SlideShare uma empresa Scribd logo
1 de 20
Motor Neurone Disease Pain and Associated Psychological  Perspectives in Terminal Illness BEGIN Click for Full Text
[object Object],[object Object],Instructions The audio is synched to run with the slides and any information on the slides will automatically progress with the audio. At the end of each slide you will be able to either go back to the previous slide, replay the current slide or progress to the next slide using the navigation buttons on the bottom of the page. ,[object Object],Next Previous Replay
[object Object],[object Object],[object Object],Defining Terminal Illness “ Terminal illness is an irreversible illness that, without life sustaining procedures, will result in death in the near future.”   (Terminal Illness Law and Legal Definition, 2011)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Defining Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],An unpleasant sensory & emotional experience associated with actual or potential tissue damage Next Previous Replay
Defining Motor  Neurone Disease MND is a disabling and ultimately fatal disease that has few effective treatments  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Pain Associated with MND ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Pain Associated with MND -  Physical Next Previous Replay
Management of Pain Associated with MND -  Physical ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Pain Associated with MND -  P sychological ,[object Object],[object Object],[object Object],[object Object],[object Object],Physicians and others involved in the care of patients with MND need to be aware that depression associated with pain is a significant problem irrespective of the level of physical disability   Tedman, Young & Williams, 1997 Next Previous Replay
Measurement of Depression Associated With Pain in MND ,[object Object],[object Object],Next Previous Replay
Measurement of Depression Associated With Pain in MND  cont… ,[object Object],[object Object],Next Previous Replay
Management of Pain Associated with MND -  Psychological Next Previous Replay
Comorbidity Factors   (Desire for Death & Suicidal Thoughts)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],“ Hope and hopelessness are important issues for MND patients, with hopelessness contributing significantly to suffering and for some a desire for hastened death” (McLeod & Clarke, 2007) Next Previous Replay
Suicide Vulnerability  Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Suicide Facts According to  Maytal and Stern, 2006 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Summary cont… ,[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Evaluation & Suggestions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Next Previous Replay
Final Thoughts ,[object Object],Next Previous Replay
References Return to 1 st  Slide Albert, S. M., Whitaker, A., Rabkin, J. G., del Bene, M., Tider, T., O’Sullivan, & Mitsumoto, H. (2009). Medical and Supportive Care among People with ALS in the Months before Death or Tracheostomy. Journal of Pain and Symptom Management. Vol. 38, No.4, 546 – 553. Anand, K.J.S., Craig, K.D. (1996).  New Perspectives on the definition of pain.  Pain. Vol. 67, Issue 1. P.3-6 Bohannon, R.W., DePasquale, L. (2010).  Physical Functioning Scale of the Short-Form (SF)36: Internal Consistency and Validity with Older Adults.  Journal of Geriatric Physical Therapy. Vol.33, Issue1, p.16-18 Brunner, L., S. & Smeltzer, S., C., O. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing. Wolters Kluwer Health/Lippincott Williams & Wilkins: Philadelphia. DeLisa, J. A. Gans, B. M. & Walsh, N. E. (2005). Physical medicine and rehabilitation: principles and practice. Lippincott Williams & Wilkins: Philadelphia. Dobratz, M.C. (1990).  