Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2014
The quality of dying and death in cancer and its relationship to palliative care and place of death.
Health care is increasingly focused on end-of-life care outcomes, but relatively little attention has been paid to how the dying experience is subjectively evaluated by those involved in the process. ⋯ The overall quality of death was rated positively for the majority of these cancer patients. Ratings were highest for home deaths perhaps because they are associated with fewer complications and/or a more extensive support network. For a substantial minority, symptom control and death-related distress at the end of life were problematic, highlighting areas for intervention.
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J Pain Symptom Manage · Nov 2014
Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study.
Delirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. ⋯ Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels.
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J Pain Symptom Manage · Nov 2014
Variation of opioid use in pediatric inpatients across hospitals in the u.s.
Appropriate use of opioids is essential to manage moderate-to-severe pain in children safely and effectively, yet published guidance regarding opioid treatment for pediatric patients is limited, potentially resulting in excessive variation in opioid use in pediatric patients across hospitals in the U.S. ⋯ The substantial hospital-level variation in opioid use in pediatric inpatients suggests room for improvement in clinical practice.
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J Pain Symptom Manage · Nov 2014
Pain assessment using the critical-care pain observation tool in chinese critically ill ventilated adults.
The psychometric properties of the Critical-Care Pain Observation Tool (CPOT) need to be tested in general intensive care unit patient populations in China. ⋯ The CPOT has good psychometric properties and can be used as a reliable and valid instrument for pain assessment in Chinese critically ill ventilated adults.
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J Pain Symptom Manage · Nov 2014
Palliative sedation at home for terminally ill children with cancer.
The presence of symptoms that are difficult to control always requires adjustment of treatment, and palliative sedation (PS) should be considered. ⋯ Sedation may be safely used at home. It requires close monitoring and full cooperation between the family and hospice team. Because of the limited data on home PS in pediatric populations, further studies are needed.