Journal of pain and symptom management
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The concept of "ubuntu," a Nguni word, is found in many southern African cultures and means that we are part of all humanity and we are who we are through our interconnectedness with others. Children with life-limiting conditions often become isolated and take on a new identity in the eyes of others, linked to their illness and treatment. ⋯ The concept of ubuntu can help the child, the family, and the community to ensure the child remains connected to society. Programs providing palliative care for children often say they feel isolated; ubuntu principles are relevant to effective network development.
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J Pain Symptom Manage · Sep 2015
The Benefits of Authorized Agent Controlled Analgesia (AACA) to Control Pain and Other Symptoms at the End of Life.
Eliza Coffee Memorial Hospital is a community hospital with a palliative care unit providing inpatient symptom management and end-of-life care. The palliative care unit provides authorized agent controlled analgesia (AACA). ⋯ An AACA system has been highly satisfactory for patients, families, and staff, meeting the goals of 1) allowing patients with a terminal condition to die peacefully and 2) enabling families to share in the patients' care, providing them with a more favorable memory at the end of life.
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J Pain Symptom Manage · Sep 2015
Randomized Controlled TrialThe Effect of Methylphenidate on Fatigue in Advanced Cancer: An Aggregated N-of-1 Trial.
Fatigue is common in life-limiting cancer. Methylphenidate (MPH), a psychostimulant, may be a useful therapy. Gathering evidence in patients with advanced cancer can be challenging. ⋯ MPH does not improve fatigue in the population of patients with end-stage cancer. Aggregated N-of-1 trial methodology is feasible and produces population-based sample estimates with less than half the sample size required for the equivalent parallel-group RCT. It also identified individuals who did and did not respond to MPH, which is a feature difficult to achieve in a standard RCT. The study was registered with the Australian Clinical Trials Registry (12609000794202).
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J Pain Symptom Manage · Sep 2015
Validation of the German Version of the Quality of Dying and Death Questionnaire for Informal Caregivers (QODD-D-Ang).
The quality of dying and death (QOD) influences end-of-life care for patients and their relatives. To the best of our knowledge, there are currently no validated standard instruments for evaluating the QOD of patients in palliative care units (PCUs) in Germany. ⋯ Analyses of validity and reliability of the QODD-D-Ang showed satisfactory to good psychometric properties, meaning that the QODD can be recommended for standard implementation in German hospices and palliative care institutions to measure the QOD. Feasibility could be improved by adapting the instrument so that it may be administered with minimal demands on staff. When interpreting the results, it should be kept in mind that the QODD-D-Ang does not measure quality of care but the quality of the dying process as estimated by bereaved relatives.