The Life Closure Scale: a measure of psychological adaptation in death and dying.  Hosp. J; Vol. 6. Issue 3. P. 1-15 Ganzini, L., Silveira, M. J. & Johnston, W.S. (2002). Predictors and Correlates of Interest in Assisted Suicide in the Final Month of Life Among ALS Patients in Oregon and Washington. Journal of Pain and Symptom Management. Vol. 24, No.3, 312 – 317. Knight, K., L. & Draper, D., O. (2008). Therapeutic modalities: the art and the science. Lippincott Williams & Wilkins: Baltimore, MD. Lautenbacher, S. & Filingim, R., B. (2004). Pathophysiology of pain perception. Kluwer Academic /Plenum: New York. Lindner, M. D., Bourin, C., Chen, P., McElroy, J. F., Leet, J. E., Hogan, J. B., Stock, D. A. & Machet, F. (2006). Adverse Effects of Gabapentin and Lack of Anti-Allodynic Efficacy of Amitriptyline in the Streptozotocin Model of Painful Diabetic Neuropathy. Experimental and Clinical Psychopharmacology. Vol. 14, No. 1, 42 – 51.  Lloyd-Williams, M. & Riddleston, H. (2002). The Stability of Depression Scores in Patients Who Are Receiving Palliative Care. Journal of Pain and Symptom Management. Vol. 24, No. 6, 593 – 597. Mancini, R., L. (2008). Motor neuron disease research progress.  Nova Biomedical Books: New York. Marcus, D., A. (2009). Chronic pain: a primary care guide to practical management. Humana Press, cop.: New York, NY. Maytal, G., Stern, T.A. 2006.  The Desire for death in the setting of terminal illness: A case discussion.  Primary Care Companion Journal of Psychiatry. Vol. 8. Issue 5. McLeod, J.E. & Clarke, D.M. (2007).  A review of psychosocial aspects of motor neurone disease.  Journal of Neurological Science, 258 (1-2) 4-10 Merskey, H. (1991).  The Definition of Pain.  European Psychiatry. Vol. 6, Issue 4. p.153-159 Miller, R.G., Mitchell, J.D., Lyon, M., Moore, D.H. (2007).  Riluzole for Amyotrophic Lateral Sclerosis (ALS)/Motor Neurone Disease (MND).  Cochrane Database System Review. 2007 Jan 24; (1); CD1001447 Mitsumoto, H. (2009). Amyotrophic lateral sclerosis: a guide for patients and families. New York : Demos Health.  Moore, C., McDermott, C.J., Shaw, P.J. (2008).  Clinical aspects of Motor Neurone Disease.  Medicine. Vol. 36, Issue 12. P.640-645 McLeod, J.E., Clark, D.M. (2007).  A Review of psychosocial aspects of Motor Neurone Disease.  Journal of the Neurological Sciences. Vol. 258 p.4-10 Ng, L., Khan, F. & Mathers, S. (2009). Multidisciplinary Care for Adults with Amyotrophic Lateral Sclerosis or Motor Neuron Disease. Cochrane Database of Systematic Reviews: Issue 4, Art No. CD007425. The Cochrane Collaboration. Pub by John Wiley & Sons, Ltd Serpell, M. G. (2002). Gabapentin in Neuropathic Pain Syndromes: A Randomized, Double-Blind, Placebo-Controlled Trial. Pain. 99, 557 – 566. Stiel, S., Hollberg, C., Pestinger, M., Ostgathe, C., Friedemann, N., Lindena, G., Elsner, F.,  Radbruch, L. and the Members of the HOPE Steering Group. (2011). Subjective Definitions of Problems and Symptoms in Palliative Care. Palliative Care: Research and Treatment. 5, 1 – 7. Tang, N.K.Y., & Crane, C. (2006).  Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links.  Psychological Medicine. Vol. 36. P. 575-586 Tedman, B.M., Young, C.A. & Williams, I.R. (1997).  Assessment of depression in patients with motor neurone disease and other neurologically disabiling illness.  Journal of Neurological Sciences. 152. Supp 1:S75-9 Terminal  Illness Law & Legal Definition (2011).  Retrieved on 13th May 2011 from http://definitions.uslegal.com/t/terminal-illness/ Zatzick, D. F. & Dimsdale, J. E. (1990). Cultural Variations in Response to Painful Stimuli. Psychosomatic Medicine. 52: 544 – 557.

