Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2013
Review Meta AnalysisFentanyl for the relief of refractory breathlessness: a systematic review.
Fentanyl is a potent opioid that has been proven to provide effective treatment for breakthrough cancer pain. Although opioids are the only drug group with evidence for the symptomatic treatment of breathlessness, evidence about the efficacy of fentanyl for the relief of breathlessness is unknown. ⋯ Descriptive studies yielded promising results for the use of fentanyl for the relief of breathlessness; however, efficacy trials are lacking. Fully powered RCTs are warranted to determine the efficacy of fentanyl for breathlessness relief, but these require pilot studies to evaluate effective size, study procedures, and outcome measures.
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J Pain Symptom Manage · Dec 2013
Review Meta AnalysisAdvising patients on the use of non-herbal nutritional supplements during cancer therapy: a need for doctor-patient communication.
Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. ⋯ There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
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J Pain Symptom Manage · Dec 2013
Multicenter StudyHospice caregivers' experiences with pain management: "I'm not a doctor, and I don't know if I helped her go faster or slower".
Those caring for their loved ones in hospice experience tremendous stress, being faced with numerous decisions as they work to manage the pain experienced by their loved one. Although hospice care teams create pain management strategies, it is the role of the caregiver to implement these plans. ⋯ These findings should raise concern among hospice professionals, whose commitment is to the management of pain, including emotional pain, with a focus on both the patient and the family as a unit of care. These data clearly suggest that hospice providers have an opportunity to be sensitive to perceptions held by caregivers regarding pain management. Effective planning for pain control must incorporate the values and beliefs not only of each patient but also of the family caregiver.
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J Pain Symptom Manage · Dec 2013
Controlled Clinical TrialClinical trial of a supportive care team for patients with advanced cancer.
Encouraging use of hospice and minimizing the use of cure-oriented aggressive interventions that detract from quality of life in the last month of life are specific targets for improvement in cancer care. ⋯ Individually tailored supportive services from an interdisciplinary team are associated with improved HRQOL in some patients. This has implications for the potential benefits that can be accrued from providing intensive support to all patients, even those who may appear to be at less risk for distress. There also are important methodological considerations in using aggressiveness of care indices as a measure of quality of care.
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J Pain Symptom Manage · Dec 2013
Validation of the Edmonton Symptom Assessment System in Korean patients with cancer.
The Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted, multidimensional questionnaire to evaluate patient-reported symptoms. ⋯ The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean patients with cancer.