Journal of pain and symptom management
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J Pain Symptom Manage · May 2009
Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability.
This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting for six months or longer. ⋯ Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.
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J Pain Symptom Manage · May 2009
Clinical TrialSymptom prevalence and longitudinal follow-up in cancer outpatients receiving chemotherapy.
Palliative care for cancer patients receiving chemotherapy in the outpatient setting is important. The aims of this study were 1) to identify symptom prevalence and intensity in cancer patients receiving chemotherapy and 2) to describe longitudinal follow-up data obtained from repeated assessment using the distress thermometer (DT). Questionnaires were distributed to consecutive cancer outpatients newly starting chemotherapy at the first appointment and at every hospital visit. ⋯ Frequent symptoms experienced by cancer outpatients receiving chemotherapy may be categorized as: 1) psychosocial issues (insomnia, psychological distress, decision-making support); 2) nutrition-gastrointestinal issues (oral problems, appetite loss, nausea); 3) fatigue; and 4) pain, dyspnea, and numbness. Developing a systematic intervention program targeting these four areas is urgently required. The DT score may be highly influenced by coexisting physical symptoms, and future studies to develop an appropriate system to identify patients with psychiatric comorbidity are necessary.
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J Pain Symptom Manage · May 2009
Clinical TrialConsistent and breakthrough pain in diverse advanced cancer patients: a longitudinal examination.
Although cancer pain, both consistent and breakthrough pain ([BTP]; pain flares interrupting well-controlled baseline pain), is common among cancer patients, its prevalence, characteristics, etiology, and impact on health-related quality of life (HRQOL) are poorly understood. This longitudinal study examined the experience and treatment of cancer-related pain over six months, including an evaluation of ethnic differences. Patients with Stage III or IV breast, prostate, colorectal, or lung cancer, or Stage II-IV multiple myeloma with BTP completed surveys on initial assessment and at three and six months. ⋯ Ethnic disparities persisted when data estimation techniques were used. Examined longitudinally, consistent pain on average and several BTP measures reduced over time, although not greatly, indicating the persistence of pain in the cancer experience. These data provide evidence for the significant toll of cancer pain, while demonstrating further health care disparities in the cancer pain experience.
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J Pain Symptom Manage · May 2009
Case ReportsLost in transition: the ethics of the palliative care handoff.
In the palliative care setting, patients and families may experience transitions of care between home and different care facilities. These handoffs between care teams and settings are opportunities for miscommunication about many aspects of care. ⋯ This article presents a case where preferences were unclear and unclearly communicated and the patient received care that was likely contrary to his goals. Suggestions are made for mechanisms that may increase the likelihood that information about goals of care and preferences is clearly communicated during these transitions.