Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2000
Clinical TrialEffects on cancer patients' health-related quality of life after the start of morphine therapy.
To investigate the effects of morphine on cancer patients' health-related quality of life (HRQL), we prospectively studied 40 cancer patients with moderate or severe pain despite treatment with "weak" opioids. The patients were titrated to pain relief using immediate-release (IR) morphine and then switched to slow-release (SR) morphine in the same daily dosages. HRQL was measured by the European Organization for Research and Treatment of Cancer core quality-of-life questionnaire (EORTC QLQ-C30) before the start of morphine (baseline), after stabilization with IR-morphine, and 3 days after start of SR-morphine. ⋯ Compared to normative data from the general population, physical function, role function, social function, and global health were impaired in the study patients. The patients also suffered more fatigue, pain, nausea/vomiting, appetite loss, and constipation. In conclusion, in cancer patients with reduced HRQL, the start of morphine therapy had no major influence on aspects of HRQL other than pain.
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J Pain Symptom Manage · Jul 2000
Cancer pain education: the use of a structured clinical instruction module to enhance learning among medical students.
The Structured Clinical Instruction Module (SCIM) is an educational format developed for the teaching of clinical and interpersonal skills. The purpose of this study was to develop and pilot-test a SCIM to enhance medical students' learning and understanding about cancer pain assessment and management. The Cancer Pain SCIM was presented to 34 third-year medical students. ⋯ D.)] very strongly that the SCIM was a valuable educational experience [4.4 (0.56)] and that it was beneficial to use actual cancer patients in the SCIM [4.5 (0.63)]. Students believed their skills in the assessment and management of cancer pain significantly improved after the course. The SCIM is a valuable and novel instructional format to teach essential skills in the assessment and management of cancer pain to medical students.
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J Pain Symptom Manage · Jul 2000
Clinical TrialAllodynia and pinprick hypesthesia in acute herpes zoster, and the development of postherpetic neuralgia.
Sensory loss and allodynia are hallmark signs of postherpetic neuralgia (PHN). We set out to investigate how frequently these signs are present in patients with acute herpes zoster (HZ) and what their prognostic value might be. We assessed pain, mechanical allodynia, and sensitivity to pinprick in 113 immunocompetent patients with HZ of a median duration of 5 days. ⋯ Mechanical allodynia and pinprick hypesthesia were strongly associated with the development of PHN. They merit addition to the list of potential risk factors for PHN although they cannot be used as a predictive rule for an individual patient. By contrast, lack of allodynia in the early stages of HZ predicts good recovery by three months.