"Affective" "Relating to, arising from, or influencing feelings or emotions, expressing emotion." ",1-1"
"Empathic actions" "Simple actions that communicate understanding of the patient's experience." ",1-1"
"Empathic statements" "Reflect the emotions expressed by the patient and family." ",1-2,1-1"
"Empathy" "The ability to recognize and to some extent share the emotions and states of mind of another; understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner." ",1-2,1-1"
"Facial expression" "Nonverbal method of communicating information. Listening to the patient includes being aware of nonverbal communication such as body position, eye contact and physical distance, as well as language content and style. Facial expressions associated with pain may not be a reliable indicator of the amount of pain expereinced by a person." ",1-1,2-3"
"Intonation" "Manner of utterance; specifically, the rise and fall in pitch of the voice in speech." ",1-1"
"Intuition" "The power or faculty of attaining to direct knowledge or cognition without evident rational thought and inference." ",1-1,1-2"
"Intuitive knowledge" "Knowing or perceiving by intuition; quick and ready insight; knowledge or conviction gained by intuition : the power or faculty of attaining to direct knowledge or cognition without evident rational thought and inference." ",1-1"
"Linguistic elements" "A meaningful unit of speech (as a morpheme, word, or sentence) -- called also speech form." ",1-1"
"Listening (effective)" "To pay attention; to hear something with thoughtful attention : give consideration." ",1-1,1-2"
"Nonverbal communication" "The gestures, movements, and mannerisms by which a person or animal communicates with others. Unintentional transmissions or messages between persons." ",1-1"
"Open-ended questions" "Questions which have no ""yes"" or ""no"" answers; they may be answered in many ways." ",1-1,1-2,5-3"
"Pause" "A brief suspension of the voice to indicate the limits and relations of sentences and their parts." ",1-1"
"Pitch" "The relative level, intensity, or extent of some quality or state; the difference in the relative vibration frequency of the human voice that contributes to the total meaning of speech; a definite relative pitch that is a significant phenomenon in speech." ",1-1"
"Presence" "The fact or condition of being present attending to the needs of the patient and family." ",1-1,1-2,5-4"
"Reflective statements" "A statement made by one person which repeats the substance or meaning of a statement made by another person." ",1-1,1-2"
"Verbal communication--language content and style" "An act or instance of transmitting; information communicated; a verbal or written message; a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior; a technique for expressing ideas effectively (as in speech)." ",1-1"
"Acceptance" "Understanding the meaning of the illness within the context of the bio-medical model." ",1-1,4-1"
"Agitation" "Condition of psychomotor excitement characterized by purposeless, restless activity, irritability, crying, pacing or laughing, usually associated with fear and the unknown; extreme emotional disturbance; perturbation." ",1-2"
"Anasarca" "Generalized infiltration of edema fluid into subcutaneous connective tissue." ",1-2"
"Anorexia" "Diminished appetite; aversion to food." ",1-2"
"Anxiety" "Mental uneasiness or distress arising from fear of what might happen, often accompanied by tension, restlessness, tachycardia and dyspnea; an abnormal and overwhelming sense of apprehension and fear often marked by physiological signs (sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one's capacity to cope with it." ",1-2,2-3,4-1"
"Assurance" "To inspire confidence in, guaranty; confidence of mind or manner freedom from self-doubt or uncertainty." ",1-2"
"Asthenia" "Loss or lack of physical strength; weakness; debility." ",1-2,2-5"
"Attention, paying" "Act or state of attending especially through applying the mind to an object of sense or thought; condition of readiness for such attention involving especially a selective narrowing or focusing of consciousness and receptivity; consideration with a view to action." ",1-2"
"Attitudes" "A mental position with regard to a fact or state; a feeling or emotion toward a fact or state; an organismic state of readiness to respond in a characteristic way to a stimulus (as an object, concept, or situation)." ",1-2,2-1,2-3"
"Bad news" "Verbal delivery of a diagnosis of an uncurable, life threatening illness such as cancer, or helping a patient and family understand that a chronic ongoing disease, such as COPD or heart disease is unlikely to improve." ",1-2,4-1,5-3"
"Barriers" "Issues inhibiting agreement regarding the meaning of events. Any thing that prevents passage of persons, things, ideas or social interactions barriers (internal or external-patient's and healh care professional's)." ",1-2,1-3, 2-1,2-3,2-4"
"Beliefs" "A state or habit of mind in which trust or confidence is placed in some person or thing; something believed; especially, a tenet or body of tenets held by a group; conviction of the truth of some statement or the reality of some being or phenomenon especially when based on examination of evidence." ",1-2,2-1,2-3"
"Cachexia" "A general lack of nutrition, weight loss and and muscle wasting occurring in the course of a chronic disease or emotional disturbance." ",1-2,2-5"
"Comfort" "Emphasizing physical and psychological support or relief throughout the patient's end of life." ",1-2,2-1,2-2,2-3,2-4,2-5"
"Communication (effective)" "A complex task--first you conceptualize what it is you wish to express in your mind. Then you must use words as a means of expressing what you have conceptualized. The words you choose may or may not accurately transmit what you mean to communicate. Then the listener interprets the symbols (words) you speak. The listener's understanding of what you have said may or may not reflect what you actually said and are further removed from what you originally thought in your mind." ",1-2"
"Communication skills " "Skills natural or acquired that facilitate effective communication." ",1-2"
"Compassion" "Sympathetic consciousness of others' distress together with a desire to alleviate it." ",1-2"
"Confront/confronting" "To face especially in challenges to cause to meet, bring face-to-face." ",1-2"
"Consensus (reaching consensus)" "Having the patient, family and health professionals come to a common understanding of what the medical diagnosis and prognosis means." ",1-2"
"Assent" "Developmentally appropriate awareness of condition.
- knowing what to expect with tests or treatments
- assessing childÆs knowledge and response to tests or treatment
- soliciting childÆs willingness; but if refusal will not be honored, child should not be deceived" ",3-5"
"Consent" "Provide information seeking permission from the person for procedure to therapy (e.g., inform of possible therapies, risks, benefits prior to permission given by person receiving the procedure or therapy).
