Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2014
Comparative StudyCharacteristics and outcomes of patients admitted to the acute palliative care unit from the emergency center.
Most patients admitted to acute palliative care units (APCUs) are transferred from inpatient oncology units. We hypothesized that patients admitted to APCUs from emergency centers (ECs) have symptom burdens and outcomes that differ from those of transferred inpatients. ⋯ The EC patients have a higher acute symptom burden and are more likely to be discharged alive than transferred inpatients. The APCU was successful at managing symptoms and facilitating the discharge of both inpatients and EC patients to the community although the patients had severe symptoms on admission.
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J Pain Symptom Manage · Jun 2014
Development and validation of a new tool for the assessment and spiritual care of palliative care patients.
Spiritual assessment tools and interventions based on holistic approaches are needed to promote healing. Such tools must be adapted to the wide cultural backgrounds of contemporary Western society. ⋯ The new questionnaire, based on empirical research and bedside experience, showed good psychometric properties and clinical applicability.
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J Pain Symptom Manage · Jun 2014
Calibration of quality-adjusted life years for oncology clinical trials.
Quality-adjusted life year (QALY) estimation is a well-known but little used technique to compare survival adjusted for complications. Lack of calibration and interpretation guidance hinders implementation of QALY analyses. ⋯ This calibration allows researchers to interpret the clinical significance of QALY analyses and facilitates QALY inclusion in clinical trials through improved study design.
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J Pain Symptom Manage · Jun 2014
Belgian general practitioners' perspectives on the use of palliative sedation in end-of-life home care: a qualitative study.
Palliative sedation (PS) is a far-reaching palliative measure with a life-shortening potential. Guidelines provide only for a restricted use of PS and as a last resort. ⋯ PS home practice deviates from the PS guidelines' recommendations. In addition to the GPs' shortage of knowledge, the guidelines' recommendations do not always meet the particular needs of EoL home care. If one consideration of EoL home care is to respect a patient's wish to die at home, then the pre-emptive use of PS to avoid a futile transfer to the hospital in the case of an undesirable turn of events deserves more attention in the PS debate.
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J Pain Symptom Manage · Jun 2014
Parents' experiences of pediatric palliative care and the impact on long-term parental grief.
Approximately 25% of children diagnosed with cancer eventually die. Losing a child puts parents at increased risk for developing psychological problems. ⋯ Both interaction with health care professionals, especially communication and continuity of care, and symptom management in children dying of cancer are associated with long-term parental grief levels.