Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialPain medication management processes used by oncology outpatients and family caregivers part II: home and lifestyle contexts.
Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. ⋯ Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles.
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialNeurolytic sympathectomy in the management of cancer pain-time effect: a prospective, randomized multicenter study.
Sympathectomy is currently used as the fourth step of the modified World Health Organization (WHO) analgesic ladder. Sympathectomy can be performed early, before the second step on the ladder. ⋯ Sympathectomy before Step 2 on the WHO analgesic ladder seems to lead to better pain control, less opioid consumption, and better quality of life in cancer patients.
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J Pain Symptom Manage · Nov 2014
A psychometric evaluation of the functional assessment of chronic illness therapy-palliative care (FACIT-Pal) scale with palliative care samples in three African countries.
Although sub-Saharan Africa suffers the greatest burden of progressive illness, there are few outcome measures with adequate properties to measure needs and outcomes. ⋯ The FACIT-Pal is a reliable multidimensional scale for people with life-limiting incurable diseases in sub-Saharan Africa, and the observed factors are interpretable and clinically meaningful.
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J Pain Symptom Manage · Nov 2014
Multicenter StudyLongitudinal temporal and probabilistic prediction of survival in a cohort of patients with advanced cancer.
Survival prognostication is important during the end of life. The accuracy of clinician prediction of survival (CPS) over time has not been well characterized. ⋯ Probabilistic CPS was consistently more accurate than temporal CPS over the last 14 days of life; however, its accuracy decreased as patients approached death. Our findings suggest that better tools to predict impending death are necessary.
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialPain medication management processes used by oncology outpatients and family caregivers part I: health systems contexts.
Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. ⋯ Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and health-care reform initiatives.