[Literature Review] Palliative Care

Introduction

By definition, palliative care (or hospice care) is among the various forms of medical care or treatment which concentrates in reducing the severity of the symptoms of a disease (Barraclough, 1997, p 1367; Portenoy and Bruera, 1997, Ch 2; Field et al., 2001, pp 8-10). It is often regarded as slowing the progress of a terminal illness rather than providing for a cure (Mcnamara, 2001, p. 121; Geisler, Krabbendam & Schuring, 2003, p. 103). The World Health Organization (WHO, 2005) generally define the term as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

The Hasting’s Center Report (2003, pp.6-8) enumerated the services in palliative care, which include professional nursing care, personal assistance with activities of daily living, various forms of rehabilitation therapy, dietary counseling, psychological and spiritual counseling for both patient and family, volunteer services, respite care, provision of medical drugs and devices necessary for palliative care, and family bereavement services following the patient’s death. Nurses, social workers, pastoral counselors, nursing assistants, and other health professionals under the management of a physician comprise the interdisciplinary care team.

In palliative care, pain is the most evident symptom that causes difficulty to treat. Palliative care is sometimes used in referral to the addition of symptom control and pain management services with the mainstream health care system (The Hasting’s Center Report, 2003, pp.6-8.) Thus, a health care practitioner or any individual associated with this kind of specialized medical care should be well equipped with the most comprehensive knowledge and application on pain and its management.

Pain and its Management

Pain is one of the most common human experiences, as no one is spared from such suffering, whether such to the physical or emotional. Yet for the longest time, pain has never been fully considered as a medical problem. It may be due to the fact that it is a subjective and a highly personal experience. Though pain can be measured, it cannot diagnose, felt (unless it is your own), imagined or proved its existence. Pain as a sensation differs from one person to another. LaPorte Matzo & Sherman (2001) says “pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors.” Hence, no person can exactly feel the same degree of pain at the same time. But pain is as real as the symptoms it shows, it is the reason why approximately 70 million visits were made by people to health care professionals every year (National Women’s Health Resource Center, 2004).

There has been a clear lack of knowledge when it comes to the overall nursing knowledge, whether when it comes to the physical practices that come with nursing care, the attention that they must give to the pharmaceutical concerns for their patient, and especially when it comes to the management of their patients' pains (Buschmann, 2001). Pain and its management is one of the most important parts of the nursing education which has been widely ignored by many nurses that only seek to gain monetary advancements. Palliative care is achieving the best quality of live for the patient and their families. The role of the health care provider like the nurse is to deliver the most effective and maximum utilization of resources and the proper observance of the standard operating procedures of palliative care (Marelli, 1999; Paice, 2005, p. 95). Thus, there are many aspects of caring that have been forgotten or disregarded in the effort to gain more advantage economic-wise. This ensures that the nursing profession continues to be a holistic practice that involves not only one aspect but the whole. Holistic professions do not only provide care for one of the body functions but the entire, which include the emotional health, physical health, and mental health of the patient (LaPorte Matzo & Sherman, 2001). Nurse must remember that care should be provided up to their best efforts in order to ensure that their patients are provided with the care that they are entitled to as their human rights.

At the same time, holistic care also refers to the knowledge concerning the pharmaceutical needs of the patients. Every year there have been several researches done concerning the removal of pain, whether temporarily or permanently (King, 1991) and recent studies have shown that nursing knowledge has continued to increase when it comes to the nurses’ identification of pain (Buschmann, 2001). However, studies also show that despite the knowledge many nurses have when it comes to emotional pain management, they believe that it worries them and does not give them enough to time to complete their work (Buschmann, 2001). At the similar point in time, it was shown that nurses, compared to physicians, therapists, and pharmacists, have more knowledge and experience when it comes to pain assessment, which makes them the best professionals who have the ability to judge the degree of pain that a client may have. Physicians and those in the pharmaceutical business may also be able to offer assistance when it comes to pain relief however they will still have to rely on the nurses’ ability to asses the extent of pain as well as their judgment on the immediate care for the patients once these problems start.