-Assess patientÆs capacity and understanding of the information AND / OR
-Assess surrogateÆs capacity and understanding of the information
-Assess that the patient or surrogate is not being manipulated or coerced." ",3-1"
"Mind-body systems" "This subcategory involves whole systems of mind-body practice that are used largely as primary interventions for disease. They are rarely delivered alone; instead, they are used in combination with lifestyle interventions, or are part of a traditional medical system." ",4-6"
"Mind-body methods" "Individual modalities used in mind-body approaches to health. These approaches are often considered conventional practice and overlap with CAM only when applied to medical conditions for which they are not usually used (for example, hypnosis for genetic problems). e.g.,
CAM: Yoga, Internal Qigong, Tai Chi.
Behavioral Medicine (BM): Psychotherapy, Meditation, Imagery, Hypnosis, Biofeedback, Support groups.
Overlapping CAM/BM: Art therapy, Music Therapy, Dance Therapy, Journaling, Humor, Body psychotherapy." ",4-6"
"Dyspnea" "Shortness of breath, a subjective difficulty or distress in breathing, usually associated with disease of the heart or lungs." ",1-2,2-5"
"Hospice" "An institution that provides a centralized program of palliative and supportive services to dying persons and their families, in the form of physical, psychological, social, and spiritual care; such services are provided by an interdisciplinary team of professionals and volunteers who are available at home and in specialized inpatient settings. Hospice care is family-centered care designed to assist the chronically ill person to be comfortable and maintain satisfactory lifestyle through the terminal stages of dying.
- A discrete site of care, a free standing facility or a designated area in another institution where services are delivered.
- A program that provides, arranges, and consults on services to the dying and their families.
- An approach to or philosophy of care for dying patients." ",1-2,6-2"
"Jargon" "Language or terminology peculiar to a specific field, profession, or group." ",1-2"
"Palliative care" "Care designed to relieve or reduce intensity of uncomfortable symptoms but not to produce a cure." ",1-2,2-1,6-1"
"Path" "Initiating the care plan." ",1-2"
"Spirituality" "Something that in ecclesiastical law belongs to the church or to a cleric as such; sensitivity or attachment to religious values; the quality or state of being spiritual. Merriam-Webster Collegiate Dictionary, 2001." ",1-2,4-5,4-6" "Merriam-Webster Collegiate Dictionary, 2001."
"Uncertainty" "The inability to accurately predict the disease course for individuals." ",1-2"
"Values" "Relative worth, utility, or importance; something (as a principle or quality) intrinsically valuable or desirable." ",1-2,5-1"
"Cognitive function" "An intellectual process by which one becomes aware of, perceives, or comprehends ideas; it involves all aspects of perception, thinking, reasoning, and remembering." ",1-3,2-4"
"Collaborator role" "In the role of collaborator the health professional exchanges information with the patient and family to promote a common understanding of the diagnosis and illness experience and work together to choose the treatment path. The collaborator role includes that of the consultant but extends it by adding additional traits. The collaborator; acts as a coordinator, assuring all members of the team are providing patient and family care harmonious with treatment plan; serves as a facilitator, working with the patient/family and other team members to promote the care plan; provides a therapeutic role by promoting healing through discussions and actions with the patient and family regarding medical, psychological, spiritual, and social issues related to the care plan; is a team member, working within the care plan using and respecting other team members' skills." ",1-3"
"Coordinator" "Assuring all members of the team are providing the patient/family care harmonious within the treatment plan." ",1-3"
"Guide's role" "Health professional consults and collaborates with the patient and family to achieve their goals within the medical context." ",1-3"
"Roles" "A socially expected behavior pattern usually determined by an individual's status in a particular society; a function or part performed especially in a particular operation or process." ",1-3"
"Autonomy" "An ethical principle that affirms the right of the individual to self-determination, in particular over what happens to his or her physical body." ",3-4"
"Patient advocate" "To act on behalf of a patient; to defend the patient's rights, primarily the patient's right to self-determinism in healthcare decision-making." ",3-4"
"Moral outrage" "Knowing what is the right thing to do but being unable to act, usually due to institutional constraints. Similar to moral distress." ",3-4"
"Moral distress" "Knowing what is the right thing to do but being unable to act, usually due to institutional constraints. Similar to moral outrage." ",3-4"
"Moral uncertainty" "Being unsure of what is the ethical action or even the ethical problem." ",3-4"
"Withholding therapy" "To withhold therapy implies that the therapy will not be initiated, e.g., examples include not attempting CPR in the event of an arrest or not initiating hemodialysis in spite of increasing renal failure." ",3-3" "Ethic content"
"Withdrawing therapy" "To withdraw therapy means that the therapy has already been initiated in the care of a patient, regardless of whether the therapy is continuously administered (such as mechanical ventilation) or intermittently utilized (such as antibiotics, hemodialysis, or blood transfusions)." ",3-3" "Ethic content"
"Religion and Spirituality" "This subcategory deals with those non-behavioral aspects of spirituality and religion that examine their relationship to biological function or clinical conditions.
