Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2013
Review Meta AnalysisDo community specialist palliative care services that provide home nursing increase rates of home death for people with life-limiting illnesses? A systematic review and meta-analysis of comparative studies.
Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service, but it is also likely the most costly. ⋯ A meta-analysis found evidence to be inconclusive that community SPCSs that offer home nursing increase home deaths without compromising symptoms or increasing costs. But a compelling trend warrants further confirmatory studies. Future trials should compare the relative efficacy of different models and intensities of SPCSs.
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J Pain Symptom Manage · Feb 2013
Multicenter Study Clinical TrialTrajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer.
Sleep disturbance is a problem for oncology patients. ⋯ Sleep disturbance is a persistent problem for patients with breast cancer. The effects of interventions that can address modifiable risk factors need to be evaluated.
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J Pain Symptom Manage · Feb 2013
Randomized Controlled TrialArmodafinil for sarcoidosis-associated fatigue: a double-blind, placebo-controlled, crossover trial.
Fatigue has been identified in more than one-half of patients with sarcoidosis. Although fatigue is not synonymous with impaired quality of life, most studies of sarcoidosis identify fatigue as a major cause of impaired quality of life. ⋯ Armodafinil treatment led to a significant reduction in fatigue in sarcoidosis patients. This effect was seen even in patients who did not have excessive daytime somnolence.
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J Pain Symptom Manage · Feb 2013
Randomized Controlled TrialDevelopment of fatigue in cancer survivors: a prospective follow-up study from diagnosis into the year after treatment.
There is a lack of longitudinal studies investigating fatigue from before cancer treatment to long after successful cancer treatment. ⋯ Twenty-two percent of the survivors had severe persistent fatigue in the year after cancer treatment. Fatigue and cognitive behavioral factors predicted persistent fatigue in the year after cancer treatment. Diagnosis or cancer treatment did not predict persistent fatigue. The implication is that cognitive behavioral therapy for postcancer fatigue, aimed at the fatigue-perpetuating factors, could be offered from two months after successful cancer treatment.
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J Pain Symptom Manage · Feb 2013
Review Case ReportsPalliative care after attempted suicide in the absence of premorbid terminal disease: a case series and review of the literature.
Palliative care involvement in the management of incomplete suicide in patients without terminal illness is rare. This paper documents two such cases and explores some of the clinical and ethical issues raised.