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Journal of Pain and Symptom Management

Peter Strang, Jenny Bergqvist
CONTEXT: Women with metastatic breast cancer often receive many lines of palliative chemotherapy, which might be beneficial but also harmful. Still, little is known about the patients' perception of the patient-doctor communication regarding late lines of non-curative treatment. OBJECTIVES: Our aim was to explore breast cancer patients' preferences and perceptions of patient-doctor communication regarding continuous late lines of palliative chemotherapy. PATIENTS AND METHODS: A qualitative study with semi-guided face-to-face interviews with 20 women, 40-80 years old, on at least their second line of palliative chemotherapy (2nd-8th line)...
January 10, 2019: Journal of Pain and Symptom Management
Dong-Mei Lin, Xi-Xi Yin, Ning Wang, Wei Zheng, Yan-Ping Wen, Li-Min Meng, Li-Li Zhang
CONTEXT: One of the open questions in symptom cluster (SC) research is that the numbers and types of SCs vary based on the multiple dimensions of the symptoms experienced used for SC identification. OBJECTIVE: This study aimed to identify SCs using the ratings of occurrence, severity, and distress in acute myeloid leukemia (AML) patients at three stages of their induction therapy. Then, we compared the consensus between the numbers and types of symptoms in each SC identified by multiple dimensions over time...
January 10, 2019: Journal of Pain and Symptom Management
Caterina Calderon, Pere Joan Ferrando, Urbano Lorenzo-Seva, Oliver Higuera, Teresa Ramon Y Cajal, Jacobo Rogado, Margarida Mut-Lloret, Alejandra Rodriguez-Capote, Carlos Jara, Paula Jimenez-Fonseca
OBJETCTIVES: Decisional regret is an indicator of satisfaction with the treatment decision and can help to identify those patients who need more support and evaluate the efficacy of decision support interventions. The objetives of this study are, 1) to evaluate the psychometric properties of the Decision Regret Scale and 2) to analyze the moderating effect of psychological distress on functional status and regret in patients with cancer following adjuvancy. METHODS: A prospective, multicenter cohort of 403 patients who completed the Decision Regret Scale (DRS), Health-related Quality of Life (EORTC QLQ-C30), and Brief Symptom Inventory (BSI)...
January 10, 2019: Journal of Pain and Symptom Management
Chen Hsiu Chen, Jen-Shi Chen, Fur-Hsing Wen, Wen-Cheng Chang, Wen-Chi Chou, Chia-Hsun Hsieh, Ming-Mo Hou, Siew Tzuh Tang
CONTEXT/OBJECTIVE: Half of advanced cancer patients do not have accurate prognostic awareness (PA). However, few randomized clinical trials (RCTs) have focused on facilitating patients' PA to reduce their life-sustaining treatments (LSTs) at end of life (EOL). To address these issues, we conducted a double-blinded RCT on terminally ill cancer patients. METHODS: Experimental-arm participants received an individualized, interactive intervention tailored to their readiness for advanced care-planning and prognostic information...
January 9, 2019: Journal of Pain and Symptom Management
Andie Bernard
No abstract text is available yet for this article.
January 9, 2019: Journal of Pain and Symptom Management
Magnus Ekström, Marie Williams, Miriam J Johnson, Chao Huang, David C Currow
BACKGROUND: Chronic breathlessness is a cardinal symptom in cardiopulmonary disease where both overall intensity or severity (S) and unpleasantness (U) are commonly quantified. We aimed to evaluate agreement between breathlessness severity and unpleasantness over eight days in patients with chronic breathlessness. METHODS: Longitudinal analysis of 265 patients with chronic breathlessness who rated current overall breathlessness severity and unpleasantness on 0-100mm visual analogue scales (VAS) in the morning and evening over eight days...
January 9, 2019: Journal of Pain and Symptom Management
Margaret I Wallhagen, Christine S Ritchie, Alexander K Smith
CONTEXT: Discussions regarding values and goals of care are central to providing quality palliative care. An inability to hear during these sensitive discussions may significantly impair the quality of care provided yet hearing loss (HL) is not formally addressed in these settings nor in programs designed to assist practitioners gain advanced communication skills. OBJECTIVE: To gain an understanding of hospice and palliative care practitioners' experiences with HL and its impact on the care provided...
January 7, 2019: Journal of Pain and Symptom Management
Adam Houska, Martin Loučka
CONTEXT: The predominating definition of autonomy as a capacity to make an independent rational choice may not be suitable for patients in palliative care. Therefrom arises the actual need for more contextualized perspectives on autonomy to promote the quality of life and satisfaction with care of terminally ill patients. OBJECTIVES: The review aims to develop a theoretical structural model of autonomy at the end of life based on patients' end-of-life care preferences...
January 3, 2019: Journal of Pain and Symptom Management
Zachary R Moore, Nhat-Long Pham, Jennifer Lobo Shah, Lucien Nedzi, Baran D Sumer, Andrew Day, Saad A Khan, David J Sher
CONTEXT: Radiotherapy is highly effective for treating squamous cell carcinoma of the head and neck but is often associated with significant toxicities and severe morbidity. Unplanned emergency department (ED) visits and hospitalizations are common during treatment and come with a substantial financial and health burden as well as the potential for impaired long-term outcomes due to treatment disruption. OBJECTIVES: Identify patient, disease, and treatment characteristics that were associated with ED encounters and admissions...
January 2, 2019: Journal of Pain and Symptom Management
Laura C Prater, Thomas Wickizer, Seuli Bose-Brill
CONTEXT: Opportunities for patients to receive unnecessary, costly and potentially harmful care near the end-of-life abound. Advance care planning (ACP) can help to make this vulnerable period better for patients, caregivers and providers. OBJECTIVE: The objective of this study was to determine whether older age predicted the presence of certain forms of retrievable ACP documentation in the Electronic Health Record (EHR) in a large sample of hospice-referred patients...
