Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2011
A model for increasing palliative care in the intensive care unit: enhancing interprofessional consultation rates and communication.
Only a minority of patients who die in the medical intensive care unit (MICU) receive palliative care services. At the South Texas Veterans Health Care System Audie L. Murphy Hospital, only 5% of patients who died in the MICU from May to August 2010 received a palliative care consultation. ⋯ Daily pre-rounds between the palliative care and MICU teams increased palliative care services for MICU patients at risk for poor outcomes, who may benefit from a palliative care consultation.
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J Pain Symptom Manage · Nov 2011
Process and outcomes of euthanasia requests under the belgian act on euthanasia: a nationwide survey.
Since 2002, the administration of a lethal drug by a physician at the explicit request of the patient has been legal in Belgium. The incidence of euthanasia in Belgium has been studied, but the process and outcomes of euthanasia requests have not been investigated. ⋯ Under the Belgian Act on Euthanasia, about half of the requests are granted. Factors related to the reason for the request, position of the attending physician toward the request, and advice from the second physician influence whether a request is granted or not.
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J Pain Symptom Manage · Nov 2011
Validity of the memorial symptom assessment scale-short form psychological subscales in advanced cancer patients.
The Memorial Symptom Assessment Scale-Short Form (MSAS-SF) is designed to evaluate physical and psychological symptom burden in advanced cancer patients. There are no current data assessing the validity of the MSAS-SF psychological symptom scores when compared with anxiety and depression. ⋯ These results support the validity of the MSAS-SF global distress index and psychological subscales in the assessment of patients with anxiety and depressive disorders.
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J Pain Symptom Manage · Nov 2011
Navigating tensions: integrating palliative care consultation services into an academic medical center setting.
Despite rapid proliferation of hospital-based palliative care consultation services (PCCSs) across the country, there is little description of the dynamic processes that the PCCS and the non-PCCS hospital cultures experience during the institutionalization of a successful PCCS. ⋯ An in-depth understanding of the dynamic interaction of the infrastructures and processes of a successful institutionalization, in their unique complexity, may help other PCCSs identify and negotiate attributes of their own circumstances that will increase their chances for successful and sustainable implementation.
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J Pain Symptom Manage · Nov 2011
Implementation and evaluation of a network-based pilot program to improve palliative care in the intensive care unit.
Intensive care unit (ICU) care could be improved by implementation of time-triggered evidence-based interventions including identification of a patient/family medical decision maker, the patient's advance directive status, and cardiopulmonary resuscitation preferences by Day 1; offer of social work and spiritual support by Day 3; and a family meeting establishing goals of care by Day 5. We implemented a program to improve care for ICU patients in five Department of Veterans Affairs' ICUs. ⋯ ICU nurse teams can be engaged to improve care under the aegis of a collaborative quality improvement project.