Mais conteúdo relacionado

Mais procurados

Pain management vels
Pain management velsPain management vels
Pain management vels
velspharmd
 
Pain Management In Nursing4 With K I W I N
Pain Management In Nursing4 With  K I W I NPain Management In Nursing4 With  K I W I N
Pain Management In Nursing4 With K I W I N
gerlam
 
1 adequate therapy for chronic non cancer pain
1 adequate therapy for chronic non  cancer pain1 adequate therapy for chronic non  cancer pain
1 adequate therapy for chronic non cancer pain
Puya Arash
 

Mais procurados (20)

Pain management
Pain managementPain management
Pain management
 
Pain management vels
Pain management velsPain management vels
Pain management vels
 
Pain management
Pain managementPain management
Pain management
 
Pain from psychiatric point of view
Pain from psychiatric point of viewPain from psychiatric point of view
Pain from psychiatric point of view
 
Course 5 psychological aspects of chronic pain
Course 5 psychological aspects of chronic painCourse 5 psychological aspects of chronic pain
Course 5 psychological aspects of chronic pain
 
2015: Pain Management - A Practical and Functional Approach-Lakkaraju
2015: Pain Management - A Practical and Functional Approach-Lakkaraju2015: Pain Management - A Practical and Functional Approach-Lakkaraju
2015: Pain Management - A Practical and Functional Approach-Lakkaraju
 
Types of pain and assessment of pain
Types of pain and assessment of painTypes of pain and assessment of pain
Types of pain and assessment of pain
 
Chronic pain: Role of tricyclic antidepressants, dolsulepin
Chronic pain: Role of tricyclic antidepressants, dolsulepinChronic pain: Role of tricyclic antidepressants, dolsulepin
Chronic pain: Role of tricyclic antidepressants, dolsulepin
 
Chronic pain assessment & management
Chronic pain assessment & management Chronic pain assessment & management
Chronic pain assessment & management
 
New directions in the psychology of chronic pain management
New directions in the psychology of chronic pain managementNew directions in the psychology of chronic pain management
New directions in the psychology of chronic pain management
 
Pain Management In Nursing4 With K I W I N
Pain Management In Nursing4 With  K I W I NPain Management In Nursing4 With  K I W I N
Pain Management In Nursing4 With K I W I N
 
1 adequate therapy for chronic non cancer pain
1 adequate therapy for chronic non  cancer pain1 adequate therapy for chronic non  cancer pain
1 adequate therapy for chronic non cancer pain
 
Common Brain Mechanisms Between Pain & Addiction
Common Brain Mechanisms Between Pain & AddictionCommon Brain Mechanisms Between Pain & Addiction
Common Brain Mechanisms Between Pain & Addiction
 
Acute pain - dr. ike
Acute pain - dr. ikeAcute pain - dr. ike
Acute pain - dr. ike
 
Pain Management
Pain ManagementPain Management
Pain Management
 
Chronic pain syndromes
Chronic pain syndromes Chronic pain syndromes
Chronic pain syndromes
 
Pain ( M.Sc Nursing)
Pain ( M.Sc Nursing)Pain ( M.Sc Nursing)
Pain ( M.Sc Nursing)
 
Pain management
Pain managementPain management
Pain management
 
Chronic pain management
Chronic pain managementChronic pain management
Chronic pain management
 
Lemessa Jira pain managment in surgical patient ppt
Lemessa Jira  pain managment  in surgical patient pptLemessa Jira  pain managment  in surgical patient ppt
Lemessa Jira pain managment in surgical patient ppt
 

Semelhante a Pain in MND

Pain in mnd - final script
Pain in mnd - final scriptPain in mnd - final script
Pain in mnd - final script
Brendon Fulton
 
Pain Final With K I W I N
Pain  Final With  K I W I NPain  Final With  K I W I N
Pain Final With K I W I N
gerlam
 
lower, upper and middlepain-management-2010.ppt
lower, upper and middlepain-management-2010.pptlower, upper and middlepain-management-2010.ppt
lower, upper and middlepain-management-2010.ppt
AfframHspt
 
The conundrum of opioid tapering in long term opioid therapy for chronic pain...
The conundrum of opioid tapering in long term opioid therapy for chronic pain...The conundrum of opioid tapering in long term opioid therapy for chronic pain...
The conundrum of opioid tapering in long term opioid therapy for chronic pain...
Paul Coelho, MD
 

Semelhante a Pain in MND (20)

Pain in mnd - final script
Pain in mnd - final scriptPain in mnd - final script
Pain in mnd - final script
 
Diagnosis and Management of Chronic pain associated with depression.pptx
Diagnosis and Management of Chronic pain associated with depression.pptxDiagnosis and Management of Chronic pain associated with depression.pptx
Diagnosis and Management of Chronic pain associated with depression.pptx
 
