Journal of pain and symptom management
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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
Comparative StudyOpioid Concentrations in Oral Fluid and Plasma in Cancer Patients With Pain.
Measuring opioid concentrations in pain treatment is warranted in situations where optimal opioid analgesia is difficult to reach. ⋯ OFL analysis is well suited for detecting the studied opioids. For morphine and fentanyl, an approximation of the plasma opioid concentrations is obtainable, whereas for oxycodone, the OFL/plasma concentration relationship is too variable for reliable approximation results.
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J Pain Symptom Manage · Oct 2015
Religion, Spirituality, and the Hidden Curriculum: Medical Student and Faculty Reflections.
Religion and spirituality play an important role in physicians' medical practice, but little research has examined their influence within the socialization of medical trainees and the hidden curriculum. ⋯ Religion/spirituality has a largely unstudied but possibly influential role in medical student socialization. Future study is needed to characterize its function within the hidden curriculum.
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J Pain Symptom Manage · Oct 2015
A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients with Persistent Cancer Pain.
Pain coping skills training (PCST) interventions have shown efficacy for reducing pain and providing other benefits in patients with cancer. However, their reach is often limited because of a variety of barriers (e.g., travel, physical burden, cost, time). ⋯ The use of mHealth technology is a feasible and acceptable option for delivery of PCST for patients with cancer. This delivery mode is likely to dramatically increase intervention access for cancer patients with pain compared to traditional in-person delivery. Preliminary data also suggest that the program is likely to produce pretreatment to post-treatment decreases in pain and other important outcomes.
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J Pain Symptom Manage · Oct 2015
"The Patient is Dying, Please Call the Chaplain": The Activities of Chaplains in One Medical Center's Intensive Care Units.
Patients and families commonly experience spiritual stress during an intensive care unit (ICU) admission. Although most patients report that they want spiritual support, little is known about how these issues are addressed by hospital chaplains. ⋯ In the ICUs at this tertiary medical center, chaplain visits are uncommon and generally occur just before death among ICU patients. Communication between chaplains and physicians is rare. Chaplaincy service is primarily reserved for dying patients and their family members rather than providing proactive spiritual support. These observations highlight the need to better understand challenges and barriers to optimal chaplain involvement in ICU patient care.