As a consequence, nurses should have already trained and prepared for their possible confrontation with several bioethical issues. They must then be prepared to face some matters that will need to be cleared as well as have to do intense soul searching in order to help them achieve better status and deal with their own emotions as well as their patients in order to establish a caring relationship between them. In order for this to happen, it is advised that the nurses avail or establish a team pain management plan which will help standardize their goals and hoped achievements when it comes to their patients’ welfare (Angelucci, Quinn & Handlin, 1998), especially since nurses’ decisions and the patients’ pain management programs may highly affect the patients’ emotions, physical reactions, spiritual beliefs, mental health, and overall quality of life. With such, it is suggested that nursing pain management should be as thorough and ethically charged as possible in order to ensure the best quality of care that the patients will receive.

Pain management, in this case, is an important aspect of caring for patients. However, despite of the available pain management guidelines, many patients complain incessantly about the pain after surgery or as a symptom of a terminal disorder (Buschmann, 2001). This perhaps implies the important correlation of theories and the role of nurses to pain management. Nurses should do more than administer methods or means to control the pain. As care providers, they should feel what their patients are feeling by establishing a personal bond with them and by being effective listeners.

New Breakthroughs in Other Symptoms and Pain Management

Other symptoms such as gastrointestinal, dyspnoea, confusional states, depression and distress are encountered in palliative care (Billings, 2000). Gastrointestinal symptoms include gastroparesis, nausea, and vomiting present in cancer related ailments. Diarrhea is also common to AIDS victims. With the help of new pharmaceutical substances, medicines to alleviate these symptoms are useful. Examples include the use of prokinetic drugs and new serotonin antagonist antiemetics to cancer related symptoms; Octreotide relieves AIDS related diarrhea; and progestational drug, such as megastrol acetate and glucocorticoids improve anorexia (Bruera & Neumann, 1998, pp. 1717-26). Dyspnoea, on the other hand, is perceived as the difficulty or pain in breathing. This is considered to be a common symptom of a serious many disorder. But now, breathlessness is manageable by using opioids and oxygen. Confusional states like delirium are under-recognized and under-treated in terminally ill patients (Billings, 2000). Using some drugs like haloperidol, chlorpromazine, and lorazepam alleviates the delirious behaviour of AIDS patients. Depression is also under-recognized and under-treated although it is very much common to everyone who suffers in a terminal ailment. According to Block SD for the ACP-ASIM End-of-Life Care Consensus Panel (2000), there is a significant number of clinicians who incorrectly presume that the stage of depression is natural and normal or expected to anyone, rather than a biologically based and treatable form of emotional suffering distinct from the state of sadness. J Andrew Billings (2000) affirmed that “the biological signs that usually form the basis of a diagnosis of major depression are often present in a terminal condition but are attributable to the medical illness rather than the psychological state. Clinicians must assess patients for classic depressive signs that cannot be ascribed to the underlying illness (for example, early morning waking that is not due to pain) and rely more on such psychological findings as excessive hopelessness, helplessness, worthlessness, and guilt and suicidal ideation.” With the suppressing effects of psychostimulants like dexamfetamine or methylphenidate, depression to such patients was use as treatment. Other advances on drugs in pain management were comprehensively presented in Billings’ work.

Palliative Care: an ethical “end-of-life” responsibility

"Ethical dilemmas have always been with us, but their nature in health care settings has changed radically with the development of new knowledge and technology" (Thompson & Thompson, 1990, p. 89). Nurses caring for terminally ill patients hold a great responsibility in numerous aspects. The many problems and difficulties encountered by nurses in the course of palliative care are numerous. A survey conducted to identify the five most frequent and five most difficult problems perceived by nurses in hospice, community and acute care settings revealed physical problems, emotional problems, work-related, death-related, and nurse-related problems as a result of caring for dying patients and their families (Copp & Dunn, 1993, pp. 19-25). Central issues are also identified such as talking to patients about dying, the decision to die at home or not, 'difficult' patients (or family), quality-of-life versus prolonging life and pain management (McGrath, Yates, Clinton & Hart, 1999, pp, 17-33).