Management oF Chronic Pain-- Seminar.pptx
Management oF Chronic Pain-- Seminar.pptxManagement oF Chronic Pain-- Seminar.pptx
Management oF Chronic Pain-- Seminar.pptx
 
10461913 2.ppt
10461913 2.ppt10461913 2.ppt
10461913 2.ppt
 
Recovery from chronic pain is possible
Recovery from chronic pain is possibleRecovery from chronic pain is possible
Recovery from chronic pain is possible
 
Diagnosis and evaluation
Diagnosis and evaluationDiagnosis and evaluation
Diagnosis and evaluation
 
Pain Final With K I W I N
Pain  Final With  K I W I NPain  Final With  K I W I N
Pain Final With K I W I N
 
Are your clients in pain
Are your clients in painAre your clients in pain
Are your clients in pain
 
Pain and Orthopedic Physical Therapy
Pain and Orthopedic Physical TherapyPain and Orthopedic Physical Therapy
Pain and Orthopedic Physical Therapy
 
drmkj
drmkjdrmkj
drmkj
 
Chronic pain_1.ppt
Chronic pain_1.pptChronic pain_1.ppt
Chronic pain_1.ppt
 
Shame, addiction & chronic pain
Shame, addiction & chronic painShame, addiction & chronic pain
Shame, addiction & chronic pain
 
Pain
Pain Pain
Pain
 
Pain management
Pain managementPain management
Pain management
 
lower, upper and middlepain-management-2010.ppt
lower, upper and middlepain-management-2010.pptlower, upper and middlepain-management-2010.ppt
lower, upper and middlepain-management-2010.ppt
 
Hanipsych, pain & dep
Hanipsych, pain & depHanipsych, pain & dep
Hanipsych, pain & dep
 
Fibromyalgia lecture2010
Fibromyalgia lecture2010Fibromyalgia lecture2010
Fibromyalgia lecture2010
 
Acupuncture for fibromyalgia
Acupuncture for fibromyalgiaAcupuncture for fibromyalgia
Acupuncture for fibromyalgia
 
pain
painpain
pain
 
The conundrum of opioid tapering in long term opioid therapy for chronic pain...
The conundrum of opioid tapering in long term opioid therapy for chronic pain...The conundrum of opioid tapering in long term opioid therapy for chronic pain...
The conundrum of opioid tapering in long term opioid therapy for chronic pain...
 

Último

Último (20)

Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
 
O963O942363 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O963O942363 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO963O942363 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O963O942363 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 

