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Journal of Pain and Symptom Management

Marilyn Herleth
No abstract text is available yet for this article.
October 20, 2016: Journal of Pain and Symptom Management
Stephen R Connor, Julia Downing, Joan Marston
CONTEXT: The need for children's palliative care (CPC) globally is unknown. In order to understand the scope of the need and to advocate to meet it, more accurate estimates are needed. OBJECTIVES: To create an accurate global estimate of the worldwide need for CPC based on a representative sample of countries from all regions of the world and all World Bank income groups. METHODS: This work builds on previously published methods developed by the International Children's Palliative Care Network, UNICEF, and WHO and tested in three African countries...
October 17, 2016: Journal of Pain and Symptom Management
Sheng-Yu Fan, I-Mei Lin, Jyh-Gang Hsieh, Chih-Jung Chang
CONTEXT: Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. OBJECTIVE: The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from psychosocial care professionals. METHODS: A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited...
October 15, 2016: Journal of Pain and Symptom Management
Kelsey M Flint, Sarah J Schmiege, Larry A Allen, Timothy J Fendler, John Rumsfeld, David Bekelman
CONTEXT: Health status (i.e., symptoms, function, and quality of life) is an important palliative care outcome in patients with heart failure, however patterns of health status over time (i.e. trajectories) are not well described. OBJECTIVES: To identify health status trajectories in outpatients with heart failure, and assess whether depression, symptom burden, or sense of peace predict health status trajectory. METHODS: Observational study utilizing data from the Patient-Centered Disease Management for Heart Failure trial...
October 15, 2016: Journal of Pain and Symptom Management
Tatsuya Morita, Kengo Imai, Naosuke Yokomichi, Masanori Mori, Yoshiyuki Kizawa, Satoru Tsuneto
Continuous deep sedation until death (CDS) is a type of palliative sedation therapy, and it has recently become a focus of intense debate. Marked inconsistencies in intervention procedures (i.e., what is CDS?) and unstandardized descriptions of patient backgrounds lead to difficulty in comparing the results in the literature. The primary aim of this paper was to propose a conceptual framework to perform empirical studies on CDS. We propose the definition of CDS using the intervention protocol. As there are two types of CDS proposed in world-wide literature, we recommend to prepare two types of intervention protocol for CDS: "continuous deep sedation as a result of proportional sedation" (gradual CDS), and "continuous deep sedation to rapidly induce unconsciousness" (rapid CDS)...
October 13, 2016: Journal of Pain and Symptom Management
Joseph Arthur, Sriram Yennu, Kresnier Perez Zapata, Hilda Cantu, Jimin Wu, Diane Liu, Eduardo Bruera
BACKGROUND: Data on the use of question prompt sheets (QPS) in palliative care is limited. Our team previously developed a single page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients. METHODS: 100/104(96%) eligible patients and 68/68(100%) caregivers received the QPS during their first palliative care clinic. 12 palliative medicine specialists also participated in the study...
October 12, 2016: Journal of Pain and Symptom Management
John G Cagle, Philip Osteen, Paul Sacco, Jodi Jacobson Frey
CONTEXT: Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patient's comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES: To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS: Using a clustered random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake...
October 12, 2016: Journal of Pain and Symptom Management
Sophie Robinson, David W Kissane, Joanne Brooker, Courtney Hempton, Susan Burney
CONTEXT: The risk of suicide is elevated in palliative care patients compared to the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth have been associated with a desire to hasten death. OBJECTIVES: The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death...
October 12, 2016: Journal of Pain and Symptom Management
Markus K Schuler, Leopold Hentschel, Wadim Kisel, Michael Kramer, Felicitas Lenz, Beate Hornemann, Julia Hoffmann, Stephan Richter, Gerhard Ehninger, Martin Bornhäuser, Frank Kroschinsky
CONTEXT: Physical exercise can alleviate cancer related fatigue. Randomized controlled trials (RCT) in patients with advanced cancer are scarce. OBJECTIVES: We test the impact of a structured, individual sports program on fatigue in patients with advanced cancer. METHODS: 77 patients were invited to participate in this RCT exploring the effects of physical exercises on fatigue 12 and 24 weeks after baseline. Patients were randomized into three groups...
October 12, 2016: Journal of Pain and Symptom Management
Ernesto Zecca, Cinzia Brunelli, Paola Bracchi, Giuseppe Biancofiore, Carlo De Sangro, Roberto Bortolussi, Luigi Montanari, Marco Maltoni, Cecilia Moro, Ugo Colonna, Gabriele Finco, Maria Teresa Roy, Vittorio Ferrari, Oscar Alabiso, Giovanni Rosti, Stein Kaasa, Augusto Caraceni
: Context Oxycodone and morphine are recommended as first-choice opioids for moderate/severe cancer pain but evidence about their relative tolerability has significant methodological limitations. OBJECTIVES: This study is mainly aimed at comparing the risk of developing adverse events (AEs) with controlled release oral morphine versus oxycodone; secondary aims were comparing their analgesic efficacy and testing heterogeneity in tolerability across different age and renal function subgroups...
