疼痛与缓和医疗 Pain, Palliative Care and Goals of Care

By the end of this module you can…

• Take a pain history: the 0 to 10 score, where it hurts, what it feels like and what helps.
• Explain the pain plan: medicine by the clock, a dose for flares, and when to call.
• Answer fears about morphine honestly, and teach the bowel plan and safety at home.
• Explain palliative care as extra support at any stage, not giving up.
• Ask what matters most, and talk through advance directives and who will decide if the patient can’t (a health care proxy in the US, a substitute decision-maker in Canada).

Key vocabulary

Fourteen words from this module. Tap the speaker to hear each one.

Pain & medicines

• 疼痛评分téng tòng píng fēnPain score
• 爆发痛bào fā tòngBreakthrough pain (a sudden flare)
• 止痛药zhǐ tòng yàoPainkiller, pain medicine
• 吗啡mǎ fēiMorphine
• 上瘾shàng yǐnAddiction; to become addicted
• 便秘biàn mìConstipation
• 犯困fàn kùnDrowsy, sleepy

Care & planning

• 姑息治疗gū xī zhì liáoPalliative care
• 希望xī wàngHope; to hope
• 担心dān xīnTo worry; a worry
• 预立医疗指示yù lì yī liáo zhǐ shìAdvance directive
• 医疗代理人yī liáo dài lǐ rénHealth care proxy
• 心肺复苏xīn fèi fù sūCPR (cardiopulmonary resuscitation)
• 家庭会议jiā tíng huì yìFamily meeting

Ten core phrases

The lines from this module’s take-home phrase sheet. In the course you can print them on one page for your pocket.

1. 零分是不疼，十分是最疼，您现在几分？Líng fēn shì bù téng, shí fēn shì zuì téng, nín xiàn zài jǐ fēn?Zero is no pain, ten the worst: what is it now?
2. 是什么样的疼？是胀胀的，还是像针扎一样？Shì shén me yàng de téng? Shì zhàng zhàng de, hái shi xiàng zhēn zhā yí yàng?What kind of pain? Pressing, or like a needle?
3. 疼的时候不用忍着。Téng de shí hou bú yòng rěn zhe.You don’t have to put up with pain.
4. 长效药到时间就吃，不疼也要吃。Cháng xiào yào dào shí jiān jiù chī, bù téng yě yào chī.Long-acting medicine on time, even without pain.
5. 为了止痛按医生说的吃，跟上瘾不是一回事。Wèi le zhǐ tòng àn yī shēng shuō de chī, gēn shàng yǐn bú shì yì huí shì.Taking it for pain as prescribed isn’t addiction.
6. 从第一天开始，就要按时吃通便药。Cóng dì yī tiān kāi shǐ, jiù yào àn shí chī tōng biàn yào.The laxative on schedule, from day one.
7. 药要锁好，不要给别人吃。Yào yào suǒ hǎo, bú yào gěi bié rén chī.Lock up the medicine; never share it.
8. 叫不醒，或者呼吸很慢、很浅，马上打911。Jiào bu xǐng, huò zhě hū xī hěn màn, hěn qiǎn, mǎ shàng dǎ jiǔ yāo yāo.Can’t wake them, or slow breathing: call 911.
9. 舒缓治疗是多一层帮助，不是放弃。Shū huǎn zhì liáo shì duō yì céng bāng zhù, bú shì fàng qì.Palliative care is extra support, not giving up.
10. 对您来说，现在最重要的是什么？Duì nín lái shuō, xiàn zài zuì zhòng yào de shì shén me?What matters most to you now?

What’s in Module 11

1. Part 1 · Warm-UpWarm-Up: Pain and What Matters
2. Part 2 · The Words for PainReading the Pinyin · Saying 像针扎一样 vs. Charting 刺痛 · Vocabulary · Flash Cards · The Pain Check Script
3. Part 3 · Asking About PainWhere, When and What Helps · Key Patterns · The Pain Builder · By the Clock, and for Flares
4. Part 4 · Pain MedicinesMorphine Without Fear · Side Effects and the Bowel Plan · Safe at Home, and Comfort Without Pills · When to Call, and When to Call 911
5. Part 5 · Palliative Care & GoalsSaying 舒缓治疗 vs. Charting 姑息治疗 · What Matters Most · Advance Directives and the Family · What Patients Say
6. Part 6 · Role-PlayRound 1 · Guided Conversation · Round 2 · Controlled Practice · Rounds 3, 4 & 5 · Independent
7. Part 7 · Knowledge CheckModule 11 Knowledge Check
8. Part 8 · Wrap-UpModule 11 Homework · Take-Home Phrase Sheet · Module 11 Wrap-Up · 下次见