Pain in MND

  • 1. Motor Neurone Disease Pain and Associated Psychological Perspectives in Terminal Illness BEGIN Click for Full Text
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Pain Associated with MND - Physical Next Previous Replay
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Management of Pain Associated with MND - Psychological Next Previous Replay
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20. References Return to 1 st Slide Albert, S. M., Whitaker, A., Rabkin, J. G., del Bene, M., Tider, T., O’Sullivan, & Mitsumoto, H. (2009). Medical and Supportive Care among People with ALS in the Months before Death or Tracheostomy. Journal of Pain and Symptom Management. Vol. 38, No.4, 546 – 553. Anand, K.J.S., Craig, K.D. (1996). New Perspectives on the definition of pain. Pain. Vol. 67, Issue 1. P.3-6 Bohannon, R.W., DePasquale, L. (2010). Physical Functioning Scale of the Short-Form (SF)36: Internal Consistency and Validity with Older Adults. Journal of Geriatric Physical Therapy. Vol.33, Issue1, p.16-18 Brunner, L., S. & Smeltzer, S., C., O. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing. Wolters Kluwer Health/Lippincott Williams & Wilkins: Philadelphia. DeLisa, J. A. Gans, B. M. & Walsh, N. E. (2005). Physical medicine and rehabilitation: principles and practice. Lippincott Williams & Wilkins: Philadelphia. Dobratz, M.C. (1990). The Life Closure Scale: a measure of psychological adaptation in death and dying. Hosp. J; Vol. 6. Issue 3. P. 1-15 Ganzini, L., Silveira, M. J. & Johnston, W.S. (2002). Predictors and Correlates of Interest in Assisted Suicide in the Final Month of Life Among ALS Patients in Oregon and Washington. Journal of Pain and Symptom Management. Vol. 24, No.3, 312 – 317. Knight, K., L. & Draper, D., O. (2008). Therapeutic modalities: the art and the science. Lippincott Williams & Wilkins: Baltimore, MD. Lautenbacher, S. & Filingim, R., B. (2004). Pathophysiology of pain perception. Kluwer Academic /Plenum: New York. Lindner, M. D., Bourin, C., Chen, P., McElroy, J. F., Leet, J. E., Hogan, J. B., Stock, D. A. & Machet, F. (2006). Adverse Effects of Gabapentin and Lack of Anti-Allodynic Efficacy of Amitriptyline in the Streptozotocin Model of Painful Diabetic Neuropathy. Experimental and Clinical Psychopharmacology. Vol. 14, No. 1, 42 – 51. Lloyd-Williams, M. & Riddleston, H. (2002). The Stability of Depression Scores in Patients Who Are Receiving Palliative Care. Journal of Pain and Symptom Management. Vol. 24, No. 6, 593 – 597. Mancini, R., L. (2008). Motor neuron disease research progress. Nova Biomedical Books: New York. Marcus, D., A. (2009). Chronic pain: a primary care guide to practical management. Humana Press, cop.: New York, NY. Maytal, G., Stern, T.A. 2006. The Desire for death in the setting of terminal illness: A case discussion. Primary Care Companion Journal of Psychiatry. Vol. 8. Issue 5. McLeod, J.E. & Clarke, D.M. (2007). A review of psychosocial aspects of motor neurone disease. Journal of Neurological Science, 258 (1-2) 4-10 Merskey, H. (1991). The Definition of Pain. European Psychiatry. Vol. 6, Issue 4. p.153-159 Miller, R.G., Mitchell, J.D., Lyon, M., Moore, D.H. (2007). Riluzole for Amyotrophic Lateral Sclerosis (ALS)/Motor Neurone Disease (MND). Cochrane Database System Review. 2007 Jan 24; (1); CD1001447 Mitsumoto, H. (2009). Amyotrophic lateral sclerosis: a guide for patients and families. New York : Demos Health. Moore, C., McDermott, C.J., Shaw, P.J. (2008). Clinical aspects of Motor Neurone Disease. Medicine. Vol. 36, Issue 12. P.640-645 McLeod, J.E., Clark, D.M. (2007). A Review of psychosocial aspects of Motor Neurone Disease. Journal of the Neurological Sciences. Vol. 258 p.4-10 Ng, L., Khan, F. & Mathers, S. (2009). Multidisciplinary Care for Adults with Amyotrophic Lateral Sclerosis or Motor Neuron Disease. Cochrane Database of Systematic Reviews: Issue 4, Art No. CD007425. The Cochrane Collaboration. Pub by John Wiley & Sons, Ltd Serpell, M. G. (2002). Gabapentin in Neuropathic Pain Syndromes: A Randomized, Double-Blind, Placebo-Controlled Trial. Pain. 99, 557 – 566. Stiel, S., Hollberg, C., Pestinger, M., Ostgathe, C., Friedemann, N., Lindena, G., Elsner, F., Radbruch, L. and the Members of the HOPE Steering Group. (2011). Subjective Definitions of Problems and Symptoms in Palliative Care. Palliative Care: Research and Treatment. 5, 1 – 7. Tang, N.K.Y., & Crane, C. (2006). Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychological Medicine. Vol. 36. P. 575-586 Tedman, B.M., Young, C.A. & Williams, I.R. (1997). Assessment of depression in patients with motor neurone disease and other neurologically disabiling illness. Journal of Neurological Sciences. 152. Supp 1:S75-9 Terminal Illness Law & Legal Definition (2011). Retrieved on 13th May 2011 from http://definitions.uslegal.com/t/terminal-illness/ Zatzick, D. F. & Dimsdale, J. E. (1990). Cultural Variations in Response to Painful Stimuli. Psychosomatic Medicine. 52: 544 – 557.