Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2011
Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists.
Speech-language pathologists (SLP) are often called on to evaluate eating difficulties in patients with dementia. ⋯ Misperceptions among SLPs about tube feeding in advanced dementia are common, especially in relation to risk of aspiration. Knowledge about tube feeding outcomes was positively associated with experience and inversely associated with self-perceived higher preparedness in evaluating patients with dementia.
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J Pain Symptom Manage · Sep 2011
Fentanyl buccal tablets for breakthrough pain in highly tolerant cancer patients: preliminary data on the proportionality between breakthrough pain dose and background dose.
Cancer patients receiving high doses of opioids as background medication are challenging, and it would be useful clinically to know whether a rapid-onset opioid (ROO) for breakthrough cancer pain (BTcP) may be started at a dose proportional to the background opioid dose. ⋯ FBT in doses proportional to the high doses of opioids used for background analgesia was efficacious and well tolerated when administered for BTcP. Controlled studies with a specific design and a large number of patients should confirm such preliminary results.
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J Pain Symptom Manage · Sep 2011
Letter Case ReportsKetamine infusion for sickle cell crisis pain in an adult.
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J Pain Symptom Manage · Sep 2011
ReviewPatient-reported pressure ulcer pain: a mixed-methods systematic review.
Pressure ulcers (PUs) can cause patients considerable pain and discomfort; however, little is known about how PU pain affects patients' everyday lives. To improve outcomes for patients and to help clinicians manage PU pain, the existing qualitative and quantitative research bases were systematically reviewed. ⋯ A biopsychosocial model of pain experienced from PUs is presented. Improved communication of pain experienced between the individual and health care professionals is needed to promote more effective PU pain management in the future.
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J Pain Symptom Manage · Sep 2011
Impact of availability of an inpatient hospice unit on the parent hospital's quality of palliative care for Taiwanese cancer decedents, 2001-2006.
Hospice care has increasingly been shown to affect quality of palliative care at both the individual and institutional levels. However, an institutional effect has only been addressed in single comprehensive cancer centers/selected community hospitals. ⋯ Integrating both acute care and palliative care approaches to caring for terminally ill cancer patients in the same hospital may influence the quality of palliative care throughout the hospital as evidenced by our findings that these patients have lower likelihood of being intubated with mechanical ventilation support in the last month of life, greater propensity to receive hospice care in the last year of life, and a trend toward earlier referral to hospice care. The generalizability of these results may be limited to patients who died of a noncancer cause and by the two groups not being exactly matched for patients' characteristics.