"Social and contextual areas" "This subcategory refers to social, cultural, symbolic, and contextual interventions that are not covered in other areas. e.g.,
Overlapping: Placebo, Explanatory Models, Community-based Approaches (for example, Alcoholics Anonymous, Native American sweat rituals)." ",4-6"
"Alternative medical systems" "Complete systems of theory and practice that have been developed outside of the Western biomedical approach. It is divided into four subcategories: Acupuncture and Oriental medicine; Traditional Indigenous systems; unconventional Western systems; naturopathy." ",4-6"
"Acupuncture and oriental medicine" "Acupuncture, Tai Chi, herbal formulas, massage and manipulation (Tui Na), diet, acupotomy, external & internal Qi Gong." ",4-6"
"Traditional indigenous systems" "This subcategory includes major indigenous systems of medicine other than acupuncture and traditional oriental medicine. Native American Medicine, Traditional Aboriginal, Ayurvedic Medicine, Unani-Tibbi, SDDHI, Curanderismo, Kampo Medicine, Central and South American, Traditional African Medicine, Psychic Surgery." ",4-6"
"Unconventional Western systems" "This subcategory includes alternative medical systems developed in the West that are not classified elsewhere. CAM: Homeopathy, Functional Medicine, Environmental Medicine, Radiesthesia, Psionic Medicine, Cayce-based Systems, Kneipp ôclassicalö, Orthomolecular Medicine, Radionics. Overlapping: Anthroposophically-extended Medicine." ",4-6"
"Naturopathy" "This subcategory is an eclectic collection of natural systems and therapies that has gained prominence in the United States." ",4-6"
"Physician-assisted suicide" "Patient requests assistance from his or her doctor to commit suicide." ",2-1,2-4,3-3"
"Mechanical ventilation" "The use of a machine to support a patient's pulmonary status by ensuring adequate lung inflation via an endotracheal or tracheostomy tube. (Note that the correct term for these machines is ventilators, not respirators: ventilation is the expansion of the lungs with air while respiration is the exchange of O2 and CO2 at the membrane level.)" ",3-3"
"Artificially-provided nutrition or hydration" "An artificial means to convey food into the body such as an intravenous infusion, nasogastric (NG) or percutaneous enteral gastrostomy (PEG) tube. The nutrition and hydration provided via these means are not artificial, but generally are in liquid forms. In contrast, a special feeding spoon, bottle, or diet designed to reduce the risk of choking are not considered artificial means." ",3-3"
"Parental nutrition" "The provision of nutrition via a central line directly into the blood stream. Also called total parental nutrition." ",1-2"
"Killing" "An action, whether intentional or accidental, that results in another person's death." ",3-3"
"Assisted suicide" "To assist another to take his or her life by providing the means to accomplish his or her death; e.g., a loaded gun or a type and quantity of prescription medication that will result in death." ",2-1,3-3"
"Mercy killing" "Lay term used to describe cases where someone kills another person out of ""compassion"" or mercy such as when the person is in unremitting pain." ",3-3"
"Competency" "A legal state; a person is presumed competent and must be proven incompetent. Decision is made by a judge and generally reflects a permanent lack of mental capacity for the person." ",3-1"
"Incompetency" "Persons who are not capable of making healthcare decisions for themselves have several mechanisms for ensuring that someone close to them speaks for them and/or that their previously stated wishes are honored." ",3-1" "Sarah's content"
"Euthanasia" "A general term derived from the Greek eu, well, + thanatos, death, or "" good death."" Currently used broadly to refer to the act of causing a painless death for a person or animal." ",2-4,2-5,3-3"
"Voluntary euthanasia" "The act of painlessly killing another person at that person's request or with the person's informed consent." ",2-1,3-3" "ethic content from Sarah"
"Involuntary euthanasia" "The act of painlessly killing another person without the person's expressed permission or even without their prior knowledge." ",3-3"
"DNR order" "Do-not-resuscitate order; a physician's order to not attempt cardiopulmonary resuscitation should a patient experience a respiratory or cardiac arrest; sometimes called a ""no code"" order, code blue, or DNAR order." ",3-2"
"DNAR order" "Do-not-ATTEMPT-resuscitation order; same as a DNR order but this term has gained popularity to emphasize the fact that resuscitation is unlikely to be successful given the relatively low success rates for in-hospital CPR." ",3-2"
"Portable or community-based DNR order" "A physician's order that has the informed consent of the patient or their legal surrogate to withhold (CPR) in the community setting; applies to emergency medical personnel." ",3-1,3-2"
"Surrogate [proxy]" "Person or persons who make decisions for an incapacitated person." ",3-1" "Sareh's content"
"Decisional incapacity" "Unable to make decisions related to healthcare or other areas due to a permenent or temporary disruption in a person's cognitive abilities (e.g., anesthesia, head injury, severe illness, post-cardiac arrest, meningitis, coma, etc.). Determination is made by a physician often in consultation with a psychiatrist if the person is alert but there are questions of thought disturbances due to depression, mental illness, etc." ",3-1"
"Prima facie" "Evidence that is adequate to establish a fact unless it is specifically refuted." ",3-1"
"Guardian" "A person who has been appointed, usually by the court, to ensure an incompetent person's rights are respected; similar to a surrogate or proxy in terms of healthcare decision-making but generally also has the power to make decisions about housing, financial matters, etc." ",3-1"
"Durable power of attorney for health care" "Legal appointment of an individual to speak for a person if that person should become decisionally incapacitated. There are multiple types of durable power of attorney, some of which cover business decisions, financial decisions, or healthcare decisions." ",3-1"
"Advance directive" "A document completed by an individual that specifies treatment preferences for healthcare decision making (particularly around end-of-life care and life-sustaining treatment decisions; e.g., a Living Will or directive to Physician). Or, an Advance Directive that specifies a surrogate decision-maker (e.g., a Durable Power of Attorney for Health Care)." ",3-2,3-1"
"Attitude" "A state of mind or a feeling; disposition (e.g., an attitude of open hostility)." ",5-1" "
