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Journal of Pain and Symptom Management

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https://www.readbyqxmd.com/read/28923527/symptom-intensity-of-hospice-patients-a-longitudinal-analysis-of-concordance-between-patients-and-nurses-outcomes
#1
Everlien de Graaf, Daniëlle Zweers, Alexander de Graeff, Rebecca K Stellato, Saskia Teunissen
Nearing death, hospice patients are increasingly unable or unwilling to self-report their symptom intensity and rely on nurses' assessments. We hypothesized that concordance between patients' and nurses' assessments of symptom intensity improves over time. METHOD: A prospective longitudinal study was conducted from January 2012 to June 2015 using dyads of patients' and nurses' reported outcome measures, collected in daily hospice practice in the first three weeks after admission. Main outcomes were symptom intensity and well-being, measured using the Utrecht Symptom Diary (USD) and USD-Professional (USD-P)...
September 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28923526/results-of-a-double-blind-randomized-placebo-controlled-study-of-nabiximols-oromucosal-spray-as-adjunctive-therapy-in-advanced-cancer-patients-with-chronic-uncontrolled-pain
#2
Aron H Lichtman, Eberhard Albert Lux, Robert McQuade, Sandro Rossetti, Raymond Sanchez, Wei Sun, Stephen Wright, Elena Kornyeyeva, Marie T Fallon
CONTEXT: Prior phase 2/3 studies found that cannabinoids might provide adjunctive analgesia in advanced cancer patients with uncontrolled pain. OBJECTIVE: To assess adjunctive nabiximols (Sativex(®)), an extract of Cannabis sativa containing two potentially therapeutic cannabinoids (Δ9-tetrahydrocannabinol [27 mg/mL] and cannabidiol [25mg/mL]), in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy. METHODS: Phase 3, double-blind, randomized, placebo-controlled trial in patients with advanced cancer and average pain NRS scores ≥ 4 and ≤ 8 despite optimized opioid therapy...
September 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28919541/drugs-for-treating-opioid-induced-constipation-a-mixed-treatment-comparison-network-meta-analysis-of-randomized-controlled-clinical-trials
#3
Kannan Sridharan, Gowri Sivaramakrishnan
CONTEXT: Opioid-induced constipation is a common problem associated with chronic use of opioid analgesics. OBJECTIVES: To compare available interventions for the treatment of opioid-induced constipation, using principles of network meta-analysis. METHODS: Electronic databases were searched for randomized controlled clinical trials evaluating drugs used in opioid induced constipation. Number of patients with rescue-free bowel movements (RFBM) was the primary outcome and time for achieving RFBM, adverse events and changes in the analgesic activity of the opioid analgesics were the secondary outcomes...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28919540/changes-in-nurses-knowledge-difficulties-and-self-reported-practices-toward-palliative-care-for-cancer-patients-in-japan-an-analysis-of-two-nationwide-representative-surveys-in-2008-and-2015
#4
Yoko Nakazawa, Masahi Kato, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa
CONTEXT: The Cancer Control Act was passed in Japan in 2007, and various additional programs on palliative care have been implemented to improve quality of life and relieve pain and suffering in patients with cancer. However, how clinical settings have changed remains unclear. OBJECTIVES: The primary aim of the present study was to determine changes in nurses' palliative care knowledge, difficulties, and self-reported practices between 2008 and 2015. METHODS: This study was an analysis of two nationwide observational studies from 2008 and 2015...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28919539/the-nexus-between-the-documentation-of-end-of-life-wishes-and-awareness-of-dying-a-model-for-research-education-and-care
#5
Deborah P Waldrop, Jacqueline M McGinley, Brian Clemency
The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision-making into sharp focus. Communication between families and clinicians can be confusing, uncertain and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This paper presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28917672/corticosteroids-as-co-analgesics-with-opioids-for-cancer-related-pain-a-feasibility-study
#6
LETTER
Amna Ashar, Amanda Fischer, Janet Hardy, Phillip Good
No abstract text is available yet for this article.