October 11, 2016: Journal of Pain and Symptom Management
Jeanne Kerwin
No abstract text is available yet for this article.
October 7, 2016: Journal of Pain and Symptom Management
Vincent Maida
No abstract text is available yet for this article.
October 7, 2016: Journal of Pain and Symptom Management
Joakim Öhlén, Lara Russell, Cecilia Håkanson, Anette Alvariza, Carl Johan Fürst, Kristofer Årestedt, Richard Sawatzky
CONTEXT: Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people in order to understand and evaluate symptom relief as an indicator of quality of care at end of life. OBJECTIVES: The aims of this study were to distinguish classes of patients who have different symptom relief patterns during the last week of life and to identify predictors of these classes in an adult register population...
October 7, 2016: Journal of Pain and Symptom Management
Gail Ewing, Clarissa Penfold, John Benson, Ravi Mahadeva, Sophie Howson, Julie Burkin, Sara Booth, Roberta Lovick, David Gilligan, Christopher Todd, Morag Farquhar
CONTEXT: Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease which focus on symptoms are scarce and absent for breathlessness. OBJECTIVES: To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness and relevant outcomes for a future randomised controlled trial (RCT) of an educational intervention for carers...
October 7, 2016: Journal of Pain and Symptom Management
Teresa L Hagan, Joel N Fishbein, Ryan D Nipp, Jamie M Jacobs, Lara Traeger, Kelly E Irwin, William F Pirl, Joseph A Greer, Elyse R Park, Vicki A Jackson, Jennifer S Temel
CONTEXT: Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple, distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. OBJECTIVES: We sought to validate seven subscales of the Brief COPE in a large sample of patients newly diagnosed with incurable lung and non-colorectal gastrointestinal cancers (N=350)...
October 7, 2016: Journal of Pain and Symptom Management
Richard R Reich, Cecile A Lengacher, Carissa B Alinat, Kevin E Kip, Carly Paterson, Sophia Ramesar, Heather S Han, Roohi Ismail-Khan, Versie Johnson-Mallard, Manolete Moscoso, Pinky Budhrani-Shani, Steve Shivers, Charles E Cox, Matthew Goodman, Jong Park
CONTEXT: Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biological and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters. OBJECTIVES: The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program...
October 5, 2016: Journal of Pain and Symptom Management
Susan Enguidanos, Jennifer Ailshire
CONTEXT: Given recent Medicare rules reimbursing clinicians for engaging in advance care planning, there is heightened need to understand factors associated with the timing of advance directive (AD) completion before death and how the timing impacts care decisions. OBJECTIVE: The purpose of this study is to investigate patterns in timing of AD completion and the relationship between timing and documented care preferences. We hypothesize that ADs completed late in the course of illness or very early in the disease trajectory will reflect higher preferences for aggressive care...
October 5, 2016: Journal of Pain and Symptom Management
Daryl Bainbridge, Deanna Bryant, Hsien Seow
INTRODUCTION: Measuring palliative care experience using patient-reported outcomes is becoming important for assessing and improving quality, though most validated outcome tools solely use scaled questions. We analyzed open text survey responses from bereaved caregivers to identify strengths and weaknesses in the quality of end-of-life care services and to assess the usefulness of qualitative survey data for quality improvement. METHODS: This was a retrospective observational study involving bereaved caregivers of decedents who had received palliative homecare services in one of six healthcare regions in Ontario, Canada...
October 5, 2016: Journal of Pain and Symptom Management
Robert J Zalenski, Spencer S Jones, Cheryl Courage, Denise R Waselewsky, Anna S Kostaroff, David Kaufman, Afzal Beemath, John Bronfman, James W Castillo, Hicham Krayem, Anthony Marinelli, Bradley Milner, Maria Teresa Palleschi, Mona Tareen, Sheri Testani, Ayman Soubani, Julie Walch, Judy Wheeler, Sonali Wilborn, Hanna Granovsky, Robert D Welch
CONTEXT: There are few multi-center studies that examine the impact of systematic screening for palliative care and specialty consultation in the ICU. OBJECTIVE: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria. METHODS: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was utilized to estimate the conditional probability of receiving a PCC and to balance important covariates...
October 5, 2016: Journal of Pain and Symptom Management
Alexia M Torke, Patrick Monahan, Christopher M Callahan, Paul R Helft, Greg A Sachs, Lucia D Wocial, James E Slaven, Kianna Montz, Lev Inger, Emily Burke
CONTEXT: Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. OBJECTIVES: To validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers and health systems. METHODS: After expert review and cognitive interviewing (n=10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 and older from three hospitals in one metropolitan area...
October 5, 2016: Journal of Pain and Symptom Management
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