Ubuhlungu bokuphulukana (BTP) ubuhlungu obuba khona phakathi kwemithi ejwayelekile ehleliwe yemithi yobuhlungu. Kuyisifo esicindezelayo esidinga ukwelashwa okusheshayo.
Iningi leziguli ezinezinhlungu ezingapheliyo, okubandakanya ukunakekelwa kwezilonda kanye neziguli zokugula , zinikezwa imishanguzo yokusebenzisa njengoba kudingeka ukuze uphathe ubuhlungu obukhulu. Imithi ye-BTP iyashesha ngokusebenza isikhathi esifushane esenziwe (ngokuvamile ukuhlinzeka ukuphumula amahora amabili kuya kwangu-4).
Ngeshwa, ucwaningo luye lwabonisa ukuthi nakuba ubuhlungu obuphuthumayo buvame kakhulu ezigulini ezinezifo eziphambili ekhaya, imithi yokuyidambisa ayinqunyelwe ngaso sonke isikhathi, futhi iziguli ezibuhlungu azisebenzisi njalo imithi eminingi yokwelapha ubuhlungu babo njengoba kuvunyelwe.
Ngabe i-BTP ivele nini?
Iziguli ezithola ubuhlungu obuhlala njalo zivame ukubekwa ngama-oda we- opioid ubuhlungu obuzungezile-iwashi (ATC) . Ubuhlungu bokuphulukisa buveza phakathi kwalezi zilinganiso zemithi futhi ngokuvamile kubangela ukucindezeleka okukhulu kwesiguli. Kubalulekile ukuthi ukwazi ukubona i-BTP futhi ugcine irekhodi eliqondile ukuze umhlinzeki wakho wokunakekelwa kwezempilo, noma lowo othandekayo onakekelayo, angayiphatha ngendlela efanele.
Ubuhlungu bokuphumula bukhona imikhakha emithathu eyisisekelo: ubuhlungu besigameko, ubuhlungu obukhulu, nokuhluleka kwemithi yokuphela kwemithi. Kubalulekile ukuthi umhlinzeki wakho wokunakekelwa kwezempilo aqaphele ukuthi yiluphi uhlobo lwe-BTP ohlangabezana nalo kusukela ukwelashwa ngayinye kungahluka kakhulu.
Ukwelapha Ubuhlungu Besehlakalo
Ubuhlungu besigameko ubuhlungu obungakunqunywa futhi okwenzeka ngemisebenzi ethile. Isibonelo salokhu yisiguli esinezinhlungu njalo lapho ephendukile kusuka ohlangothini kuya kolunye ukunakekelwa komuntu siqu.
Ubuhlungu besigameko buvame ukuphathwa kahle. Ngenxa yokuthi ubuhlungu bubikezelwa, iziguli ezinezinhlungu zesigameko zingahle zihlolwe ngokushesha ngemithi yokuhlunguphaza isikhathi esifushane ngaphambi kwemisebenzi ebangela ubuhlungu.
Umthamo ungalungiswa ngokususelwa ezingeni nasemkhakheni womsebenzi okulindeleke ukuba ubangele ubuhlungu.
Ukwelapha Ubuhlungu Bokuzenzekelayo
Ubuhlungu obungavamile abukwazi ukubikezela futhi abuhlobene nanoma yimuphi umsebenzi othize. Ngenxa yokungalindeleki kwayo, ngokuvamile kunzima kakhulu ukuphatha.
Ubuhlungu obungavamile buvame ukuphathwa ngemithi yokwelashwa esheshayo, ehlala isikhathi esifushane esinikezwa ngokushesha uma ubuhlungu bufika. Imithi ye-Adjuvant ingase ihlolwe futhi ukunikeza ukulawula okungcono kobuhlungu. Imithi ye-Adjuvant ihlanganisa anti-depressants, anti-seizure , kanye neminye imithi ethuthukisa ukuphathwa ubuhlungu kweziguli ezithile.
Ukwelashwa Ukwehluleka Kwemithi Ekupheleni
Lokhu yilokho okukuzwakalayo: ubuhlungu obwenzeka ngasekupheleni kwesikhathi lapho umthamo wezokwelapha uhlose ukuphumelela. Isibonelo, esigulini esithatha isikhathi eside sokukhululwa i- morphine amahora angu-12, ubuhlungu obwenzeka phakathi kwehora lesishiyagalombili nehora leshumi kuthathwa njengokuhluleka kokuphela kwesilinganiso.
Ukwelashwa kokuhluleka kokuphela kwesilinganiso kungahlanganisa ukunciphisa isikhala phakathi kwamanani noma ukwandisa umthamo wemithi. Isibonelo, isiguli esibhekene nobuhlungu ngemva kwamahora ayisishiyagalombili ngenkathi isidakamizwa esihloselwe ukunikeza amahora amahora angu-12 singase sibe nekhefu phakathi kwamanani kuyehla kuze kube njalo emahoreni ayisishiyagalombili, noma umthamo wakhe unganda ngamaphesenti angu-25 kuya kuma-50%.
Kuzo zonke izimo, imithi ejwayelekile evame ukusetshenziselwa isilungiselelo sokubeletha ukuphatha i-BTP yisisombululo somlomo we-morphine (OMS). I-OMS ifomu le-morphine eligxile kakhulu eliqala ukusebenza ngokushesha futhi lihlinzeke ngokukhululeka amahora amabili kuya kwangu-4.
Ukugcina Umlando Wezinhlungu Zokuphulukisa
Indlela engcono kakhulu yokuqinisekisa ukuthi ubuhlungu bubuhlungu buyaphathwa kahle ngokwanele ukugcina imithi yokwelashwa ephelele futhi enembile. Ukugcina irekhodi elinembile lamazinga obuhlungu, imithi esetshenziselwa ukuyiphatha, nokuphendula imithi izosiza umhlinzeki wezempilo ukuba anqume ukwelashwa okungcono kakhulu. Imithi yakho yemithi ingase ibonakale ifana nale engezansi.
Isibonelo sokuPhuthukiswa kwemithi yokuhlunguphaza
| Isikhathi / Isikhathi / Izinga lezinhlungu | Ngomhlaka 8th, 9: 00a, ubuhlungu 5/10 | Ngomhlaka 8, 5: 00p, ubuhlungu 6/10 | Ngomhlaka 11, 11: 00a, ubuhlungu 4/10 | Ngomhlaka 12, 2: 00a, ubuhlungu 6/10 |
| Imithi / i-Dose / impendulo | i-morphine 5mg, ubuhlungu abukhululekile, omunye u-5mg unikezwe ngosizo | i-morphine 10mg, ubuhlungu bukhululiwe | i-morphine 10mg, ubuhlungu bukhululiwe | i-morphine 10mg, ubuhlungu bukhululiwe |
Imithombo:
Ferrell, BR noCoyle, N; I-Bookbook ye-Nursing Palliative, i-Oxford University Press, ngo-2006.
UFerrell BR, uMcGuire DB, no-Yarbro CH; Ukuphathwa Kwezinhlungu Ze-Cancer, uJones noBartlett Abashicileli, ngo-1995.
I-Mercadante, C, et. i-al .; Ukuhlukunyezwa Kweziguli Eziphakeme Zomdlavuza Olandelwa Ekhaya: I-Longitudinal Study, Journal of Pain and Symptom Management, Volume 38, Issue 4, Amakhasi 554-560 (Okthoba 2009).