"Value" "A principle, standard, or quality considered worthwhile or desirable." ",2-1" "www.dictionary.com (Merrimam WebsterÆs Collegiate Dictionary, Tenth Edition)"
"Belief" "Something believed or accepted as true, especially a particular tenet or a body of tenets accepted by a group of persons." ",5-1" "www.dictionary.com (Merrimam WebsterÆs Collegiate Dictionary, Tenth Edition)"
"Societal" "Of or relating to the structure, organization, or functioning of society. Relating to human society and its members, ""social institutions,"" ""societal evolution,"" ""societal forces,"" ""social legislation.""" ",5-1" "www.dictionary.com (Merrimam WebsterÆs Collegiate Dictionary, Tenth Edition)"
"Culture" "The totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought." ",5-1" "www.dictionary.com (Merrimam WebsterÆs Collegiate Dictionary, Tenth Edition)"
"Grief" "The process of psychological, social and somatic reactions to the perception of loss." ",5-2,5-5,5-4,5-3,5-1" "Rando 1984"
"Bereavement" "State of having suffered a loss." ",5-2,5-5" "Rando 1984"
"Mourning" "Culturally influenced responses to grief as well as the intrapsychic process which enable the bereaved to relinquish their emotional bonds to the deceased and promotes healing by helping the bereaved to learn how to live in a world without their loved one." ",5-2" "(Martin and Doka, 1998)"
"Stressor" """Events that have the capacity to induce emotional distress."" (Nott, Vedhara, & Spickett, 1995: 456)" ",4-1"
"Stress" """Refers to the experience of emotional distress."" (Nott, Vedhara, & Spickett, 1995: 456)" ",4-1"
"Denial" "An unconscious defense mechanism characterized by refusal to acknowledge painful realities, thoughts, or feelings." ",4-1"
"Fear" "A feeling of agitation and anxiety caused by the presence or imminence of danger. A feeling of disquiet or apprehension." ",4-1"
"Depression" "A psychotic or neurotic condition characterized by an inability to concentrate, insomnia, and feelings of extreme sadness, dejection, and hopelessness." ",4-1" "Webster"
"Withdrawal" "The act or process of withdrawing; detachment, as from social or emotional involvement." ",4-1"
"Resignation" "Unresisting acceptance of something as inescapable; submission. The state of being resigned or submissive; quiet or patient submission; unresisting acquiescence; as, resignation to the will and providence of God." ",4-1"
"Transendence" "A state of being or existence above and beyond the limits of material experience." ",4-1,4-2,4-5"
"Clinical preventative practices" "Unconventional approaches used to screen for and prevent health-related imbalances, dysfunction and disease." ",4-6"
"Lifestyle therapies" "This subcategory deals with complete systems of lifestyle management that include behavioral changes, dietary changes, exercise, stress management, and addiction control. To be classified as CAM, the changes in lifestyle must be based on a nonorthodox system of medicine, be applied in unconventional ways, or be applied across non-Western diagnostic. Approaches" ",4-6"
"Health promotion" "Involves laboratory and epidemiological research on healing, the healing process, health promoting factors, and autoregulatory mechanisms that forms the basis for health messages to the public." ",4-6"
"Biologically-based therapies" "Natural and biologically-based practices, interventions, and products. Many overlap with conventional medicineÆs use of dietary supplements. Includes four types of therapies--phytotherapy or herbalism; special diet therapies; orthomolecular medicine; pharmacological, biological and instrumental interventions." ",4-6"
"Cortex" "Outer areas/layers of an organ ( i.e., the brain)." ",2-2"
"Excitatory interneurons" "Spinal cord cells that enhance transmission of nociceptive signal from first-order neuron to second neuron in spinal cord (projection cell)." ",2-2"
"Inhibitory interneurons" "Spinal cord cells that block or inhibit transmission of nociceptive signal to brain. It is not transmitted beyond the first order neuron." ",2-2"
"Projection cells" "Second-order neuron responsible for transmitting action potential from PAN to third-order neurons in brain (Rostral ventral medulla or thalamus, predominately)." ",2-2"
"Neuroablative procedures" "Procedures that block pain pathways by destroying nerve tissue, sometimes using chemicals or thermal lesions." ",2-2"
"Self-transcedence" """Is characterized by an increased understanding of self and moving beyond self that is associated with rising above crisis situations such as physical and emotional pain due to ill health, loss and threat of loss. It is often accompanied by a sense of feeling uplifted; a physical lightness, and relief of burden; a closeness to ohers, to environment and to God; a renewed commitment to life purpose; and an acceptance of inescapable circumstances."" Mellors, Riley & Erlen (1997)" ",4-5" "Mellors, Riley & Erlen (1997)"
"Nonsteroidal anti-inflammatory drugs (NSAIDs)" "Large class of drugs with anti-inflammatory, analgesic and antipyretic effects.
prototype: aspirin" ",2-4"
"Anti-inflammatory" "Reducing pain, redness, swelling and heat." ",2-4"
"Analgesic" "Pain relieving agent." ",2-4"
"Antipyretic" "Reducing fever." ",2-4"
"Narcotic" "A drug that produces stupor or narcosis (sleep); an obsolete term for analgesics-legal definitions that applies to all drugs that cause dependence." ",2-4"
"Opiate" "A drug that is a derivative from opium." ",2-4"
"Opioid" "A drug that binds to opiate receptors and produces morphine-like action (generic-like term for opium derivatives and synthetic drugs). Opiate and Opioid are used interchangeably in clinical practice and much of the literature." ",2-4"
"Analgesia" "Absence of sensibility to pain; not the same as suffering." ",2-4"
"Mu receptor" "Primary receptor for morphine." ",2-4"
"Delta receptors" "Primary receptor for the endogenous opioid enkephalin." ",2-4"
"Kappa receptors" "Primary receptor for the endogenous opioid dynorphin." ",2-4"
"Agonists" "Drugs that bind and produce morphine-like actions at mu, delta and kappa receptors." ",2-4"
"Mixed agonists antagonists" "Bind and produce morphine-like actions at kappa receptors; bind, but do not produce morphine-like effects at mu and delta receptors (don't produce full morphine-like effects; e.g., can cause withdrawal symptoms in people dependent on agonists, potentially life threatening." ",2-4"
"Partial agonists" "Bind and produce morphine-like actions at mu receptors." ",2-4"
"Antagonists" "Drugs that bind to mu, delta and kappa receptors, but do not produce morphine-like effects, a competitive agonist such as naloxone (Narcan)." ",2-4"
"Tolerance" "Increased dose required to produce the same effects when pain stimulus remains unchanged." ",2-4"