September 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916295/utilization-of-hospice-services-in-a-population-of-patients-with-huntington-s-disease
#7
Margaret O Johnson, Samuel Frank, Matthew Mendlik, David Casarett
CONTEXT: Although the early and middle stages of Huntington's Disease (HD) and its complications have been well described, less is known about the course of late-stage illness. In particular, little is known about the population of patients who enroll in hospice. OBJECTIVES: Our goal is to describe the characteristics of patients with HD who enrolled in hospice. METHODS: Retrospective cohort study of electronic medical record data from 12 not-for-profit hospices in the United States from 2008 to 2012...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916294/characteristics-of-older-adults-in-primary-care-who-may-benefit-from-primary-palliative-care-in-the-united-states
#8
Nancy Dudley, Christine S Ritchie, Margaret I Wallhagen, Kenneth E Covinsky, Bruce A Cooper, Kanan Patel, Irena Stijacic-Cenzer, Susan A Chapman
CONTEXT: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. OBJECTIVES: To describe U.S. primary care visits among adults 65 years and older with advanced illness. METHODS: Cross-sectional analysis of the National Ambulatory and Hospital Ambulatory Medical Care Surveys (2009-2011) was conducted using chi-square tests to compare visits without and with advanced illness to U...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#9
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916292/response
#10
LETTER
Cui-Ping Xu
No abstract text is available yet for this article.
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916291/re-association-of-inflammatory-cytokines-with-the-symptom-cluster-of-pain-fatigue-depression-and-sleep-disturbance-in-chinese-patients-with-cancer
#11
LETTER
Tomoyuki Kawada
No abstract text is available yet for this article.
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28887271/comparing-the-palliative-care-needs-of-patients-with-hematologic-and-solid-malignancies
#12
Michael J Hochman, Yinxi Yu, Steven P Wolf, Greg P Samsa, Arif H Kamal, Thomas W LeBlanc
CONTEXT: Hematologic cancer patients use palliative care services less frequently than their solid tumor counterparts. Prior work suggests these patients have a sizeable symptom burden, but comparisons between hematologic and solid tumor patients near the end of life are limited. OBJECTIVES: To compare unmet symptom needs in a cohort of hematologic and solid tumor patients referred to specialty palliative care services. METHODS: Using a novel data registry of initial palliative care encounters, we performed a cross-sectional analysis of cancer patients receiving care across seventeen sites within the Global Palliative Care Quality Alliance...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28887270/temporal-trends-between-2010-and-2015-in-intensity-of-care-at-end-of-life-for-patients-with-chronic-illness-influence-of-age-under-versus-over-65-years
#13
Seelwan Sathitratanacheewin, Ruth A Engelberg, Lois Downey, Robert Y Lee, James A Fausto, Helene Starks, Ben Dunlap, James Sibley, William Lober, Elizabeth T Loggers, Nita Khandelwal, J Randall Curtis
CONTEXT: Recent analyses of Medicare data show decreases over time in intensity of end-of-life care. Few studies exist regarding trends in intensity of end-of-life care for those under 65. OBJECTIVES: To examine recent temporal trends in place of death, and both hospital and ICU utilization, for age-stratified decedents with chronic, life-limiting diagnoses (<65 versus ≥65 years) who received care in a large healthcare system. METHODS: Retrospective cohort using death certificates and electronic health records for 22,068 patients with chronic illnesses who died between 2010 and 2015...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28887269/which-physicians-behaviors-on-death-pronouncement-affect-family-perceived-physician-compassion-a-randomized-scripted-video-vignette-study
#14
Masanori Mori, Maiko Fujimori, Jun Hamano, Akemi Shirado Naito, Tatsuya Morita
CONTEXT: Although the death of a loved one is a devastating family event, little is known about which behaviors positively affect families' perceptions on death pronouncements. OBJECTIVES: To evaluate the effect of a compassionate death pronouncement on participant-perceived physician compassion, trust in physicians, and emotions. METHODS: In this randomized, video-vignette study, 92 people (≥50 years) in Tokyo metropolitan area viewed two videos of death pronouncements by an on-call physician with or without compassion-enhanced behaviors, including 5 components: waiting until the families calm themselves down; explaining that the physician has received a sign-out about information of the patient's condition; performing examination respectfully; ascertaining the time of death with a wristwatch (vs...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28887268/association-of-advance-directives-completion-with-the-utilization-of-life-sustaining-treatments-during-the-end-of-life-care-in-older-patients
#15
Yung-Feng Yen, Li-Ying Huang, Hsiao-Yun Hu, Wen-Jung Sun, Ming-Chung Ko, Ya-Ling Lee, Sheng-Jean Huang, Dachen Chu
CONTEXT: Evidence is mixed regarding the impact of advance directives (AD) on the utilisation of end-of-life treatments. OBJECTIVES: This study evaluated the effect of AD on the utilization of end-of-life treatments during the last month of life in older patients. METHODS: Taipei City Hospital initiated an advance care planning (ACP) program to promote AD for admitted patients in 2015. This prospective study recruited deceased older patients who completed ACP communication between 2015 and 2016...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28887267/patterns-and-outcomes-of-care-in-children-with-advanced-heart-disease-receiving-palliative-care-consultation
#16
Katherine L Marcus, Emily M Balkin, Hasan Al-Sayegh, Elyssa Guslits, Elizabeth D Blume, Clement Ma, Joanne Wolfe
CONTEXT: While access to subspecialty pediatric palliative care (PPC) is increasing, little is known about the role of PPC for children with advanced heart disease (AHD). OBJECTIVES: To examine features of subspecialty PPC involvement for children with AHD. METHODS: Retrospective single-institution medical record review of patients with a primary diagnosis of AHD for whom the PPC team was initially consulted between 2011 and 2016. RESULTS: Among 201 patients, 87% had congenital/structural heart disease, the remainder having acquired/non-structural heart disease...
