Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2015
Multicenter StudyValidation of the Simplified Palliative Prognostic Index Using a Single Item From the Communication Capacity Scale.
Although the Palliative Prognostic Index (PPI) is a reliable and validated tool to predict the survival of terminally ill cancer patients, all clinicians cannot always precisely diagnose delirium. ⋯ The simplified PPI showed essentially the same predictive value as the original PPI and is an alternative when clinicians have difficulties in diagnosing delirium.
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J Pain Symptom Manage · Oct 2015
Multicenter Study Comparative Study Observational StudyAccuracy of a Diagnostic Algorithm to Diagnose Breakthrough Cancer Pain as Compared with Clinical Assessment.
Breakthrough cancer pain (BTCP) is a heterogeneous condition, and there are no internationally agreed standardized criteria to diagnose it. There are published algorithms to assist with diagnosis, but these differ in content. There are no comparative data to support use. ⋯ The diagnostic breakthrough pain algorithm had a good positive predictive value but limited sensitivity using a cutoff score of "mild" to define controlled background pain. When the cutoff level was changed to moderate, the sensitivity increased, but specificity reduced. A comprehensive clinical assessment remains the preferred method to diagnose BTCP.
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J Pain Symptom Manage · Oct 2015
Comparative StudyComparative Analysis of Informal Caregiver Burden in Advanced Cancer, Dementia, and Acquired Brain Injury.
Measurement and improvement of informal caregiver burden are central aims of policy and intervention. Burden itself is a complex construct, and total burden can differ by patient diagnosis, although how diagnosis affects different aspects of caregiver subjective burden is unclear. ⋯ Our data show that total, subscale, and most individual elements of caregiver subjective burden differ between cancer, dementia, and ABI caregivers. This should be considered when designing future intervention strategies to reduce caregiver burden in these groups.
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J Pain Symptom Manage · Oct 2015
A Quantitative Study of Triggered Palliative Care Consultation for Hospitalized Patients With Advanced Cancer.
Unplanned cancer-related hospital admissions often herald entry into the final phase of life. Hospitalized patients with advanced cancer have a high symptom burden and a short life expectancy, which may warrant palliative care intervention. ⋯ Although TPCC was viewed favorably, implementation was logistically challenging because of short stays, high-acuity symptoms, and individual provider resistance. TPCC improved patients' understanding of their cancer. This population demonstrates high palliative care needs, warranting further research into how best to deliver care.