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Journal of Pain and Symptom Management

Leslie P Scheunemann, Ramy Khalil, Padma S Rajagopal, Robert M Arnold
CONTEXT: There are no evidence-based programs to train physicians to facilitate shared decision-making based on incapacitated intensive care unit (ICU) patients' values and preferences. OBJECTIVES: To develop a high-fidelity simulation to fill this gap. METHODS: Case development involved 6 steps: 1) drafting a case about an elderly patient receiving prolonged mechanical ventilation; 2) engaging an expert advisory board to optimize case content; 3) revising the case based on advisory board input; 4) training actors to portray the case patient's daughter; 5) obtaining physician feedback on the simulation; 6) revising the case based on their feedback...
November 5, 2018: Journal of Pain and Symptom Management
Neil Chevli, Gary D Lewis, Todd A Swanson
CONTEXT: Patients with locoregional anal carcinoma who don't qualify for standard definitive chemoradiation are candidates for a short course of palliative hypofractionated radiotherapy such as QUAD Shot. METHODS: A 57-year-old man with massive locoregional squamous cell carcinoma of the anal canal was treated with QUAD Shot (14.8 Gy in 4 fractions over 2 consecutive days) repeated every 4 weeks for a total of 2 courses. RESULTS: He reported symptomatic relief following each course of radiation...
November 4, 2018: Journal of Pain and Symptom Management
Kabir O Olaniran, Shananssa G Percy, Sophia Zhao, Chantal Blais, Vicki Jackson, Mihir M Kamdar, Jeremy Goverman, Daniela Kroshinsky, Jennifer S Temel, Sagar U Nigwekar, Nwamaka D Eneanya
No abstract text is available yet for this article.
November 3, 2018: Journal of Pain and Symptom Management
Yansheng Ye, Dengyan Ma, Huaihong Yuan, Lin Chen, Guorong Wang, Jing Shi, Yan Yu, Yu Guo, Xiaolian Jiang
CONTEXT: Health-related quality of life (QOL) is a recommended clinical tool to assess hemodialysis patients and a primary end point to observe the effectiveness of overall disease management. Empathy is associated with positive outcomes such as pain relief and reduced anxiety and distress. Numerous studies have tested the relationships among empathy, forgiveness and QOL; however, a mechanism of forgiveness has not been fully explored in hemodialysis patients. OBJECTIVES: To test the relationship among empathy and health-related QOL, and confirm the moderating effects of forgiveness on relationship between empathy and health-related QOL among hemodialysis patients...
November 3, 2018: Journal of Pain and Symptom Management
Qingyuan Zhuang, Grace Meijuan Yang, Shirlyn Hui-Shan Neo, Yin Bun Cheung
BACKGROUND: The prevalence and severity of dyspnea increases at the end of life. Many of these patients have difficulty in reporting their symptoms. Accurate surrogate measures are needed for appropriate assessment and treatment. The Respiratory Distress Observation Scale (RDOS) is proposed as a possible scale although more external validation is needed. We set out to validate the RDOS in the context of palliative care patients near the end of life. METHODS: We prospectively studied 122 palliative care patients in a tertiary hospital in Singapore...
November 1, 2018: Journal of Pain and Symptom Management
Matthew E Modes, Ruth A Engelberg, Lois Downey, Elizabeth L Nielsen, J Randall Curtis, Erin K Kross
CONTEXT: Goals-of-care discussions are associated with improved end-of-life care for patients and therefore may be used as a process measure in quality improvement, research, and reimbursement programs. OBJECTIVES: To examine three methods to assess occurrence of a goals-of-care discussion - patient report, clinician report, and documentation in the electronic health record (EHR) - at a clinic visit for seriously ill patients and determine whether each method is associated with patient-reported receipt of goal-concordant care...
