Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2014
Cancer caregivers advocate a patient- and family-centered approach to advance care planning.
Cancer caregivers have important roles in delivering practical, emotional, and end-of-life support to patients; however, they express multiple unmet needs, particularly information on future care planning. Early regular communication and decision making may improve access to timely information, alleviate anxiety, reduce uncertainty, and improve coping strategies. ⋯ Findings highlight the influence of cancer caregivers and family dynamics over ACP decisions and actualization of future care plans. A patient- and family-centered care approach to ACP, promoting shared decision making and caregiver support, is recommended. Given that caregivers may override and, plausibly, misinterpret patients' desires, caregivers' subsidiary planning warrants further investigation.
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J Pain Symptom Manage · Jun 2014
Clinical parameters associated with pressure ulcer healing in patients with advanced illness.
Pressure ulcers are the most prevalent wounds affecting patients with advanced illness. Although complete wound healing is the most desired outcome, it remains unlikely in the setting of patients with limited life expectancy. Realistic goal setting may be enabled using objective clinical parameters. ⋯ Higher levels of PPS scores are associated with complete healing of Stage II pressure ulcers in patients with advanced illness.
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J Pain Symptom Manage · Jun 2014
Current state of psychiatric involvement on palliative care consult services: results of a national survey.
Palliative care consult services have emerged as an excellent resource for physicians seeking help with patients' symptoms. Symptoms include those of a psychiatric nature (e.g., depression, anxiety, delirium); however, little information is known about whether palliative care services include psychiatric input as part of multidisciplinary teams. ⋯ There are shared objectives between psychiatry and palliative care; however, currently, co-involvement on treatment teams is quite limited. Future research is needed to identify ways to facilitate the interface of palliative care and psychiatry.