"Cross-tolerance" "Refers to incomplete tolerance to similar drugs, e.g., morphine and hydromorphone; when switching drugs reduce equianalgesic dose by 2/3 to adjust for incomplete cross-tolerance." ",2-4"
"Dependence" "Abstinence from drug use produces physical withdrawal syndrome (runny nose, sweating, anxiety, irritability, abdominal cramps, diarrhea). To withdraw from morphine, decrease the 24 hour dose by 50% and 25% of this dose every 6 hours; after 2 days, reduce daily dose by an additional 25% every 2 days until 24 hour dose is 30 mg. PO per day, then discontinue the morphine." ",2-4"
"Addiction" "Psychological drive (desire) to take a drug (opioid) for euphoric reasons. Rare event when opioids are used for medically indicated purposes." ",2-4"
"Equianalgesic dose" "Dose considered equivalent when considering different drugs or adminstration routes." ",2-4"
"Equianalgesic conversion" "Change of dose, adminstration route or drug based on equianalgesic guidelines." ",2-4"
"Titration" "Increasing dose of an alagesic based on the pain relief and side effects of the dose." ",2-4"
"Nociception" "The activation of primary afferent nerves with peripheral terminals that respond differently to noxious (i.e. tissue damaging) stimuli. Nociception may or may not be perceived as pain, depending on a complex interaction within the nociceptive pathways." ",2-3,2-2"
"Suffering" "The state of severe distress associated with events that threaten the intactness of the person (Cassell, 1982)." ",2-3,4-2,5-4,4-3" "(Cassell, 1982)"
"Affective pain dimension" "Dimension that focuses on emotional and psychological aspects of pain." ",2-3"
"Behavioral pain dimension" "Dimension that focuses on actions or behaviors exhibited by people in pain." ",2-2,2-3,2-4,2-5"
"Evaluative pain dimension" "Same as cognitive dimension of pain." ",2-3"
"Cognitive pain dimension" "Peoples thoughts about pain, illness and pain therapies depending on their attitudes, beliefs and experiences." ",2-3"
"Neural mechanisms of pain" "Anatomy, physiology and pathophysiology of pain." ",2-3"
"Assessment" "The act of determining the importance, size, or value of something. Making an estimate.
(WebsterÆs, 1974)" ",2-3" "(WebsterÆs, 1974)"
"Measurement" "The act of applying a metric to quantify how much there is of something.
(WebsterÆs, 1974)" ",2-3" "(WebsterÆs, 1974)"
"Location of pain" "The site or sites where the pain is experienced." ",2-3"
"Intensity of pain" "Amount of pain that is experienced." ",2-3"
"Quality of Pain" "Nature or characteristics of the pain (e.g., shooting, stabbing, dull, burning)." ",2-2,2-3"
"Pattern of pain" "The experienced timing, duration and course of the pain." ",2-3"
"Phytotherapy or herbalism" "This subcategory addresses plant-derived preparations that are used for therapeutic and preventive purposes." ",4-6"
"Special diet therapies" "This subcategory includes dietary approaches and special diets that are applied as alternative therapies for risk factors or chronic disease in general." ",5-6"
"Anticipatory grief" "Phenomenon encompassing the processes of mourning, coping, interaction, planning and psychosocial reorganization that are stimulated and begin in part due to the awareness of the impending loss of a loved one and the recognition of associated losses in the past, present, and future." ",5-3" "Marie-Annette"
"Transduction" "Conversion of a mechanical, thermal or chemical stimulus to a neuronal action potential." ",2-2"
"Death-defying" "Refuse to believe that death would take anything away and believe it could be overcome." ",5-1" "Rando (1984)"
"Death-accepting" "View death as inevitable and natural part of the life cycle. Behaviors and events of the dying process are integrated into everyday life." ",5-1" "Rando (1984)"
"Death-denying" "Refuse to confront death, believe that death is antithetical to living and that is not a natural part of human existence." ",5-1" "Rando (1984)"
"Orthomolecular medicine" "This subcategory refers to products used as nutritional and food supplements (and not covered in other categories). These products are used for preventive or therapeutic purposes. They are usually used in combinations and at high doses. Examples include niacinamide for arthritis and melatonin to prevent breast cancer." ",4-6"
"Manipulative and body-based systems" "This category refers to systems that are based on manipulation, movement of the body or both, and is divided into three subcategories: chiropractic medicine; massage and body work; unconventional physical therapies." ",4-6"
"Biofield" "Biofield medicine involves systems that use subtle energy fields in and around the body for medical purposes." ",4-6"
"Cheyne-stokes breathing" "rhythmic waxing and waning of respiratory depth with regularly recurring apnea, seen in coma" ",2-5"
"Death rattle" "A rattling or gurgling in the throat of a dying person." ",2-5"
"Anuria" "No urinary output." ",2-5"
"Structural losses" "Through amputation (e.g., mastectomy, colostomy, hysterectomy, heart and kidney transplant, etc.) and through disfigurement due to congenital deformation, accidents, bums, etc." ",5-2" "Rando"
"Functional losses" "Through loss of mobility due to paralysis, stroke, spinal cord injury; loss of one or more of the five senses; loss of elimination control; loss of sexual functioning; loss of health; etc." ",5-2" "Rando"
"Physical loss" "Loss of body parts or normal body functions and abilities." ",5-2" "Rando"
"Developmental losses" "The ""necessary losses"" that come with physical, emotional and psychological growth and development are significant issues." ",5-2" "Judith Vorist"
"Chronic grief" "Reaction is one that is prolonged, is excessive in duration, and never comes to a satisfactory conclusion." ",5-2"
"Delayed grief" "Reaction is one, which has been inhibited, suppressed or postponed. A subsequent loss may illicit an exaggerated reaction because the bereaved is grieving for two losses." ",5-2"
"Exaggerated grief" "Reaction occurs when feelings of fear, hopelessness, depression or other symptoms become so excessive that they interfere with the daily existence of the bereaved." ",5-2"
"Masked grief" "Reactions are symptoms and behaviors experienced by a person who does not recognize the fact that these are related to a loss." ",5-2"
"Secondary losses" "Losses that develop as a consequence of the death of the loved one." ",5-2,5-3" "Rando"
"Rituals" "Ceremonial act or series of such acts." ",5-4,5-1" "content gm1"
"Coping" "Management through cognitive and behavioral efforts of specific external/internal demands that are judged as challenging the person's resources." ",4-4" "Herth, K. (1989). The relationship between level of hope and level of copoing response and other variables in patients with cancer. Oncology Nursing Forum, 16(1), 67-72."