October 31, 2018: Journal of Pain and Symptom Management
Robert Gramling, Elizabeth Gajary-Coots, Jenica Cimino, Kevin Fiscella, Ronald Epstein, Susan Ladwig, Wendy Anderson, Stewart C Alexander, Paul K Han, David Gramling, Sally A Norton
CONTEXT: Clinicians frequently overestimate survival time in serious illness. OBJECTIVE: To understand the frequency of overestimation in palliative care (PC) and the relation with end-of-life (EOL) treatment. METHODS: This is a multi-site cohort study of 230 hospitalized patients with advanced cancer who consulted with PC between 2013 and 2016. We asked the consulting PC clinician to make their "best guess" about the patients' "most likely survival time, assuming that their illnesses are allowed to take their natural course...
October 31, 2018: Journal of Pain and Symptom Management
Erica C Kaye, Melanie Gattas, Ashley Kiefer, Jason Reynolds, Kristina Zalud, Chen Li, Zhaohua Lu, Justin N Baker
CONTEXT: Approximately 500,000 children in the United States suffer from life-limiting illnesses each year, many of whom are hospice eligible each year. Few hospice agencies, however, offer formal pediatric programs. OBJECTIVE: To determine the levels of experience and comfort of hospice nurses who provide care to children and families in the community. METHODS: A cross-sectional survey was developed to assess hospice nurse experience/comfort across the domains of symptom management, end-of-life care, goals of care, family-centered care, and bereavement...
October 31, 2018: Journal of Pain and Symptom Management
Andréia Ferreira Nunes, Cristiane Orlanda Bezerra Orlanda, Jaqueline Dos Santos Custódio, Celena Freire Friedrich, Indiara Soares de Oliveira, Adriana Claudia Lunardi
BACKGROUND: The clinimetric properties of the Brief Fatigue Inventory (BFI) were not previously assessed in oncological patients hospitalized for chemotherapy. OBJECTIVE: To assess the reliability and validity of the construct, ceiling and floor effects, and responsiveness of the Brief Fatigue Inventory (BFI) administered to oncological patients hospitalized for chemotherapy. METHODS: This test-retest study included 100 oncological patients hospitalized for chemotherapy...
October 31, 2018: Journal of Pain and Symptom Management
Yinyan Gao, Yanping Wei, Wenjiao Yang, Lili Jiang, Xiuxia Li, Jie Ding, Guowu Ding
CONTEXT: The quality of death has increasingly raised concern because of the physical and psychological suffering of patients with advanced disease. Music therapy has been widely used in palliative care; however, its physical and mental effectiveness remains unclear. OBJECTIVE: To assess the effectiveness of music therapy during palliative care in improving physiology and psychology outcomes. METHODS: Randomized controlled trials evaluating music therapy for terminally ill patients were searched and included from inception up to April 25, 2018...
October 30, 2018: Journal of Pain and Symptom Management
Tracy A Smith, Jane M Ingham, Christine R Jenkins
INTRODUCTION: Non-invasive ventilation(NIV) is commonly used to manage acute respiratory failure due to decompensated cardiorespiratory disease. We describe symptom burden in this population. METHODS: Fifty, consecutive, consenting, English speaking, cognitively intact patients, admitted to wards other than the intensive care unit (ICU) in a tertiary teaching hospital and treated with NIV for hypercapnic respiratory failure, were recruited. The 14-item Condensed Memorial Symptom Assessment Scale was used to assess physical and psychological symptoms within 36 hours of commencing NIV...
October 30, 2018: Journal of Pain and Symptom Management
Sangeeta C Ahluwalia, Christine Chen, Laura Raaen, Aneesa Motala, Anne M Walling, Margaret Chamberlin, Claire O'Hanlon, Jody Larkin, Karl Lorenz, Olamigoke Akinniranye, Susanne Hempel
CONTEXT: Palliative care continues to be a rapidly growing field aimed at improving quality of life for patients and their caregivers. OBJECTIVES: The purpose of this review was to provide a synthesis of the evidence in palliative care to inform the fourth edition of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care. METHODS: Ten key review questions addressing eight content domains guided a systematic review focused on palliative care interventions...
October 26, 2018: Journal of Pain and Symptom Management
Sebastiano Mercadante
No abstract text is available yet for this article.