September 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28870800/cancer-pain-with-a-neuropathic-component-a-cross-sectional-study-of-its-clinical-characteristics-associated-psychological-distress-treatments-and-predictors-at-referral-to-a-cancer-pain-clinic
#17
Paulo Reis-Pina, Anand Acharya, Peter G Lawlor
CONTEXT: In patients with cancer pain, identifying a neuropathic pain component (NPC) may inform the selection of subsequent therapeutic interventions. OBJECTIVES: To determine the prevalence, clinical characteristics, associated psychological distress, pre-referral treatment, and predictors of cancer pain with a NPC in patients referred to a cancer pain clinic. METHODS: Participants had standard assessments and documentation: Brief Pain Inventory ratings; presence of a NPC, based on a DN4 (neuropathic pain screening scale) score ≥4 combined with a physician's clinical assessment (blinded to DN4 result); the Hospital Anxiety Depression Scale (HADS) and Emotional Thermometer scores...
September 1, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28870799/cranial-electrotherapy-stimulation-for-the-management-of-depression-anxiety-sleep-disturbance-and-pain-in-patients-with-advanced-cancer-a-preliminary-study
#18
Sriram Yennurajalingam, Duck-Hee Kang, Wen-Jen Hwu, Nikhil S Padhye, Charles Masino, Seyedeh S Dibaj, Diane D Liu, Janet L Williams, Zhanni Lu, Eduardo Bruera
CONTEXT: Cranial Electrotherapy Stimulation (CES) is a safe modulation of brain activity for treating depression, anxiety, insomnia, and pain. However, there are no published studies in patients with advanced cancer (ACP). OBJECTIVES: The aim of the study was to determine the feasibility and preliminary efficacy of a 4-week CES intervention on depression, anxiety, sleep disturbance, and pain scores. Concurrent salivary biomarker studies were conducted. METHODS: In this one group open label pre- and post-intervention study with a 4-week CES intervention, ACP's with one or more of four moderate intensity (≥3/10) ESAS symptoms (depression, anxiety, sleep disturbance, and pain) were eligible...
September 1, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28867461/the-development-of-practice-guidelines-for-a-palliative-care-multidisciplinary-case-conference
#19
Matthew Furman, Laura Harild, Michael Anderson, Jonathan Irish, Karen Nguyen, Frances Wright
BACKGROUND: In Ontario, we identified that few hospitals have developed multi-disciplinary case conferences or forums for discussion of patients with palliative care issues. OBJECTIVE: We describe the process of creating a province-wide standards document for palliative care Multidisciplinary Case Conferences (pMCCs). DESIGN: and setting: A provincial survey as well as a multidisciplinary cancer conference symposium identified pMCCs as a priority...
August 31, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28865872/reliability-and-validity-of-the-korean-memorial-symptom-assessment-scale-short-form-in-gynecological-cancer-patients
#20
Ju-Hee Nho, Sung Reul Kim, Victor T Chang, Joo-Hyun Nam
OBJECTIVES: The aim of the present study was to validate the Korean-version MSAS-SF in patients with gynecologic cancer. METHODS: We translated the MSAS-SF into Korean and 175 gynecologic cancer inpatients completed the MSAS-SF, Functional Assessment Cancer Therapy-General (FACT-G), and gathered demographic and clinical data and Karnofsky Performace Status (KPS). Reliability was assessed for internal consistency with Cronbach's alpha coefficient. Pearson's correlation coefficient was calculated between the MSAS-SF and FACT-G subscales for convergent validity...
August 30, 2017: Journal of Pain and Symptom Management
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