Journal of pain and symptom management
-
J Pain Symptom Manage · Feb 2011
Randomized Controlled Trial Multicenter StudyConsistency of efficacy, patient acceptability, and nasal tolerability of fentanyl pectin nasal spray compared with immediate-release morphine sulfate in breakthrough cancer pain.
We recently reported that fentanyl pectin nasal spray (FPNS) provides superior pain relief from breakthrough cancer pain (BTCP) compared with immediate-release morphine sulfate (IRMS), with significant effects by five minutes and clinically meaningful pain relief from 10 minutes postdose. ⋯ This study demonstrates that FPNS is efficacious, well accepted, and well tolerated by patients with BTCP.
-
J Pain Symptom Manage · Feb 2011
Continuous deep sedation at the end of life of children in Flanders, Belgium.
Few guidelines have yet been put forth for continuous deep sedation in pediatrics, and empirical data on the use of this practice in minors are rare. ⋯ Minor patients were commonly kept in continuous deep sedation or coma until death in Flanders, Belgium. Given the high incidence of the practice and indications that it is often used without involving the patient--and sometimes with a life-shortening intention--the development of specific guidelines for sedation in children might contribute to due care practice.
-
J Pain Symptom Manage · Feb 2011
Case ReportsShades of truth: cultural and psychological factors affecting communication in pediatric palliative care.
Communication with children who have life-threatening illnesses is a major challenge. Communication practices are greatly influenced by factors such as the child's age, the parents' wishes, and the cultural norms. This article presents the case of a 12-year-old Japanese boy with advanced hepatoblastoma. ⋯ The case is discussed from the perspective of clinical ethics, especially with regard to truth telling. The health care team faced an ethical dilemma because of the complications involved. Physicians treating children with cancer should be aware of these issues to be able to effectively communicate with their patients.
-
J Pain Symptom Manage · Feb 2011
Pain documentation and predictors of analgesic prescribing for elderly patients during emergency department visits.
Inappropriate pain documentation is likely to be an important contributor to the poor management of pain in elderly patients in the emergency department (ED). Failure to assess pain limits ability to treat pain. ⋯ ED pain score documentation is suboptimal in the elderly population. Disparity in the use of analgesic prescriptions and opioid analgesics exists and may result in patients not receiving analgesics. Improving pain assessment and documentation, changes in attitude toward analgesic prescribing, and recognition of ethnic, racial, and age differences in patients with pain have the potential to contribute to effective management of pain in the ED.
-
J Pain Symptom Manage · Feb 2011
Multicenter Study Comparative StudyA multicenter study comparing two numerical versions of the Edmonton Symptom Assessment System in palliative care patients.
The Edmonton Symptom Assessment System (ESAS) is a widely used, self-report symptom intensity tool for assessing nine common symptoms in palliative care, with ratings ranging from 0 (none, best) to 10 (worst). Based on a "think-aloud" study of 20 advanced cancer patients, the ESAS was revised (ESAS-r). ⋯ The ESAS-r retains core elements of the ESAS, with improved interpretation and clarity of symptom intensity assessment. It represents the next generation of ESAS development, with further validation recommended for drowsiness, appetite, and well-being.