Universitat Internacional de Catalunya - BarcelonaPalliative Care Medicine
Main language of instruction: Catalan
Head instructor
Dr. Christian Antonio VILLAVICENCIO - cavillavicencio@uic.es
Office hours
Dr. Christian Villavicencio cavillavicencio@uic.es
Palliative Medicine is the medical discipline devoted to the study and treatment of patients with a limited life prognosis due to incurable and progressive diseases, where the goal is to offer the best quality of life through adequate symptom control, psychosocial social and spiritual support.
Palliative Medicine is a term referred to the medical activity, while activity developed by a multidisciplinary team, that usually includes physicians, nurses, social workers, psychologists, physiotherapists, pastoral agents and volunteers, is recognized worldwide as palliative care.
Palliative care in general and Palliative Medicine, in particular, is a discipline of more than 50 years of development around the world, and in some countries is a medical specialty, like in the United Kingdom or United States of America.
The Palliative Care, in Spain in the last 25 years, has been an activity recognized, regulated and funded within the NHS.
Nowadays, the training of future physicians would be partial if do not incorporate the basic knowledge and skills to manage major physical, emotional, social and spiritual problems that arise on the medical care of patients at the end of life.
Not applicable
The subject of Palliative Medicine aims that future physicians can recognize the importance, necessity and responsibility they have in the care of people with diseases that will not cure and evolve to death.
The subject of Palliative Medicine also wants to provide to the students a basic knowledge and skills to facing common clinical problems, from the clinical and ethical point of view.
1. – At the end of the course, students must be able to give a reasoned explanation of the principles and tools of Palliative Medicine.
2. – The students must be able to carry out a multidimensional and interdisciplinary assessment of patients with progressive advanced illness.
3. - The students must be able to prescribe opioids (specially morphine) for chronic cancer and non-cancer pain, adjust the dose properly and, prevent and treat its main side effects.
4. - The students must be able to identify the main problems related to the last days of life and to plan an interdisciplinary approach.
5. - The students must be able to reasonably identify and discuss the ethical principles governing decision making in patients with progressive advanced illness.
- Principles and tools of Palliative Medicine: Objectives from cure to palliation. The natural history of progressive diseases and end of life. WHO palliative care model. The multidimensionality of the human being. Definition of Palliative Medicine and Palliative Care. Basic structure of the model of palliative care.
- Models and organization of Palliative Care: A brief history and development of palliative care. The Catalonia Palliative Care Model and it evolution in Spain. The organization core: the multidisciplinary team. Basis of the interdisciplinary teamwork.
- Communication: Ethical Principles and practice of communication. How to break bad news (6-step protocol).
- Multidimensional assessment: Evaluation and multidimensional assessment instruments in Palliative Medicine. Physical, emotional, social and spiritual dimensions.
- Pain: Epidemiology, nociception pathophysiology, taxonomy, assessment. Pharmacological and non-pharmacological measures. The clinical use of morphine and other opioids.
- Gastrointestinal symptoms: Sd. Cachexia-anorexia, xerostomia, nausea and vomiting, constipation. Epidemiology, pathophysiology, differential diagnosis, pharmacological and non-pharmacological treatment.
- Respiratory symptoms: Dyspnea, cough. Epidemiology, pathophysiology, differential diagnosis, pharmacological and non-pharmacological treatment.
- Neuropsychiatric symptoms: Delirium, depression, anxiety, insomnia. Epidemiology, pathophysiology, differential diagnosis, pharmacological and non-pharmacological treatment.
- Last days of life: Characteristics. Overall treatment strategy. Common symptoms: pain, delirium, dyspnea, death rattle. Pharmacological and non-pharmacological treatment. Family care.
- Palliative Sedation: Ethical and clinical practice.
- Family Care : Specific aspects related with the care of the family, as part of the Plliative Medicine unit of care.
- Bearevement: Adaptative process to loss. Complicate bearevement and its features.
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· Manual de Medicina Paliativa. Carlos Centeno Cortés et al. Editorial EUNSA
· Manual de control de síntomas en pacientes con cáncer avanzado y terminal. Josep Porta et al. Editorial ARAN
· Medicina Paliativa . (Ed. Española). Declan Walsh et al. Editorial Elsevier Saunders
· Societat Catalana-Balear de Cures Pal.liatives. http://webs.academia.cat/societats/curespal
· Sociedad Española de Cuidados Paliativos. http://www.secpal.com
· European Asociación for Palliative Care. http://www.eapcnet.eu
· International Associacion for Hospice and Palliative Care. http://www.hospicecare.com
· Qualy. Centre col.laborador de la OMS per a programes públics de cures pal.liatives. Institut Català d’Oncologia. http://www.iconcologia.net
· Regional Palliative Care Program. Edmonton (Alberta). http://www.palliative.org
· MD Anderson, Palliative Care. http://www.mdanderson.org