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Journal of Pain and Symptom Management

Jun Kako, Tatsuya Morita, Takuhiro Yamaguchi, Masamitsu Kobayashi, Asuko Sekimoto, Hiroya Kinoshita, Asao Ogawa, Sadamoto Zenda, Yosuke Uchitomi, Hironobu Inoguchi, Eisuke Matsushima
CONTEXT: Dyspnea is a common distressing symptom among patients with advanced cancer. OBJECTIVE: To determine the effect of fan therapy on dyspnea in terminally ill cancer patients. METHODS: This parallel arm, randomized controlled trial included 40 patients with advanced cancer from a palliative care unit at the National Cancer Center Hospital in Japan. All patients experienced dyspnea at rest with a score of at least 3 points on a subjective 0-10-point numerical rating scale (NRS), showed peripheral oxygen saturation levels of ≥90%, an Eastern Cooperative Oncology Group grade of 3 or 4, and were aged 20 years or more...
July 12, 2018: Journal of Pain and Symptom Management
Cristini Klein, Wolnei Caumo, Céline Gélinas, Valéria Patines, Tatiana Pilger, Alexandra Lopes, Fabiane Neiva Backes, Débora Feijó Villas-Boas, Silvia Regina Rios Vieira
CONTEXT: The Behavioral Pain Scale (BPS) or the Critical-Care Pain Observation Tool (CPOT) are recommended in practice guidelines for pain assessment in critically ill adults unable to self-report. However, their use in another language requires cultural adaptation and validation testing. OBJECTIVES: Cross-cultural adaptation of the CPOT and the BPS English versions into Brazilian Portuguese, and their validation by comparing behavioral scores during rest, standardized nociceptive stimulation by pressure algometry (SNSPA) and turning were completed...
July 12, 2018: Journal of Pain and Symptom Management
Chandana Banerjee
No abstract text is available yet for this article.
July 12, 2018: Journal of Pain and Symptom Management
Sigrid Dierickx, Joachim Cohen, Robert Vander Stichele, Luc Deliens, Kenneth Chambaere
CONTEXT: - According to guideline recommendations, barbiturates and neuromuscular relaxants are the recommended drugs for euthanasia. OBJECTIVES: - To describe changes over time in drugs used to perform euthanasia and differences in case characteristics according to the drugs used. METHODS: - Repeated population-based mortality follow-back study among physicians attending a large representative sample of deaths in 1998, 2007 and 2013 in Flanders, Belgium...
July 12, 2018: Journal of Pain and Symptom Management
Victoria L Allgar, Hong Chen, Ed Richfield, David Currow, Una Macleod, Miriam J Johnson
BACKGROUND: The assessment of patients' needs for care is a critical step in achieving patient-centred cancer care. Tools can be used to assess needs and inform care planning. The Needs Assessment Tool: Progressive Disease- Cancer (NAT: PD-C) is an Australian oncology clinic tool for assessment by clinicians of patients' and carers' palliative care needs. This has not been validated in the UK Primary Care setting. AIM: To test the psychometric properties and acceptability of a UK primary-care adapted NAT:PD-C...
July 12, 2018: Journal of Pain and Symptom Management
Linda Nguyen, Paul J Hutchison
No abstract text is available yet for this article.
June 28, 2018: Journal of Pain and Symptom Management
Robrecht De Schreye, Tinne Smets, Luc Deliens, Lieven Annemans, Birgit Gielen, Joachim Cohen
INTRODUCTION: Large-scale evaluations of the quality of end-of-life care in people with COPD are lacking. By means of a validated set of quality indicators, this study aims to: 1. Assess appropriateness of end-of-life care in people dying from COPD, 2. Examine variation between care regions, 3. Establish performance standards. METHODS: We conducted a retrospective observational study of all deaths from COPD (ICD10 codes J41-J44) in 2012 in Belgium, using data from administrative population-level databases...
June 27, 2018: Journal of Pain and Symptom Management
Joseph Clark, Amy Barnes, Clare Gardiner
CONTEXT: The World Health Assembly Palliative Care Resolution in 2014 and the inclusion of palliative care within the Sustainable Development Goals raised optimism that palliative care would no longer be a peripheral aspect of global health. However, no funding, accountability measures or indicators for palliative care development accompanied these policy developments. This risks health actors continuing to prioritise the attainment of better known, target-driven aspects of healthcare...
June 25, 2018: Journal of Pain and Symptom Management
Franchesca Hwang, Christine Boardingham, Susanne Walther, Molly Jacob, Andrea Hidalgo, Chirag D Gandhi, Anne C Mosenthal, Sangeeta Lamba, Ana Berlin
CONTEXT: Few patients with dysphagia due to stroke receive early palliative care to align treatment goals with their values, as called for by practice guidelines, particularly before enteral access procedures for artificial nutrition. OBJECTIVES: To increase documented goals of care (GOC) discussions among acute stroke patients prior to feeding gastrostomy tube placement. METHODS: We undertook a rapid-cycle continuous quality improvement (CQI) process with interdisciplinary planning, implementation, and performance review to operationalize an upstream trigger for palliative care referral prompted by the speech and language pathology evaluation...
June 25, 2018: Journal of Pain and Symptom Management
Abby R Rosenberg
No abstract text is available yet for this article.