"High hopes" "Concept usually refers to achievement of some goal; namely, a successful outcome to some venture." ",4-4" "Inge content"
"Little hope" "Often applied after an airplane crash, or other devastating occurrence such as a mud-slide regarding finding anyone alive." ",4-4" "Inge content"
"False hope" "Indicates that a specified outcome is not very likely to occur." ",4-4" "Inge content"
"Hopeless" "Giving no ground for hope." ",4-4" "Webster"
"Well-being" "The state of being happy, healthy, or prosperous often in combination." ",4-1,4-2,4-3,4-4,4-5" "Webster"
"Psychosocial" "Involving both psychological and social aspects." ",4-1" "Webster"
"Psychological well-being" "Seeking a sense of control in the face of life-threatening illness characterized by emotional distress, altered life priorities, and fears of the unknown, as well as positive life changes." ",4-1" "Ferrell, B. R. (1996). The quality of lives: 1525 voices of cancer. Oncology Nursing Forum, 23(6), 907-916."
"Supernatural" "Of or relating to an order of existence beyond the visible observable universe; especially of or relating to God or a god, demigod, spirit, or devil." ",4-5" "Webster"
"Complementary and alternative medicine (CAM)" "Complementary and alternative medicine (CAM) covers a broad range of healing philosophies, approaches, and therapies. CAM therapies are treatments and healthcare practices that do not form part of the dominant healthcare management paradigm (e.g., not approved by the Food and Drug Administration; not routinely taught in conventional medical schools; are used 'off-label' from FDA recommendations(e.g., different dosage, disease or condition differing from the FDA approval, etc.; or are not covered by most insurance policies). Therapies used alone are often referred to as alternative, and when in combination with other alternative therapies, or in addition to conventional therapies they are often referred to as complementary." ",4-6" "MacIntyre, Holzemer & Philippek (1997)"
"Complementary methods" "Methods applied by conventionally trained physicians and health care providers are based on tradition, or the perspective of the human arts, which are not investigated or taught at universities." ",4-6,6-2" "Hurny, et. al., (1994)"
"Mind-body medicine" "Mind-body medicine involves behavioral, psychological, social, and spiritual approaches to health. It is divided into four subcategories: mind-body systems; mind-body methods; religion and spirituality; social and contextual areas." ",4-6" "Inge content (NCCAM)"
"Olgiuria" "Diminished urinary output compared to fluid intake, less than 400 cc per day." ",2-5"
"Signs of death" "Cessation of heart beat and respiration, pupils fixed and dilated, no response to stimuli, eyelids open without blinking, decreasing body temperature, jaw relaxed and slightly open, body color is a waxen pallor." ",2-5"
"Quality of Life" "Measures difference, at a particular point in time, between the hopes and expectations of the individual and that individual's present experience. (Calman 1984)" ",4-3" "Calman 1984"
"Hope" "A desire of some good accompanied with at least a slight expectation of obtaining it, or a belief that it its obtainable; expectationn of something desirable; confidence in a future event." ",4-4,5-3"
"Religious" "Relating to or concerned with religion or spiritual things; especially dedicated to service in a religion." ",4-5"
"Spiritual well-being" "A sense of inner peace, compassion for others, reverence for life, gratitude and appreciation of both unity and diversity. (Vaughn)" ",4-5,4-3"
"Alternative medicine" "Alternative medicine is defined as any treatment (substance or modality) that is used by or prescribed to patients that is not a Food and Drug Administration (FDA) approved pharmaceutical substance or device; FDA -approved substances or devices that are being used for indications and in doses not approved by the FDA for that agent or device. This definition addresses the legitimating power of the FDA and the process by which drugs are approved." ",4-6" "Reeves, C., Calabrese, C., Standish, L. J., & Bain, S. (1998). Screening alternative therapies for HIV. AIDS Patient Care and STD's, 12(2), 87-89"
"Complementary medicine" "Alternative therapies are sometimes also termed complementary. There are subtle differences in the meaning of these terms. Most complementary practitioners in the United States, whatever their training, view their work as additional to conventional therapies, not in competition to them." ",4-6"
"Double effect" "Derives from Catholic theology and distinguishes between intent and consequences. It holds that when an act has two foreseeable effects (such as pain relief and suppression of respirations) it is ethical to provide the act if oneÆs intent is the good effect not the bad." ",3-3"
"Minor" "A person under the age of 18 or 21 (depending on state law) who cannot legally make healthcare decisions for him or herself independently (also cannot enter into legal contracts, etc. without parental permission)." ",3-5"
"Emancipated minor" "A person under the age of 18 or 21 (but usually at least 16) who is legally considered to be an adult due to circumstances that are defined by state law. For example, marriage usually leads to a minor being considered emancipated. (Each state differs as to the circumstances leading to emancipation so check your state law)." ",3-5"
"PAS" "Physician-assisted suicide: a patient requests assistance from his or her doctor to commit suicide." ",2-1,3-3"
"A-alpha fibers" "Large, myelinated sensory nerve fibers that transmit sensation of soft touch to skin and vibration. A-alpha fibers have a lower threshold for activation and transmit signals more rapidly than smaller, or unmyelinated fibers." ",2-2"
"A-beta fibers" "Smaller, myelinated sensory nerve fibers that transmit sensation of light pressure to deep muscles." ",2-2"
"Delta fibers" "Small, myelinated fibers that are important in the transmission of acute pain." ",2-2"
"C fibers" "Small, unmyelinated sensory nerve fibers that convey noxious information to the entral nervous system; conducts slowy." ",2-2"
"Nociceptive pain" "Pain resulting from activation of primary afferent nociceptors by mechanical, thermal or chemical stimuli." ",2-2,2-3"
"Primary afferent nociceptors (PAN)" "Nerve cell primarily responsible for for sensing and transmitting pain information." ",2-2"
"Stimuli (chemical, mechanical, thermal)" "Chemical, mechanical or thermal events that can cause pain to be transmitted." ",2-2"
"Silent nociceptors" "Mechancally insensitive nociceptors that become active when tissues are injured." ",2-2"
"Neuropathic pain" "Pain resulting from damage to peripheral nervous or central nervous system tissue or from altered processing of pain in the central nervous system.
