Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2014
Multicenter StudyHospices' use of electronic medical records for quality assessment and performance improvement programs.
Electronic medical records (EMRs) are increasingly viewed as essential tools for quality assurance and improvement in many care settings, but little is known about the use of EMRs by hospices in their quality assessment and performance improvement (QAPI) programs. ⋯ Most participating hospices use EMRs for retrieving items needed for QI calculations. EMR-based QIs address various quality domains and themes. Our findings present opportunities for potential future reporting of EMR-based quality data.
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J Pain Symptom Manage · Oct 2014
Multicenter Study Controlled Clinical TrialChanges in quality of care and quality of life of outpatients with advanced cancer after a regional palliative care intervention program.
A recent mixed-methods study to evaluate the effects of a comprehensive regional palliative care program, the Japan Outreach Palliative Care Trial of the Integrated Model study, achieved broad positive outcomes at a regional level. This is a secondary analysis of patient outcomes. ⋯ Although average changes in patient-reported outcomes were relatively small in the total sample of patients, the intervention seemed to provide tangible benefits for the patients with poor general conditions. A future regional intervention trial should include patient outcomes in those with a poor general condition to evaluate the net effects of the program.
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J Pain Symptom Manage · Oct 2014
Multicenter StudySubgroups of cancer patients with unique pain and fatigue experiences during chemotherapy.
Some cancer patients experience pain and fatigue, whereas others experience only one of the two symptoms. Yet, it is not clear who experiences these unique patterns and why. ⋯ This study confirmed the existence of a unique symptom experience of pain and fatigue. This pattern should be acknowledged for symptom assessment and management.
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J Pain Symptom Manage · Oct 2014
Review Case ReportsPatients who lack capacity and lack surrogates: can they enroll in hospice?
Patients who lack capacity and lack surrogates are among the most vulnerable patients we care for in palliative care. In the case we present here, we have considered how to make end-of-life decisions for a patient who lacks both capacity and surrogates, who has a terminal illness, and who is not a candidate for disease-modifying treatments. We first define and characterize this population of patients through a review of the literature and then explore some decision-making quandaries that are encountered at the end of life. Finally, we make recommendations on how best to proceed with decision making for this vulnerable population.
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J Pain Symptom Manage · Oct 2014
Comparative StudyLinking fatigue measures on a common reporting metric.
Fatigue is one of the most common and debilitating symptoms experienced by patients living with chronic conditions and is also commonly experienced in the general U.S. population. Linking fatigue scores from some of the most widely used measure of fatigue to the same metric will facilitate interpretation of fatigue outcomes. ⋯ Findings can facilitate comparison of scores across some of the most widely used fatigue measures and assist in comparing patient-reported fatigue outcomes in clinical trials, comparative effectiveness research, and clinical practice.