Nurses handle not only a huge social responsibility by a great moral responsibility as well. In relation to palliative care, Jameton (1984) stated:

Patients, their families, and clinicians make decisions

about the treatment of dying patients against a background of 

conflicting feelings about death,varying evaluations of death as 

a way of escaping painand suffering, and great uncertainty about

its timing. Clinicians now recognize that dying people are still 

actively engaged in life. Respect for persons demands a response to their needs even if they have a brief future; care is not an investment, but an ongoing human response. (p. 225)

With the ethical considerations and debates on palliative care, nurses must handle the severe problems and dilemmas occurring in practice through more research, study, training, and education.

Conclusion

Palliative care is an integral part of all health care. It neither aims to hasten nor to postpone death and involves much more than fast-acting pain relief medications; but a psychosocial and spiritual goal and dimension should be met through the building of trust, communication, and relationships not only for the body but with self of the patient and the system of the family.

The best rationale of palliative care in the society today was captured by science-fiction writer Phillip K. Dick (1965) where he stated that: “Life itself was unendurable and hence had to be ameliorated. As a thing in itself, it could not be actually lived. There had to be some way out (p. 90)”.

Palliative care still challenges the ability of every health care profession to provide the highest quality of life especially to those who are at the end of life. Thus, nurses must be equipped with competent skills acquired from continued education and training along with future researches on the effectiveness of palliative care management. With these, there is an assurance for optimum growth, development and availability of this specialized, comprehensive and functional end of life care.

Reference:

Angelucci, D, Quinn, L & Handlin, D 1998 A Pain Management Relief Plan. Nursing Management, 10th January.

Baily, MA, D’Onofrio, C, Jennings, B & Ryndes, T 2003, ‘Access to Hospice

Care: Expanding Boundaries, Overcoming Barriers’, The Hastings Center Report, vol. 33, no. 2, pp. 3+.

Barraclough, R 1997, ABCs of Palliative Care: Depression, Anxiety, and

Confusion. Journal of the American Medical Association, 279, pp. 1365-1368.

Billings, JA 2000, September 2 ‘Palliative care – Clinical Review’, British

Medical Journal, viewed 25 November 2005, <www.findarticales.com.>

Block SD for the ACP-ASIM End-of-Life Care Consensus Panel 2000 ‘Assessing

and managing depression in the terminally ill patient’, Ann Intern Med, vol.132, pp. 209-18.

Bruera, E & Neumann, CM 1998 ‘Management of specific symptom complexes in

patients receiving palliative care’, Can Med Assoc, vol. 158, pp. 1717-26.

Buschmann, MT 2001 Pain Management: ‘An Assessment of Surgical Nurses' Knowledge’, MedSurg Nursing, 1st August.

Copp, G & Dunn, V 1993 ‘Frequent and difficult problems perceived by nurses

caring for the dying in community, hospice and acute care settings’, Palliat Med, vol. 7, pp. 19-25

Dick, PK 1965 The Zap Gun, Galaxy, New York.

Field, D, Clark, D, Corner, J & Davis, C 2001, Researching Palliative Care,

Open University Press, Buckingham.

Geisler, E, Krabbendam, K,& Schuring, R (eds) 2003, Technology, Health Care

and Management in the Hospital of the Future, Praeger, Westport, CT, pp. 103-131.

Jameton, A 1984 Nursing practice: The ethical issues, Prentice Hall, Englewood,

NJ.

King, E 1991 ‘Communication, Anxiety and the Management of Postoperative Pain’, Health Communication, vol. 3, no. 2, p. 127.

