Journal of pain and symptom management
-
J Pain Symptom Manage · Mar 2013
Factor analysis of the Pittsburgh Sleep Quality Index in breast cancer survivors.
Sleep is a significant problem in breast cancer survivors (BCS) and measured frequently using the Pittsburgh Sleep Quality Index (PSQI). Thus, it is important to evaluate its factor structure. The two-process model of sleep regulation was the theoretical framework for this study. ⋯ Results were inconsistent with current PSQI scoring that assumes a single global factor and with previously published literature. Although a new two-factor model best fit the data, further quantitative and qualitative analyses are warranted to validate our results in other populations before revising PSQI scoring recommendations. Additional recommendations are described for research.
-
J Pain Symptom Manage · Mar 2013
Comparative StudyEnrollment and events of hospice patients with heart failure vs. cancer.
Hospice care is traditionally used for patients with advanced cancer, but it is increasingly considered for patients with end-stage heart failure. ⋯ Compared with patients with advanced cancer, referral to hospice is more often initiated during acute care encounters for patients with end-stage heart failure, who also more frequently return to acute care settings even after hospice enrollment.
-
J Pain Symptom Manage · Mar 2013
Putting on a happy face: emotional expression in parents of children with serious illness.
Communication is widely acknowledged as a crucial component of high-quality pediatric medical care, which is provided in situations in which parents typically experience strong emotions. ⋯ The inverse relationship between parents' positive emotional expression and their self-reported positive affect should remind both researchers and clinicians to be cognizant of the possibilities for emotional miscues, and consequent miscommunication, in the pediatric care setting.
-
J Pain Symptom Manage · Mar 2013
Applying sociodramatic methods in teaching transition to palliative care.
We introduce the technique of sociodrama, describe its key components, and illustrate how this simulation method was applied in a workshop format to address the challenge of discussing transition to palliative care. We describe how warm-up exercises prepared 15 learners who provide direct clinical care to patients with cancer for a dramatic portrayal of this dilemma. We then show how small-group brainstorming led to the creation of a challenging scenario wherein highly optimistic family members of a 20-year-old young man with terminal acute lymphocytic leukemia responded to information about the lack of further anticancer treatment with anger and blame toward the staff. ⋯ By modeling effective communication skills, the facilitators demonstrated how key communication skills, such as empathic responses to anger and blame and using "wish" statements, could transform the conversation from one of conflict to one of problem solving with the family. We also describe how we set up practice dyads to give the learners an opportunity to try out new skills with each other. An evaluation of the workshop and similar workshops we conducted is presented.