Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2011
Use of palliative care services and general practitioner visits at the end of life in The Netherlands and Belgium.
At the end of life, some personalized and specialized care is required. The way that general practitioner (GP) visits and palliative care services at the end of life are organized in different countries may impact the frequency of care provision. However, nationwide data on the prevalence of these interventions and comparisons among countries are scarce. ⋯ Independent of the differences in patient populations (at home and care home) between countries, there are more frequent GP visits at the end of life in The Netherlands and greater use of palliative care services in Belgium.
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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.
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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.
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J Pain Symptom Manage · Feb 2011
Prevalence and natural history of neuropsychiatric syndromes in veteran hospice patients.
Prospective studies are needed to adequately describe the overall impact of neuropsychiatric syndromes on the course of hospice enrollment in outpatient settings. ⋯ Psychiatric syndromes are highly prevalent in hospice patients. Systematic case finding of psychiatric disorders may be necessary to improve quality of life in the last months of life.
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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.