LaPorte Matzo, M & Sherman, DW, eds. 2001 Palliative Care Nursing: Quality

Care to the End of Life, Springer Publishing, New York, NY.

Marrelli, T 1999 Hospice and Palliative Care Handbook, Mosby, St. Louis, MO.

McGrath, P, Yates, P, Clinton, M, & Hart G 1999 ‘"What should I say?":

qualitative findings on dilemmas in palliative care nursing’, Hosp J, vol. 14, pp. 17-33

Mcnamara, B 2001, Fragile Lives: Death, Dying and Care, Allen & Unwin, Crows

Nest, N.S.W. pp. 120-135.

National Women’s Health Resource Center, 2004, Pain Management, viewed 25

November 2005, <http://www.ivillagehealth.com/library/nwh/content>.

Paice, J 2003, Practical Palliative Principles, Journal of Pain and Symptom

Management, vol. 25, pp 93-102.

Portenoy, R & Bruera, E 1997, Topics in Palliative Care, Oxford University Press,

New York.

The Hasting’s Center Report, 2003, ‘What Is Hospice Care?’, vol. 33, no. 2, pp.

6-8.

Thompson, JE, & Thompson, HO, 1990, Professional ethics in nursing, Robert E.

Kreiger, Malabar, FL.

World Health Organization 2005, WHO Definiton of Palliative Care, viewed 25 November 2005, .

Substance Misuse

Introduction

In the promotion of the health care professionals and hospitals in the health and wellness for the entire population, different lifestyles and habits should be recognized. One of the major causes of the poor health among the society is the lack of knowledge and information about the different misuse of drug and other alcohols. This is not new in the community and for almost half of the population in certain place, there are drinkers and on the other hand, there are people that were engaged in drug addiction. The increasing rate of mortality is not only because of the well-known deadly diseases but also in the responsibility of the citizens such as mal-practice or abuse.

Substance Misuse in Healthcare

The substance misuse is the applied term for the problems arising in the use of drug and alcohol. The drug and alcohol dependency and sometimes used to the addiction or abuse. The term is also carried out for the importance in working or rehabilitation for the people particularly with the sensitive public and professional judgments. The substance misuse problems may affect or seen on the pregnant women or for parents. Therefore, there are many recommendations that can serve as strategies in improving the healthcare and facilitating the wellness. Through the useful skills and multidisciplinary training, the health care providers can establish a system wherein the people engaged in the substance misuse can be lessened.

There are number of professionals that are willing to place an effort to build the expertise in the way of their practice in lessening the impact of the substance misuse. One focus of the healthcare professionals is the present population wherein there are majority of pregnant women that recognized the substance misuse. In this case, different social and health care workers joined together to integrate in minimizing the rate of addiction and alcoholic individuals. Through assessing the different needs with the present situation, the health care professionals can provide the quality health care.

Many factors that affect the outcome of pregnancy or parenting and their health development for the infants and children in the participation of the substance misuse. The care and needs that the health personnel offered is also affected by the lifestyle and socialization of the person. Therefore, the healthcare professionals should also assess the different areas of their needs such as the individuals’ physical and psychological needs and other support needs that will take an effect onto their unborn child and children.

Guidelines

There are many guidelines that affect the good practice of the health care personnel. The very first source of valuable practice is the care process which is also important in all other sector of health care settings. The process of care is applied in the areas where the patient suffers a lot in the substance misuse. The care process involves the different keys such as the stage process that covers the different stages of drug and alcohol addiction and the needs for the type of treatment and service can be duly provided. The care starts with a proper planning taking into an account about the medical or drug history of the patient. The care management of the professionals comes in a wide-range of their expertise in applying and promoting different medical practices. A good practice of the individuals can be on the appropriate drug prescription. The healthcare professionals usually visit different community to provide adequate health care, medicines, and information regarding to the misuse of different substances.

