Journal of pain and symptom management
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Children with cancer often receive less adequate pain management than adults. This survey was designed to examine current practices, knowledge, and attitudes pertaining to pediatric pain management in China. Based on the choice of opioid use and self-identification as having a conservative or liberal approach to pain management, we identified two clusters. ⋯ Members of cluster 2 (40%) had more liberal attitudes. Four factors predicted conservative membership: never having prescribed opioids for cancer pain (OR=2.67, CI=1.11-6.45), use of placebos for pain management (OR=2.32, CI=1.05-5.08), belief that the adequacy of pain management was fair or good (OR=2.10, CI=1.31-3.37), and belief that children are less sensitive to pain (OR=1.96, CI=1.02-3.76). The top barriers to optimal pediatric pain management were identified as fear of opioid addiction and inadequate knowledge of pain management.
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J Pain Symptom Manage · Aug 2003
My mind is as clear as it used to be: A pilot study illustrating the difficulties of employing a single-item subjective screen to detect cognitive impairment in outpatients with cancer.
Oncology patients often complain that their "mind does not seem to be clear." This subjective perception, sometimes referred to as "chemo brain," may be due to situational stressors, psychological disorders, organic factors, or effects of neurotoxic medications. Cognitive decline cannot only diminish quality of life, but can also interfere with a patient's ability to make decisions regarding complex treatment issues. The current study investigated the utility of using item 11 of the Zung Self-Rating Depression Screen (ZSDS) as a cognitive screen. ⋯ Patients' perceptions of having a cognitive impairment determined by item 11 of the ZSDS was predicted by total score on the ZSDS (F=42.5, P<0.001), age (F=26.0, P<0.001), and score on the Stroop test (F=19.8, P<0.001). Analysis of sensitivity and specificity indicated that the single-item screen used in this study is not an accurate means for identifying oncology patients with actual cognitive impairment. We conclude that while the perception of cognitive impairment is common in cancer patients, there may be problems in interpreting the nature of these complaints, particularly in separating them from depressive preoccupation.
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J Pain Symptom Manage · Aug 2003
Randomized Controlled Trial Multicenter Study Clinical TrialThe efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study.
As an adjunct to standard antiemetics for the relief of chemotherapy-induced nausea and vomiting (NV), 739 patients were randomly assigned to either: 1) acupressure bands, 2) an acustimulation band, or 3) a no band control condition. Patients in the acupressure condition experienced less nausea on the day of treatment compared to controls (P<0.05). There were no significant differences in delayed nausea or vomiting among the three treatment conditions. ⋯ Men in the acustimulation condition, but not the acupressure condition, had less NV compared to controls (P<0.05). No significant differences among the three treatment conditions were observed in women, although the reduction in nausea on the day of treatment in the acupressure, compared to the no band condition, closely approached statistical significance (P=0.052). Expected efficacy of the bands was related to outcomes for the acupressure but not the acustimulation conditions.
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J Pain Symptom Manage · Aug 2003
Nurses' willingness and the predictors of willingness to provide palliative care in rural communities of taiwan.
The aims of this study are to identify the willingness of district nurses to provide palliative care in the rural communities in Taiwan and determine the predictors of this willingness. A questionnaire was sent to all 1,121 community nurses of the 174 government health stations assigned to all the rural areas of Taiwan. The overall response rate was 86.4%, with 940 valid questionnaires retrieved. ⋯ However, regarding the content of services, the willingness to provide home visiting was affected positively by the level of information resources, subjective norms, and the belief in external control by authority. This willingness was negatively affected by age of the patient. These data suggest that effective training courses focused on practical knowledge of palliative care for these district nurses, the incorporation of the palliative care into nursing education, and active health policy administration are critical for the community palliative care movement in Taiwan.