Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2015
Assessing the Quality of Death and Dying in an Integrated Health Care System in Rural Pennsylvania.
With growing emphasis on improving the value of health care, there is increased scrutiny of quality outcomes and high health expenditures during the final months of life. ⋯ Several findings suggest that factors such as NOK depression and anxiety, prolonged illness, dying in the hospital, receipt of conflicting information, and confusion around the doctor in charge are associated with lower quality of the dying and death experience for NOK. Further investigation is warranted to facilitate high-quality measurement and the use of measurement results to improve care.
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J Pain Symptom Manage · Sep 2015
Medical Students' Death Anxiety: Severity and Association with Psychological Health and Attitudes Toward Palliative Care.
Death anxiety (DA) is related to awareness of the reality of dying and death and can be negatively related to a person's psychological health. Physicians' DA also may influence their care for patients approaching death. Doctors face death in a professional context for the first time at medical school, but knowledge about DA among medical students is limited. ⋯ The associations between high DA and lower psychological health and negative attitudes toward palliative care are concerning. It is important to address DA during medical education to enhance student's psychological health and the quality of their future palliative care provision.
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J Pain Symptom Manage · Sep 2015
Implementing Outcome Measures Within an Enhanced Palliative Care Day Care Model.
Specialist palliative care day care (SPDC) units provide an array of services to patients and their families and can increase continuity of care between inpatient and homecare settings. A multidisciplinary teamwork approach is emphasized, and different models of day care exist. Depending on the emphasis of care, the models can be social, medical, therapeutic, or mixed. We describe our experience of introducing an enhanced therapeutic specialist day care model and using both patient- and carer-rated tools to monitor patient outcomes. ⋯ This enhanced therapeutic model of SPDC allows for the tracking of progress toward specific goals and monitoring of patients' symptoms, functional status, QoL, and complexity. Retrospective analyses of validated tools show SPDC results in both maintenance and improvement of all parameters.
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J Pain Symptom Manage · Sep 2015
Multicenter StudyLinguistic Validation of the M. D. Anderson Symptom Inventory in Persian-Speaking Iranian Cancer Patients.
Various symptoms frequently affect cancer patients' quality of life. Appropriate assessment of these symptoms provides valuable data for cancer management. ⋯ The MDASI-P is a feasible, valid, and reliable instrument for evaluation of symptoms in Persian-speaking cancer patients and can be used to improve symptom management in these patients.
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J Pain Symptom Manage · Sep 2015
Patterns of End-of-Life Care in Children with Advanced Solid Tumor Malignancies Enrolled on a Palliative Care Service.
Pediatric patients with solid tumors can have a significant symptom burden that impacts quality of life (QoL) and end-of-life care needs. ⋯ Although children with solid tumor malignancies may have significant symptom burden toward the end of life, positive changes were documented in communication and in places of care and death after implementation of a pediatric PC service.