Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2015
The sense of security in care--Relatives' Evaluation instrument: its development and presentation.
Relatives' sense of security in their family members' palliative home care is important, and a valid and reliable instrument is needed to measure this. ⋯ The SEC-R provides a three-component assessment of palliative home care settings using valid and reliable scales associated with other concepts. The SEC-R is a manageable means of assessment that may contribute to quality-of-care measures and to further research on relatives' sense of security in care.
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The question "What is truth?" is one of the oldest questions in philosophy. Truth within the field of medicine has gained relevance because of its fundamental relationship to the principle of patient autonomy. To fully participate in their medical care, patients must be told the truth-even in the most difficult of situations. ⋯ However, this limited understanding of the truth does not account for the uniqueness of each patient. Although two patients may receive the same diagnosis (or facts), each will be affected by this truth in a very individual way. To help patients apprehend the truth, physicians are called to engage in a delicate back-and-forth of multiple difficult conversations in which each patient is accepted as a unique individual.
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J Pain Symptom Manage · Mar 2015
Fatigue is associated with serum interleukin-6 levels and symptoms of depression in patients on chronic hemodialysis.
Little is known about activated immune-inflammatory pathways and interleukin-6 (IL-6) in the development of fatigue and/or depression in patients with end-stage renal disease on chronic hemodialysis (HD). ⋯ Fatigue was significantly associated with symptoms of depression and serum IL-6 levels in patients receiving chronic HD.
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J Pain Symptom Manage · Mar 2015
Avoidable and unavoidable visits to the emergency department among patients with advanced cancer receiving outpatient palliative care.
Admissions to the emergency department (ED) can be distressing to patients with advanced cancer receiving palliative care. There is limited research about the clinical characteristics of these patients and whether these ED visits can be categorized as avoidable or unavoidable. ⋯ Nearly one-fourth of ED visits by patients with advanced cancer receiving palliative care were potentially avoidable. Proactive efforts to improve communication and support between scheduled appointments are needed.