June 22, 2018: Journal of Pain and Symptom Management
Hillary D Lum, Deborah E Barnes, Mary T Katen, Ying Shi, John Boscardin, Rebecca L Sudore
CONTEXT: Advance care planning (ACP) engagement includes a wide range of behaviors and actions related to discussions and documentation, yet few ACP intervention studies measure the full process. OBJECTIVES: To compare the effects of an easy-to-read advance directive (AD) versus an ACP website plus the AD (PREPARE+AD) on behavior change processes and actions, including discussions and documentation. METHODS: Secondary data were from a completed ACP trial...
June 22, 2018: Journal of Pain and Symptom Management
Elise C Carey, Miguel Paniagua, Laura J Morrison, Stacie K Levine, Jeffrey C Klick, Gary T Buckholz, Joseph Rotella, Julie Bruno, Solomon Liao, Robert M Arnold
BACKGROUND: We reviewed USMLE Step examinations for palliative care (PC) content, assessing whether they tested PC knowledge necessary for graduating medical students and residents applying for licensure. METHODS: Eight PC physicians reviewed three complete examination forms and a focused 509-item bundle of multiple-choice questions (MCQs) identified by the USMLE content outline as potentially assessing PC content. Reviewers determined MCQs to be PC items if the patient was seriously ill and PC knowledge was required to answer correctly...
June 21, 2018: Journal of Pain and Symptom Management
Sumytra Menon, Marijke C Kars, Chetna Malhotra, Alastair V Campbell, Johannes J M van Delden
CONTEXT: Advance care planning (ACP) has been shown to improve end-of-life care, but it was developed in the U.S., and most research has been conducted in western communities. OBJECTIVES: We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses, and medical social workers regarding ACP in a multicultural family centric community. METHODS: We conducted an explorative qualitative study, using focus groups and individual in-depth interviews...
June 20, 2018: Journal of Pain and Symptom Management
Tatiana Talya Fleishman, Jacob Dreiher, Pesach Shvartzman
CONTEXT: Pain is a common complaint in maintenance hemodialysis (MHD) patients yet is often inadequately assessed and undertreated. OBJECTIVES: The objective of this study was to evaluate the prevalence, characteristics, intensity, and impact of pain in MHD patients. METHODS: In a cross-sectional study conducted between 2013 and 2015, 336 MHD patients from five hemodialysis units in hospitals owned by Clalit were interviewed and evaluated...
June 20, 2018: Journal of Pain and Symptom Management
Nobuyuki Yotani, Yoshiyuki Kizawa
CONTEXT: According to the International Observatory on End of Life Care, the level of pediatric palliative care in Japan is Level 2 (capacity building) and the current status of palliative care for children in Japan has not been clarified. OBJECTIVES: To clarify the availability and utilization of specialist palliative care services among children with life-threatening conditions in Japan. METHODS: A questionnaire was administered to assess the availability of specialist palliative care services among children with life-threatening conditions...
June 14, 2018: Journal of Pain and Symptom Management
Caterina Calderón, Paula Jimenez-Fonseca, Carlos Jara, Raquel Hernández, Eva Martínez de Castro, Sonal Varma, Ismael Ghanem, Alberto Carmona-Bayonas
CONTEXT: Patients with gastrointestinal cancers are at high risk for functional problems that are generally accompanied by a decline in their overall status and intense psychological distress. OBJECTIVES: This study compares the level of functioning in individuals with gastric cancer (GC) and colorectal cancer (CRC) and analyzes whether improved functioning can be explained by patients' psychological status and coping strategies. METHODS: This is a prospective, transversal, multicenter study in patients with nonmetastatic GC and CRC before initiating adjuvant chemotherapy...
June 13, 2018: Journal of Pain and Symptom Management
Lodovico Balducci
Cancer is a major cause of morbidity and mortality for older individuals. Palliative care is essential to improve the outcome of cancer treatment in terms of quality of life and treatment satisfaction. This review examines the influence of spirituality on aging in general and on the management of older cancer patients. A spiritual perspective has been associated with successful aging, and with better tolerance of physical and emotional stress, including the ability to cope with serious diseases and with isolation...
June 13, 2018: Journal of Pain and Symptom Management
Andie Bernard
No abstract text is available yet for this article.
June 11, 2018: Journal of Pain and Symptom Management
Alison E Turnbull, Sarina K Sahetya, Elizabeth Colantuoni, Josephine Kweku, Roozbeh Nikooie, J Randall Curtis
CONTEXT: Goal-concordant care has been identified as an important outcome of advance care planning and shared decision-making initiatives. However validated methods for measuring goal-concordance are needed. OBJECTIVES: To estimate the inter-rater reliability of senior critical care fellows rating the goal-concordance of preference-sensitive interventions performed in intensive care units (ICUs) while considering patient-specific circumstances as described in a previously-proposed methodology...
June 11, 2018: Journal of Pain and Symptom Management
Kristof Faes, Joachim Cohen, Lieven Annemans
CONTEXT: Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC. AIM: To describe end-of-life resource use in people diagnosed with COPD and compare this resource use between those dying of COPD, CVD and LC...
June 11, 2018: Journal of Pain and Symptom Management
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