October 24, 2018: Journal of Pain and Symptom Management
K Clark, C Sheehan, D C Currow
No abstract text is available yet for this article.
October 24, 2018: Journal of Pain and Symptom Management
Amy M Westcott, Daniel R Wolpaw, Janet M Riddle
CONTEXT: Non-physician members of the interprofessional palliative care team often participate in teaching physicians and others in the context of workplace learning due to the interprofessional collaborative nature of the specialty. OBJECTIVE: This pilot study examines the beliefs of the non-physician members of the interprofessional team about teaching physicians-in-training; the disciplinary training and expertise that informs their teaching; and approaches to teaching in the workplace...
October 24, 2018: Journal of Pain and Symptom Management
Raafat M Reyad, Azza F Omran, Dina N Abas, Mahmoud A Kamel, Ehab H Shaker, Jhon Tharwat, Ehab M Reyad, Tarek Hashem
CONTEXT: Chronic post-mastectomy pain syndrome (PMPS) has a considerable negative impact on the quality of life of breast cancer patients. OBJECTIVE: To assess the possible preventive role of perioperative pregabalin in PMPS. METHODS: This randomized controlled study included 200 patients with breast cancer scheduled for elective breast cancer surgery. They were randomly assigned to one of two treatment groups. The Pregabalin Group received 75 mg pregabalin twice daily for 7 days and the Control Group received oral equivalent placebo capsules...
October 22, 2018: Journal of Pain and Symptom Management
Marta Villa-Alcázar, Juan Aboitiz, Camino Bengoechea, Isabel Martínez-Romera, Cristina Martínez-Naranjo, Blanca López-Ibor
No abstract text is available yet for this article.
October 19, 2018: Journal of Pain and Symptom Management
Jessica S Merlin, Kanan Patel, Nicole Thompson, Jennifer Kapo, Frank Keefe, Jane Liebschutz, Judith Paice, Tamara Somers, Joanna Starrels, Julie Childers, Yael Schenker, Christine S Ritchie
CONTEXT: Chronic pain, or pain lasting > 3 months, is common among cancer survivors, who are often prescribed long-term opioid therapy (LTOT). OBJECTIVE: Our objective was to explore palliative care providers' experiences with managing chronic pain in cancer survivors prescribed LTOT, specifically in ambulatory palliative care settings, and their strategies for overcoming challenges. METHODS: We recruited providers through leading national palliative care organizations who manage chronic pain in cancer survivors...
October 17, 2018: Journal of Pain and Symptom Management
Laura C Hanson, Christine E Kistler, Kyle Lavin, Stacey L Gabriel, Natalie C Ernecoff, Feng-Chang Lin, Greg A Sachs, Susan L Mitchell
CONTEXT: Persons with late-stage dementia have limited access to palliative care. OBJECTIVE: To test dementia-specific specialty palliative care triggered by hospitalization. METHODS: This pilot randomized controlled trial enrolled 62 dyads of persons with late-stage dementia and family decision-makers on admission to hospital. Intervention dyads received dementia-specific specialty palliative care consultation plus post-acute transitional care...
October 17, 2018: Journal of Pain and Symptom Management
Sebastiano Mercadante, Claudio Adile, Federica Aielli, Lanzetta Gaetano, Kyriaki Mistakidou, Marco Maltoni, Luiz Guilherme Soares, Stefano De Santis, Patrizia Ferrera, Marta Rosati, Romina Rossi, Alessandra Casuccio
AIM: The aim of this study was to assess the Personalized Dyspnea Intensity Goal, and the achievement of Personalized Goal Response and Patient Global impression, after comprehensive symptom management. The secondary outcome was to assess factors related to personalized goal response. PATIENTS AND METHODS: Advanced cancer patients admitted to palliative care units rated pain and symptoms intensity, and their Personalized Dyspnea Intensity Goal , by using the Edmonton Symptom Assessment Score (ESAS)...
October 15, 2018: Journal of Pain and Symptom Management
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