Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2014
Documented electronic medical record-based pain intensity scores at a tertiary pediatric medical center: a cohort analysis.
Previous surveys have suggested that pain in hospitalized patients remains undertreated. However, little is known about those with persistently high pain scores. ⋯ Detailed review of clinical characteristics of patients with persistently high scores led to the strong impression that, in most cases, persistently high pain was not simply because of inadequate administration of opioids. Instead, the first step in improving pain management of hospitalized children may be the identification of outliers with high pain scores to direct efforts on the development of interventions for patient groups with mechanistically similar pain.
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J Pain Symptom Manage · Nov 2014
Observational StudyCombination of initial palliative prognostic index and score change provides a better prognostic value for terminally ill cancer patients: a six-year observational cohort study.
The Palliative Prognostic Index (PPI) is among the most popular scores used to predict life expectancy in terminally ill patients worldwide. PPI assessed on the first day of palliative care might be inappropriate because the contribution from subsequent changes in a patient's condition are not taken into account. ⋯ Combination of initial PPI and score change is more useful than initial PPI for identifying patients with poor outcomes in good prognostic groups and patients with better outcomes in poor prognostic groups.
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J Pain Symptom Manage · Nov 2014
Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain.
According to the literature, 25%-60% of women treated for breast cancer, regardless of the stage, experience pain. Many risk factors have been suggested, with many possible confounding factors. ⋯ Young age, previous comorbidities (such as back pain, arthritis, arthrosis, and fibromyalgia), and combined treatment with axillary lymph node dissection, chemotherapy, and radiotherapy were risk factors for chronic pain. Whether depression or anxiety is a risk factor for chronic pain remains unclear.
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J Pain Symptom Manage · Nov 2014
Observational StudyClinical impact of a home-based palliative care program: a hospice-private payer partnership.
Outpatient programs have been traditionally offered in the U.S. under programs such as the Medicare Hospice Benefit. Recommendations now emphasize a blended model in which palliative care is offered concurrently with curative approaches at the onset of serious or life-limiting disease. The efficacy of nonhospice outpatient palliative care programs is not well understood. ⋯ A home-based palliative care program was developed between two local commercial payers and a not-for-profit hospice. Not only did this program improve symptom management, advance directive completion, and satisfaction, but it also facilitated the transition of patients into hospice care, when appropriate.
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J Pain Symptom Manage · Nov 2014
Discerning the meaning of human suffering through the discourse of Judeo-Christian scriptures and other faith teachings.
When confronted with the meaning of human suffering, many experts from a variety of professional disciplines admit to being incapable of formulating, on the basis of scientific method, a coherent explanation or rationale. Within that perspective, this article proposes another approach to the dilemma-that of reflection rooted in faith. The author examines the discourse of the Judeo-Christian scriptures and the comprehensive and cohesive doctrine developed by Pope John Paul II to find and track an evolving theology on the meaning of human suffering-one that includes understanding of this phenomenon as a "punishment for sin or evil," a test for fidelity, an occasion for God to show mercy and love, and a redemptive act by which Jesus took on all human suffering through his own death on the Cross and gave a salvific meaning to suffering through his resurrection from the dead. Further scriptural reflection and later Christian doctrines acknowledged that the suffering of other believers has its own redemptive value and that human suffering presents an occasion for all believers to respond with compassion and care to the pain of others.