January 2, 2019: Journal of Pain and Symptom Management
Andrea Cortegiani, Eugenio Garofalo, Andrea Bruni, Filippo Sanfilippo, Federico Longhini
No abstract text is available yet for this article.
December 27, 2018: Journal of Pain and Symptom Management
Joseph Clark, Amy Barnes, Mike Campbell, Clare Gardiner
CONTEXT: Palliative Care advocates argue that service implementation is feasible in all settings. Yet, services have developed patchily in low and middle-income settings. Beyond Human Development Index indicators, there has been limited engagement with the broader development challenges facing nations tasked with implementing palliative care. OBJECTIVE: To describe how indicators of national development relate to levels of palliative care services in 207 countries around the world...
December 27, 2018: Journal of Pain and Symptom Management
Alexa Kanbergs, Cyrus Ahalt, Irena Stijacic Cenzer, R Sean Morrison, Brie A Williams
CONTEXT: Deaths among incarcerated individuals have steadily increased in the United States, exceeding 5,000 in 2014. Nearly every state has a policy to allow patients with serious life-limiting illness to apply for release from prison or jail to die in the community ("early medical release"). Although studies show these policies are rarely used, patient-level barriers to their use are unknown. OBJECTIVES: To assess incarcerated patients' knowledge of early medical release policies and to identify patient-level barriers to accessing these policies...
December 26, 2018: Journal of Pain and Symptom Management
Hye Yoon Park, Young Ae Kim, Jin-Ah Sim, Jihye Lee, Hyewon Ryu, Jung Lim Lee, Chi Hoon Maeng, Jung Hye Kwon, Yu Jung Kim, Eun Mi Nam, Hyun-Jeong Shim, Eun-Kee Song, Kyung Hae Jung, Eun Joo Kang, Jung Hun Kang, Young Ho Yun
CONTEXT: To respect a patient's wish for end-of-life care, "the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life" was enacted in South Korea in 2016. Current understanding of people who would be involved in advance care planning (ACP) is crucial to disseminate it systematically. OBJECTIVES: To investigate awareness and attitudes toward ACP in South Korea. METHODS: A multicenter, nationwide cross-sectional study was conducted a survey regarding ACP among four groups that would have different positions and experiences: 1,001 cancer patients, 1,006 family caregivers, 928 physicians, and 1,241 members of the general public...
December 26, 2018: Journal of Pain and Symptom Management
Richard Egan
Spirituality is about what is of utmost value, it is a values lens that asks 'what really matters most to me, my family, our community, our country and our world'. This personal reflection comes from a New Zealand academic who works in the spirituality and healthcare research field. While largely biographical, this reflection offers some insight into the New Zealand context and this emergent field.
December 26, 2018: Journal of Pain and Symptom Management
Céline Gélinas, Madalina Boitor, Kathleen A Puntillo, Caroline Arbour, Jane Topolovec-Vranic, Michael D Cusimano, Manon Choinière, David L Streiner
CONTEXT: Many brain-injured patients are unable to self-report their pain during their hospitalization in the intensive care unit (ICU), and existing behavioral pain scales may not be well suited. OBJECTIVES: To describe and compare behaviors in brain-injured patients with different levels of consciousness (LOC) during nociceptive and non-nociceptive care procedures in the ICU, and to examine interrater agreement of individual behaviors as well as discriminative and criterion validation of putative pain behaviors...
December 26, 2018: Journal of Pain and Symptom Management
Mirjam Ekstedt, Tone Rustøen
CONTEXT: Pain management education may improve pain control for some patients, while individual differences exist. OBJECTIVES: To evaluate possible critical components, facilitators and hindrances for improved knowledge about pain management, in not hospitalized adult oncology patients with pain from bone metastasis participating in a pain management intervention. METHODS: This sub-study is a qualitative evaluation of The PRO-SELF© Pain Control Program, tested in a randomized controlled trial...
December 26, 2018: Journal of Pain and Symptom Management
Margot L Schwartz, Julie C Lima, Melissa A Clark, Susan C Miller
CONTEXT: The Nursing Home (NH) culture change (CC) movement, which emphasizes person-centered care, is particularly relevant to meeting the unique needs of residents near the end-of-life (EOL). OBJECTIVES: We aimed to evaluate the NH-reported adoption of person-centered EOL-CC practices and identify NH characteristics associated with greater adoption. METHODS: We used NH and state policy data for 1,358 NHs completing a nationally representative 2016/17 NH Culture Change Survey...
December 19, 2018: Journal of Pain and Symptom Management
Mary Lynn McPherson, Kathryn A Walker, Mellar P Davis, Eduardo Bruera, Akhila Reddy, Judith Paice, Kasey Malotte, Dawn Kashelle Lockman, Charles Wellman, Shelley Salpeter, Nina M Bemben, James B Ray, Bernard J Lapointe, Roger Chou
Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society (APS), College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed...
December 19, 2018: Journal of Pain and Symptom Management
Naoto Kuroda, Hisaya Hiramatsu, Masanori Mori, Tokutaro Tanaka
Trousseau syndrome was first described by Armand Trousseau in 1865 and is characterized by hypercoagulation resulting from malignant tumors. This complication can markedly impact quality of life (QOL). This is the first report of a terminally ill patient who developed large-vessel occlusion stroke from Trousseau syndrome and underwent mechanical thrombectomy. A 75-year-old woman presented with stage IV ovarian cancer. Goals of care were transitioned to palliative care. The patient was hospitalized with vertebral compression fracture, and suddenly developed right hemiparesis and total aphasia during admission...
December 18, 2018: Journal of Pain and Symptom Management
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