- Takes unprecedented multidisciplinary approach to understanding the effective evaluation and management of pain across the life process in the context of palliative care.
- Includes expert research from the fields of genetics, biology, psychology, anthropology, neurology, oncology, substance abuse and pharmacology, pharmacoeconomics, gerontology, pediatrics, health services research, rehabilitative medicine, palliative care, and public policy.
Pain has long been regarded as an unpleasant sensory consequence of neuronal activity in specific nociceptive pathways that is triggered by noxious stimuli, inflammation, or damage to the nervous system structure or function. However, classic models of disease and pain mechanisms do not adequately explain the commonly observed discrepancies between the extent of pathology levels of reported pain, the impact of experience of illness, disability, or in certain instances death, on the lived experience of pain. In other words, pain is not only a sensory event but a biobehavioral event as well. As such, it is subjective and therefore a significant cause of psychological suffering and even existential questioning. Thus treatment for many chronic pain syndromes, early in life, over the life course, and certainly at the end of life, remains an inexact science.
Recent studies over the past decade have begun to explore a biobehavioral approach, one that considers the interactive role of biological, environmental, emotional, existential, and psychosocial processes that can adversely impact the development, course, and experience of illness and disease over the life course. Illness is defined as the subjective experience of a disease or disorder. In contrast, disease is defined as an objective biological event involving the disruption of specific body structures or organ systems. The central goal of palliative care is to prevent and relieve suffering and to enable the best quality of life possible for patients, their families or significant others, no matter what the stage of the disorder, the need for other treatments, or the setting in which care is delivered. Thus, better palliative care services are one potential response that could alleviate some of the more challenging concerns associated with chronic pain. This is because palliative care focuses on patients of all ages with a chronic disorder – whether an illness, condition, or injury – that adversely impact daily functioning or reduces life expectancy. For such individuals, having access to early palliative care represents an opportunity to maintain the hopes of avoiding undue toxicity and fulfilling whatever tasks are important as they live their life or approach the end of life. Yet despite an increasing need for palliative care for patients with a variety of chronic conditions, such as musculoskeletal pain and cancer, individuals are often referred too late to receive the benefit of palliative care services. Moreover, limited research exists in which adequately provides a sufficient understanding of the biobehavioral approaches and mechanisms that can enhance palliative care practice and quality of care outcomes.
The broad aim of this edited volume is to take a multidisciplinary as well as a biobehavioral approach to understanding the effective management, evaluation, and treatment of pain across the life process, including in the context of palliative care. The central aim is to better convey how these biologic, environmental, existential, emotional, and psychosocial processes influence and interact with one another to influence the development and maintenance of chronic pain states. The collaborators for this project are experts from diverse clinical settings in the United States, Europe, Asia, and Africa providing cutting-edge research and clinical expertise from the fields of genetics, biology, psychology, anthropology, neuroanatomy, medicine, rehabilitation, pharmacology, pain imaging, gerontology, pediatrics, health services research, palliative care, as well as insights from philosophy, ethics, and public policy.
This book is organized in several major sections and then as a series of chapters. The first section provides a background and introduction of the problem of pain and palliative care in society. The second section emphasizes communication issues in pain and palliative care. The third section of the book highlights the basic science of pain. The forth section will provide a clinical review of pain conditions. The fifth section of the book emphasizes interventions for pain and pain management. The sixth section explores clinical trials for pain and palliative care. The seventh section focuses on psychosocial approaches for the management and treatment of pain and palliative care. The eight section highlights symptom control in pain and palliative care. The eighth section focuses on pain and palliative care assessment. The ninth section emphasizes socioeconomic and health disparities in pain and palliative care. The tenth section focuses on ethical and legal concerns associated with the management of pain and palliative care. The eleventh section highlights the role of health information technologies on the management of pain and palliative care. The twelfth and final section of the book is the conclusion which highlights future directions for the field.