Effects of Substance Misuse

The effect of the substance misuse may be on the well-being of an individual and his/her relationship on other people. The impact may appear in the development of the infants, not only in physical but also in their mental health, and the happiness and welfare of the children. Various evidences show that the children that living in homes with an adult engaged in the substance misuse experience the abuse and neglect. In the future, the children might show the same behavior with the idea of chaos and violence. Children might feel that their parents have more affection on their drugs or alcohol, and this is one of the many reasons why children suffer in the clouded feeling of unloved.

Conclusion

The substance misuse can be cures or treated even if it not a disease but a bad habit. Through the different techniques such as the prevention, support of the health car professionals, proper education, and public care, the individual might minimize or escape in their habits that will surely cause problems and trouble. In addition there is a need for the improvement in the health care system with appropriate investment and support coming from the government, the quality health care can be delivered.

Sources:

Children1st, 2008 Parental Substance Misuse [Online] Available at: http://www.children1st.org.uk/common/uploads/what_we_do/parental_substance_misuse.pdf [Accessed 26 Feb 2010].

Whittaker, A., 2003. Substance Misuse in Pregnancy, NHS Lothian [Online] Available at: http://www.nhslothian.scot.nhs.uk/news/publications/substance_misuse_pregnancy.pdf [Accessed 26 Feb 2010].

Consumer Use of Non-prescription Medicines or Antidepressant Use in the Community

Synopsis

People who experienced depression need medical attention such as psychological treatment and antidepressant medication. More often, people that having the illness of depression took or use some non-prescription medicines in order to overcome their symptoms which can be resulted from addiction if improperly used. However, if people combined their medication with learning the greatest benefit will be achieved.

Research Objectives

There are two main objectives that the study identified. First, the study aims to provide awareness about the use of non-prescription medicines or antidepressants. This involves the issue of using the medicines with the right knowledge and right medication. Second, the study aims to set another thrust for the promotion of innovative healthcare program such as leaflets or commercial pertaining to the idea of using the antidepressants and other non-prescribed medicines.

Background of the Study

Most of the prescription and non-prescription medicines were written in the leaflets that explains how the medicine works, how to take it, the common side effects, and the potential interactions. In this way, the consumers gather the idea about the medicines even if they did not seek the doctor’s help. Many people, in all over the world, suffer from depression. As part of the aspect of life, depression makes it difficult for people to perform their normal activities. People who are involved in this scenario may not seek help but getting help and not avoiding may help the person recover fast and avoid the other consequences. The mild depression can be treated by gaining knowledge about the phase of depression and taking psychological treatment through the usage of antidepressant medication (Wood and Fogg, 2008).

Within the community, there are high rates of reported prevalence of depression that are reflected in their poor physical health and functions. Therefore, experts recognized the strong association between the chronic illness and depression. The depressive symptoms for over the time can lead to disability. With this evidence, people turn to the use of antidepressants even if it is non-prescribed (Anstey, et al., 2007). However, people who are known to rely on tranquilizers or antidepressants to tackle the problems of anxiety, sleeplessness, depression, and suicidal thoughts are also known as drug users. The abuse of the medicine or misuse of the antidepressant medicines will only lead to bad results (Kalunta-Crumpton, 2004).

Significance

The study will help the people who have trouble in depression and its symptoms. With proper treatment and understanding about the medicines and other psychological treatment, the person who is engaged in depression problems can consume the medicines without the aid of the medicinal professional. Also, the study gave full importance about the issue of medicinal abuse of the people that will lead to their worst outcome. Again, the study promotes the idea of using the medicines with the right action or right usage to achieve the health benefits.

Methodology

The applied methodology in the study is the use of an efficient tool which is the questionnaires. Through the material, the participants in the community can answer diligently about their medical history. It was indicated in the questionnaire about the brief medical history and needed medical attention of the person, especially in the case of the depression. This method will help the study provide the people’s view on the use of the antidepressants, their side effects (if there’s any), and the peoples current situation after the medication. It is a great advantage in using the method because it allows the researchers to take a deeper view on the people’s idea about their action towards depression and its chain of consequences.

