Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2015
Comparative StudyDifferences in Composition of Symptom Clusters Between Older and Younger Oncology Patients.
Older oncology patients have unique needs associated with the many physical, psychological, and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. ⋯ The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.
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J Pain Symptom Manage · Jun 2015
Randomized Controlled Trial Multicenter StudyFeasibility of Conducting a Palliative Care Randomized Controlled Trial in Children With Advanced Cancer: Assessment of the PediQUEST Study.
Pediatric palliative care randomized controlled trials (PPC-RCTs) are uncommon. ⋯ A PPC-RCT in children with advanced cancer was feasible, post-inclusion retention adequate; many families participated for altruistic reasons. Strategies that may further PPC-RCT feasibility include: increasing target population through large multicenter studies, approaching sicker patients, preventing exclusion of certain patient groups, and improving data collection at end of life.
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J Pain Symptom Manage · Jun 2015
An Assessment of Hospital-Based Palliative Care in Maryland: Infrastructure, Barriers, and Opportunities.
Maryland recently passed legislation mandating that hospitals with more than 50 beds have palliative care (PC) programs. Although the state's health agency can play a key role in ensuring successful implementation of this measure, there is little actionable information from which it can guide resource allocation for enhancing PC delivery statewide. ⋯ Systematic collection of state-level PC infrastructure data can be used to guide state health agencies' understanding of extant resources and challenges, using those data to determine resource allocation to promote the timely receipt of PC for patients and families.
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J Pain Symptom Manage · Jun 2015
Multicenter StudyPatient-Clinician Communication About End-of-Life Care in Patients With Advanced Chronic Organ Failure During One Year.
Patient-clinician communication is an important prerequisite to delivering high-quality end-of-life care. However, discussions about end-of-life care are uncommon in patients with advanced chronic organ failure. ⋯ End-of-life care communication is poor in patients with chronic organ failure and does not change toward the end of life. Future studies should develop an intervention aiming at initiating high-quality end-of-life care communication between patients with advanced chronic organ failure and their clinicians.
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J Pain Symptom Manage · Jun 2015
Randomized Controlled TrialAdvance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients With Advanced Cancer.
Many physicians avoid advance care planning (ACP) discussions because they worry such conversations will lead to psychological distress. ⋯ Engaging in ACP with online planning tools increases knowledge without diminishing hope, increasing hopelessness, or inducing anxiety in patients with advanced cancer. Physicians need not avoid ACP out of concern for adversely affecting patients' psychological well-being.