(Cassell, 1982)" ",2-2,2-3"
"Noxious stimulus" "Stimulus which is damaging to normal tissues." ",2-2"
"Cure" "Treatment of disease or illness with the intent to overcome it." ",2-1,2-2,2-3"
"Preemptive Analgesia" "Preventing pain bebore it begins." ",2-2,2-4"
"Palliation" "Treatment to relieve symptoms and distress of disease process or illness." ",2-2,2-3,6-1"
"Sensitization" "Increased sensitivity of a nerve fiber as a result of repeated stimulation." ",2-2"
"Activation of neuronal action potential" "The condition in which a stimulus causes a nerve fiber to begin to transmit a signal." ",2-2"
"Allodynia" "A condition in which pain is perceived after a stimulus that would not normally cause pain." ",2-2"
"Primary hyperalgesia" "Increased pain sensation occurring at the site of the damaged tissue." ",2-2"
"Secondary hyperalgesia" "Increased pain sensation occurring at a site tissue is not damaged." ",2-2"
"Neuroma" "Nerve tissue tumor." ",2-2"
"Sympathetic ganglia" "Bundles of nerves of the autonomic nervous system connecting in the thoracic and upper lumbar spinal segments." ",2-2"
"Efferent fibers" "Nerve fibers that carry signals back to muscles and glands." ",2-2"
"Stellate ganglion block" "Injection of anesthetic into the nerves of the sympathetic nervous system in the neck." ",2-2"
"Superior hypogastric plexus block" "Use of local anesthetics to block the nerves of the superior hypogastric plexus that normally carry pain information from middle pelvic organs such as the bladder and uterus." ",2-2"
"Celiac plexus block" "Use of local anesthetics or surgical procedure to block the nerves of the celiac plexus that normally carry pain information from organs in the abdomen." ",2-2"
"Lumbar blocks" "Injections of medication in the lumbar region of the spine to block pain in the lower body." ",2-2"
"Epidural blocks" "Injections of medication into the epidural space in the outer layers of the spinal cord to block pain." ",2-2"
"Neurolysis" "Destruction of nerve tissue." ",2-2"
"Dorsal rhizotomy" "Cutting or disabling of dorsal nerve root in order to stop transmission of pain." ",2-2"
"Counterirritation (DNIC)" "A modulating stimulus affecting receptors near the pain site that lessens the intensity of pain." ",2-2"
"Transcutaneous electrical stimulation (TENS)" "Process of passing small electric currents through the skin to stimulate nerve fibers." ",2-2"
"Dorsal root entry zone lesion (DREZ)" "Lesions created to block pain transmission at the entry point of nerves into the dorsal horn of the spinal column." ",2-2"
"Intrathecal blocks or neurolysis" "Injections of medication into the intrathecal space surrounding the spinal cord to block pain." ",2-2"
"Cordotomy (surgical or percutaneous)" "Operation to cut nerves in the spinal cord in order to stop them from transmitting pain signals to the brain." ",2-2"
"Ascending tracts" "Nerve pathways that carry pain signals to the brain." ",2-2"
"Reticular activating system (RAS)" "Connections in the brainstem that are involved with alertness and waking/sleep." ",2-2"
"Thalamus" "Portion of the brain where sensory impulses are processed before being relayed to the cerebral cortex." ",2-2"
"Music therapy" "Prescribed use of music and musical interventions in order to restore, maintain, and improve emotional, physical, physiological, and spiritual health and well-being." ",4-6" "http://members.aol.com/kathysl/def.html Katherine A. Lindberg, MT-BC"
"Art therapy" "As a form of psychotherapy, is an interdisciplinary practice across health and medicine, using various visual art forms such as drawing, painting, sculpture and collage." ",4-6"
"Guided-imagery" "A mind-body intervention aimed at easing stress, and promoting a sense of peace and tranquillity at a stressful or difficult time in someone's life." ",2-4,4-6" "http://www.guidedimageryinc.com/guided.html"
"Terminal sedation" "Sedation for intractable distress in the dying." ",2-4,2-5,3-3" "Chater, S., Viola, R., Paterson, J., & Jarvis, V. (1998). Sedation for intractable distress in the dying--a survey of experts [see comments]. Palliat Med, 12(4), 255-269."
"Bioelectromagnetics" "Bioelectromagnetics refers to the unconventional use of electromagnetic fields for medical purposes." ",4-6"
"Pharmacological and instrumental interventions" "This subcategory includes products and procedures applied in an unconventional manner that are not covered in other categories." ",4-6"
"Holistic nursing" "Holistic Nursing is given as an example of a caring-based approach and is considered CAM.
On the other hand Alcoholics Anonymous and Native American ôsweatö rituals are considered overlapping." ",5-6"
"End-of-life care" "Health care provided in the last six months of life when the person is nearing death." ",6-1"
"End of life" "The time period for patients in which: a) there is little likelihood of cure for their disease, and b) further aggressive therapy is judged to be futile, and c) comfort is the primary goal of health care." ",6-1"
"Life expectancy" "The average number of years people born in a given year are expected to live based on a set of age-specific death rates." ",6-1"
"Years of healthy life" "The difference between life expectancy and years of healthy life reflects the average amount of time spent in less than optimal health because of chronic or acute limitations." ",6-1"
"Illness and disease trajectories" "Sudden, unexpected death -- Less than 10% of the American population die suddenly from a myocardial infarction, accident, homicide or another, unexpected event.