Work Plan

In the prescription of the antidepressant medicines, there is an effect in which it can lower or reduce the symptoms of depression by restoring the imbalance of the chemicals in the brain. In choosing a treatment, people in the community that turn into non-prescribed medicines should take the considerations about their age, their symptoms, and their conditions about the depression or if there is any history of medication.

Conclusion

People who use antidepressants or other non-prescribed medicines should be also aware about the negative effects of its excessive usage or abuse. They must ask help to the other people close to them or seek the medical advice if they are engaged in depression because too much intake of the medicines can get their health in to drastic situation.

Resources:

Anstey, K., Von Sanden, C., Sargent-Cox, K., & Luszcz, M., 2007. Prevalence and Risk Factors for Depression in a Longitudinal, Population-based Study Including Individuals in the Community and Residential Care. The American Journal of Geriatric Psychiatry, Vol. 15, No. 6.

Kalunta-Crumpton, A., 2004. A Community without a Drug Problem? Black Drug Use in Britain. Social Justice, Vol. 31, No. 2.

Wood, R., & Fogg, S., 2008. Treating and Beating Depression. Medicines Talk – Information for Consumers and Consumer Group about Using Medicines Wisely, No. 26. [Online] Available at: http://www.nps.org.au/__data/assets/pdf_file/0006/37779/MT_Winter_08_web.pdf. [Accessed 08 Feb 2010].

Pain Treatment

Chronic Pain

Chronic pain treatment programs are mostly based on a behavioral science model of contingency management, where the focus of treatment is directed toward the psychological aspects of pain. Chronic pain has captured the attention in the medical and health care profession and becoming a complex problem of major medical, social, economic, and personal proportion. The chronic pain sufferers do not face the pain itself but also the expensive costs that it brought because of various treatments.

Pain treatment options may involve a variety of interventions, including nerve blocks, surgeries, injections, therapy, and other appropriate medications. Chronic pain can be a life-defeating experience, where powerlessness, loss of control, emotional grief, and physical anguish are difficulties (Macdonald, 2000).

Pain That Persists

Acute pain after surgery or trauma comes on suddenly and lasts for a limited time, whereas chronic pain persists. An acute pain is a direct response to disease of injury to tissue. Chronic pain goes on and on for months or even years and the experts’ advice that the first step in treating chronic pain is to identify the source of pain, if it is possible. But persistent pain should never be ignored because it could signal disease of injury that will worsen if left untreated.

The physical and emotional effects from any type of chronic pain can be devastating and treatment for chronic pain is much more than medication. It also involves stress relief and relaxation, physical therapy, improved sleep and nutrition habits, and exercise (Meadows, 2004).

Case 1: Pain from Amputation

Numerous complications of diabetes can be related to neuropathy. Those complications are the most common cause of early death among patients with diabetes. One of the familiar complications of diabetes in the society is the diabetic foot ulcer. The cumulative effects of neuropathy, deformity, high plantar pressure, poor glucose control, duration of diabetes, and gender are all contributory factors for foot ulceration (Frukberg, 2000).

Amputation is the complete or partial removal of a limb or body appendage by surgical or traumatic means. Meanwhile, the neuropathy is a nerve dysfunction affecting sensory, motor, or autonomic fibers with varying degrees of impairment, symptoms, and signs.

The potential manifestation of diabetes is the limb removal when the diabetes is left untreated. Identifying the potential problems and treatment of foot disorders in a diabetic patient requires skills, integration of knowledge and experience to promote more effective treatment or improving outcomes and limiting the risk of amputations (Frukberg, 2000).

Treatment of pain includes medications and other options. Medications used include opiods, anticonvulsants, antidepressants, and anesthetics, to name a few. Non-pharmacological management measures include TENS-devices, acupuncture, and electroconvulsive therapy.

