Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2013
Capturing the patient's experience: using qualitative methods to develop a measure of patient-reported symptom burden: an example from ovarian cancer.
Experts in patient-reported outcome (PRO) measurement emphasize the importance of including patient input in the development of PRO measures. Although best methods for acquiring this input are not yet identified, patient input early in instrument development ensures that instrument content captures information most important and relevant to patients in understandable terms. ⋯ The qualitative interviewing process, used to develop the test MDASI-OC, systematically captures common symptoms important to patients with OC. This methodology incorporates the patient experience recommended by experts in PRO instrument development.
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J Pain Symptom Manage · Dec 2013
Multicenter Study Comparative StudyClinically important differences in the intensity of chronic refractory breathlessness.
Clinically important differences in chronic refractory breathlessness are ill defined but important in clinical practice and trial design. ⋯ This larger dataset supports a clinically important difference of 10mm. Studies should be powered to detect this difference.
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J Pain Symptom Manage · Dec 2013
Dynamic preferences for site of death among patients with advanced chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure.
To die at the preferred site is a key principle of a good death. ⋯ Preferences for site of death may change in patients with advanced chronic organ failure. Future studies should explore whether and to what extent discussing the possibilities for the site of end-of-life care as a part of advance care planning can prepare patients and relatives for in-the-moment decision making and improve end-of-life care.
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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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Fever is an important sign of inflammation recognized by health care practitioners and family caregivers. However, few empirical data obtained directly from patients exist to support many of the long-standing assumptions about the symptoms of fever. Many of the literature-cited symptoms, including chills, diaphoresis, and malaise, have limited scientific bases, yet they often represent a major justification for antipyretic administration. ⋯ Our data not only confirm long-standing symptoms of fever but also suggest new symptoms and a level of variability and complexity not captured by the existing fever literature. Greater knowledge of patients' fever experiences will guide more accurate assessment of symptoms associated with fever and the impact of antipyretic treatments on patient symptoms in this common condition. Results from this study are contributing to the content validity of a future instrument that will evaluate patient outcomes related to fever interventions.