Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2015
Multicenter Study Observational StudyA prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.
Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). ⋯ HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.
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J Pain Symptom Manage · Feb 2015
An important but stressful part of their future work: medical students' attitudes to palliative care throughout their course.
Palliative care (PC) education for medical students is important. Knowledge concerning drugs and services can be readily taught, and skills of communicating with terminally ill patients and their families are increasingly being addressed. Developing positive attitudes toward caring for patients near the end of life is more challenging. ⋯ Medical students' attitudes toward their future role in caring for people with PC needs were broadly positive. Core science was associated with increasingly negative attitudes and clinical studies with increasingly positive attitudes. For teaching faculty, the challenge remains to address negative and foster positive attitudes toward PC during medical school.
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J Pain Symptom Manage · Feb 2015
Randomized Controlled Trial Comparative StudyMorphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial.
There is wide interindividual variation in response to morphine for cancer-related pain; 30% of patients do not have a good therapeutic outcome. Alternative opioids such as oxycodone are increasingly being used, and opioid switching has become common clinical practice. ⋯ In this population, there was no difference between analgesic response or adverse reactions to oral morphine and oxycodone when used as a first- or second-line opioid. These data provide evidence to support opioid switching to improve outcomes.
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J Pain Symptom Manage · Feb 2015
Comparative StudyGrief after patient death: direct care staff in nursing homes and homecare.
Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. ⋯ Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare.
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J Pain Symptom Manage · Feb 2015
Dying in the hospital: what happens and what matters, according to bereaved relatives.
Most deaths in Western countries occur in hospital, but little is known about factors determining the quality of dying (QOD). ⋯ Relatives rated QOD as sufficient. A majority of patients and relatives were not sufficiently prepared for imminent death, and relatives experienced many problems. QOD appears to be a multidimensional construct, strongly affected by medical care and staff attentiveness.