Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2013
Trends in the consumption of opioid analgesics in Taiwan from 2002 to 2007: a population-based study.
Morphine consumption is an important indicator of a country's progress in cancer pain relief. However, opioid prescription data are lacking for Taiwan. ⋯ Opioid prescriptions and expenditure increased steadily from 2002 to 2007 in Taiwan, as in nearby Asian countries, but remained much lower than in developed countries. Pethidine (meperidine) was predominantly prescribed to noncancer patients, whereas morphine and fentanyl were mainly prescribed for cancer patients.
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J Pain Symptom Manage · Feb 2013
The relationship between spirituality, psychosocial adjustment to illness, and health-related quality of life in patients with advanced chronic kidney disease.
Spirituality may promote psychosocial adjustment to illness, and this may be a mechanism by which patients with greater existential well-being (EWB) experience better health-related quality of life (HRQL) in the context of life-limiting illness. ⋯ Adjustment in the domains of psychological distress and extended family relationships appears to mediate some of the beneficial effect of EWB on HRQL. Spirituality, however, provides unique variance in patients' HRQL, independent of their psychosocial adjustment. This study testifies to the importance of targeting both psychosocial adjustment to illness and spirituality as ways to preserve or enhance HRQL of predialysis and dialysis patients.
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J Pain Symptom Manage · Feb 2013
Opioid switching in patients with advanced cancer followed at home. A retrospective analysis.
Opioid switching has been found to improve opioid responsiveness in different conditions. However, data on opioid switching performed at home are almost nonexistent, despite the fact that most patients are followed at home. ⋯ Opioid switching was useful for most patients in the home environment, at least in less complex circumstances, when done by experienced home care teams. Prospective studies are needed to provide information about the decision to admit to hospital for this purpose and the predictive factors that may relatively contraindicate transportation to a facility in severely ill patients.
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J Pain Symptom Manage · Feb 2013
Nurse executives' perceptions of end-of-life care provided in hospitals.
With the aging of our population, almost one in five adults, or 19% of the population, will be older than 65 years by 2030. Many persons have expressed concern about the inadequate preparation of hospitals to provide high-value end-of-life care for the current and anticipated population of older adults. ⋯ These findings highlight the need for interventions that focus on improving communication at the bedside and in transitions of care, enhancing educational interventions, and developing patient-centered care systems, which translate into a higher quality end-of-life experience for patients and their family members. Nurse executives are currently an underused resource in end-of-life care but are poised to be able to champion innovative models and a culture of change that integrates high-value care for patients with serious and chronic illnesses.