving palliative care and can cause extreme suffering and discomfort. The aims of this study are to raise awareness of constipation in palliative care, provide clear, practical guidance on management and encourage further research in the area. A pan-European working group of physicians and nurses with significant experience in the management of constipation in palliative care met to evaluate the published evidence and produce these clinical practice recommendations. Four potentially relevant publications were identified, highlighting a lack of clear, practical guidance on the assessment, diagnosis and management of constipation in palliative care patients. Given the limited data available, our recommendations are based on expert clinical opinion, relevant research findings from other settings and best practice from the countries represented. Palliative care patients are at a high risk of constipation, and while general principles of prevention should be followed, pharmacological treatment is often necessary. The combination of a softener and stimulant laxative is generally recommended, and the choice of laxatives should be made on an individual basis. The current evidence base is poor and further research is required on many aspects of the assessment, diagnosis and management of constipation in palliative care. </jats:p>
収録刊行物
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- Palliative Medicine
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Palliative Medicine 22 (7), 796-807, 2008-08-28
SAGE Publications