Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2014
Comparative StudyEnd-of-life communication: a retrospective survey of representative general practitioner networks in four countries.
Effective communication is central to high-quality end-of-life care. ⋯ The prevalence of end-of-life discussions varied across the four countries. In all countries, training priorities should include the identification and discussion of spiritual and social problems and early end-of-life discussions with older patients, those with cognitive decline if possible, and those with non-malignant diseases.
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J Pain Symptom Manage · Mar 2014
Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: a longitudinal study.
Family carers of palliative care patients report high levels of psychological distress throughout the caregiving phase and during bereavement. Palliative care providers are required to provide psychosocial support to family carers; however, determining which carers are more likely to develop prolonged grief (PG) is currently unclear. ⋯ Screening family carers on entry to palliative care seems to be the most effective way of identifying who has a higher risk of developing PG. We recommend screening carers six months after the death of their relative to identify most carers with PG.
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J Pain Symptom Manage · Mar 2014
Comparative StudyThe relationship between two performance scales: New York Heart Association Classification and Karnofsky Performance Status Scale.
Performance status is used to quantify the well-being and functional status of people with illness. Clinicians and researchers from differing fields may not instinctively understand the scales, typically disease specific, used in other disciplines. ⋯ We suggest that the NYHA discriminates poorly between clinically important performance states in people with advanced disease (NYHA III and IV; KPS <50%). The KPS, used in conjunction, would provide useful additional information in research and clinical practice.
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Patients or family members facing serious illness often express regrets over life events or the need for forgiveness. Professionals, including nurses as the prominent discipline at the bedside, witness these expressions of regret or needs for forgiveness but may not be adequately prepared to optimally address patient concerns regarding forgiveness. ⋯ Nurses provide clinical care for patients with advanced illness who struggle with issues of forgiveness. Nurses would benefit from additional education regarding how best to address these concerns.
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J Pain Symptom Manage · Mar 2014
The activity of palliative care team pharmacists in designated cancer hospitals: a nationwide survey in Japan.
The role of pharmacists in palliative care has become more important now that they are able to provide medication review, patient education, and advice to physicians about a patient's pharmacotherapy. However, there is little known about pharmacists' activity on palliative care teams. ⋯ In Japan, pharmacists exercise a moderate level of clinical activity on palliative care teams. Many pharmacists believe that they contribute to such a team and generally place more emphasis on their educational and research roles compared with clinical work.