-Chronic, steady -- a lengthy life-threatening illness, usually with a highly predictable steady course ending with a shorter ôterminalö phase which results in death (most frequently cancer).
-Chronic, intermittent -- an illness characterized by a slow decline interrupted by crises (congestive heart failure or emphysema)." ",2-1,6-1"
"Futility" "Quantitative futility: research suggests that a therapy will have a less than 1% chance of producing the desired physiological effect, e.g., CPR will restore cardiac function (Jecker, 1994; Schneiderman et al., 1990).
- Qualitative futility: where personal, professional or public opinion suggests that while a therapy can achieve a desired effect, it will not produce the desired benefit; e.g., a situation such as persistent vegetative state (PVS) where CPR is expected to be successful in restoring cardiac function but the individual will not and cannot regain neurological function or meaningful consciousness. Qualitative futility is dangerous in that the definition of what is beneficial lacks any kind of clear societal (or professional) consensus. Hence, hospital policies that address withholding CPR on the basis of futility, generally specify quantitative futility versus qualitative (Schneiderman et al., 1990)." ",6-2"
"Probabilistic" "A point on a continuum where the probability of cost (physical, emotional, cognitive, financial, resources) vs. benefit is very low, i.e., 1 in 100." ",6-2"
"Family caregivers" "The immediate family, relatives by blood, marriage, or adoption, partners, or close friends who provide directly or manage the care of people who need medical and non-medical assistance, emotional support, and advocacy because they are ill or disabled." ",6-2,6-4"
"Quality of care" "The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." ",5-4"
"Continuous quality improvement (CQI)" "A set of principles that reinforce change implementation and often include ""targeting systemic defects rather than individual mistakes; encouraging close relationships among the participants in health care; using planning, control, assessment, and improvement activities that are grounded in statistical and scientific precepts and techniques; provide the statistical information back to practitioners on how their practices may differ from their peers' or depart from evidence-based standards for practice; standardizing processes to reduce the opportunity for error and link specific care processes to outcomes; and striving for continuous improvement in contrast to merely meeting established goals or criteria. Also known as Total Quality Management (TQM)." ",6-4"
"Outcomes research" "Research that seeks to understand the end results of particular health care practices and interventions. End results include effects that people experience and care about, such as change in the ability to function. In particular, for individuals with chronic conditionsùwhere cure is not always possibleùend results include quality of life as well as mortality." ",6-4"
"Outcomes and effectiveness research (OER)" "OER evaluates the impact of health care (including discrete interventions such as particular drugs, medical devices, and procedures as well as broader programmatic or system interventions) on the health outcomes of patients and populations. OER may include evaluation of economic impacts linked to health outcomes, such as cost-effectiveness and cost utility. OER emphasizes health problem- (or disease-) oriented evaluations of care delivered in general, real-world settings; multidisciplinary teams; and a wide range of outcomes, including mortality, morbidity, functional status, mental well-being, and other aspects of health-related quality of life. OER may entail any in a range of primary data collection methods and secondary (or ""synthetic"") methods that combine data from primary studies." ",6-4"
"Nursing" "The diagnosis and treatment of human responses to actual or potential health problems." ",6-4"
"Purpose of nursing" "To assist the individual, sick or well, in the performance of those activities contributing to health or its recovery, or to a peaceful death, that he would perform unaided if he had the necessary strength, will, or knowledge." ",6-4"
"Attending physician" "Designated by the patient to manage his or her care." ",6-3"
"Bereavement counselor" "Supports patient and especially family throughout the dying process and offers follow-up grief support and education." ",6-3"
"Complementary / alternative medical practitioners" "Provide palliative care to patient and family including massage, acupuncture, aroma, music, art, drama, dance, pet, herbal, etc. therapies." ",6-3"
"Funeral director" "Assists patient and family with planning funeral and burial arrangements." ",6-3"
"Home health aide" "Assists with personal care and light housekeeping services." ",6-3"
"Hospice or palliative care nurse" "Acts as case manager, coordinates the individualized care plan, provides specialized palliative care to the patient and family, and may lead the team." ",6-3"
"Patient and family" "Are at the center of the interdisciplinary hospice or palliative care team and the most important members." ",6-3"
"Pharmacist" "Provides counseling and support as needed regarding medications including possible adverse interactions." ",6-3"
"Social worker" "Offers psychosocial (emotional) support, counseling and community resources support services." ",6-3"
"Specialist physicians" "May provide specialized palliative care such as radiation therapists, surgeons, etc." ",6-3"
"Spiritual care" "Spiritual care coordinator or chaplain assists with any spiritual concerns." ",6-3"
"Therapists" "Physical, occupational and speech therapists provide care according to the patient's care plan." ",6-3"
"Volunteers" "Trained volunteers provide multiple services including companionship and respite care." ",6-3"
"Kussmaul respiration" "Air hunger, distresing dyspnea occuring in paroxysms (sudden recurence or intensitfication of symptom)." ",2-5"
"World Health Organization Analgesic Ladder" "In 1986, the World Health Organization first proposed that clinicians use analgesic medications via a systematic plan. The systematic plan includes a three-step ladder approach. For chronic nonmalignant and cancer pain, drug use is recommended from the bottom of the ladder to the top, i.e., up the ladder from Step 1 to Step 2 to Step 3. For acute pain, the steps are ordered from the top step to the bottom step, i.e., down the ladder from Step 3 to Step 2 to Step 1." ",2-3,2-4"
"Analgesic Ladder" "In 1986, the World Health Organization first proposed that clinicians use analgesic medications via a systematic plan. The systematic plan includes a three-step ladder approach. For chronic nonmalignant and cancer pain, drug use is recommended from the bottom of the ladder to the top, i.e., up the ladder from Step 1 to Step 2 to Step 3. For acute pain, the steps are ordered from the top step to the bottom step, i.e., down the ladder from Step 3 to Step 2 to Step 1." ",2-3,2-4"