Case 2: Abdominal Hysterectomy

Hysterectomy or the surgical removal of the uterus is the most commonly performed gynecological surgical procedure. Once the decision has been made to proceed with hysterectomy, the physician and patient must decide whether the procedure will be performed abdominally, vaginally, or with laparoscopic assistance. The route chosen depends upon the woman's clinical circumstances and the surgeon's technical expertise; the surgeon's personal preference also plays a major role.

The reason for the hysterectomy, risks and benefits of the procedure, alternatives, and expectations for outcome should be discussed with the woman in detail. Since a number of the indications for hysterectomy are based more upon opinion than evidence from well-designed studies, informed consent with thorough exploration of patient preferences and expectations is particularly important. In the absence of a life-threatening emergency like uterine hemorrhage, the decision to proceed with hysterectomy is made mutually by the woman and her physician based upon her functional impairment, childbearing plans, response to medical therapy, discussion of alternatives, and perception that the risks of the procedure are outweighed by the expected benefits (Falcone and Cogan-Levy, 2008).

Current therapeutic strategies for the management of acute pain are largely dependent on opioid analgesics and non-steroidal anti-inflammatory drugs. The preoperative administration of oral rofecoxib medicine provided a significant analgesic benefit and decreased the opioid requirements in patients undergoing abdominal hysterectomy. However, rofecoxib was not effective in preventing postoperative pain or reducing morphine consumption in patients after prostate surgery (Turan, et al., 2004).

Case 3: Chronic Headaches

Tension headaches are associated with muscle tension is a common type of pain. These are sometimes described as feeling like a tight band squeezing the head. Meanwhile, migraines are characterized by throbbing pain on one side of the head. Most people with migraines also experience nausea and sensitivities to light and sound.

In 1992 when the FDA approved Imitrex (sumatriptan), the first drug in a class known as triptans. This class of drugs marked a huge leap forward for headache sufferers. Unlike some previous drugs that dulled the perception of pain, triptans stop the pain by narrowing blood vessels in the brain and reducing inflammation (Meadows, 2004).

Most headaches can be successfully treated with over-the-counter pain relievers. But it is better if a person will seek professional help if the pain persists or get worse and keeps on keeping an individual from work and other activities.

It is easy for people to fall into an analgesic trap. A headache sufferer may take and benefit from a painkiller, then begins to use it more freely, perhaps even to prevent pain. As medication and headache pain increase together, the individual begins to find that the analgesic is less effective, so he or she takes more or tries new ones. In the end, the person gets a headache whenever the medicine is not being taken.

The first step in treatment is to get the person to withdraw from the analgesics, which sometimes requires inpatient care. Complete treatment, however, includes finding a medication that will serve to prevent the pain and reduce the frequency of headaches. Finally, adequate, psychological support should be provided, including behavior modification, relaxation therapy, emotional support, and education (USA Today, 1993).

References:

Falcone, T., & Cogan-Levy, S., (2008) Overview of Hysterectomy, Accessed 22 October 2009, from http://www.uptodate.com/patients/content/topic.do?topicKey

Frukberg, R., et al., (2000) Diabetic Foot Disorders. A Clinical Practice Guideline, The Journal of Foot and Ankle Surgery, 39(5), Accessed 22 October 2009, from www.apwca.org/guidelines/report_diabeticFoot.pdf

Macdonald, J., (2000) A Deconstructive Turn in Chronic Pain Treatment: A Redefined Role for Social Work, The Journal for Health and Social Work, 25(1):51.

Meadows, M., (2004) Managing Chronic Pain, FDA Consumer Magazine, 38(2).

Turan, A., et al., (2004) Preoperative Oral Rofecoxib Reduces Postoperative Pain and Tramadol Consumpton in Patients After Abdominal Hysterectomy, Pain Medicine. International Anesthesia Research Society, Accessed 22 October 2009, from www.anesthesia-analgesia.org/cgi/reprint/98/4/1039.pdf

USA Today, (1993) Painkillers May Make Headaches Worse, USA Today Magazine, 122(2581): 6.