Journal of pain and symptom management
-
J Pain Symptom Manage · Oct 2016
Capturing the palliative homecare experience from bereaved caregivers though qualitative survey data:Towards informing quality improvement.
Measuring palliative care experience using patient-reported outcomes is becoming important for assessing and improving quality, although most validated outcome tools solely use scaled questions. ⋯ The qualitative survey data in this study provided key recommendations toward making care more responsive to the needs of dying patients and their families. Capturing the narrative responses of bereaved caregivers is feasible and informative for palliative care program development.
-
J Pain Symptom Manage · Oct 2016
Randomized Controlled TrialImpact of Prophylactic Fentanyl Pectin Nasal Spray on Exercise-Induced Episodic Dyspnea in Cancer Patients: A Double-Blind, Randomized Controlled Trial.
Episodic breathlessness is common and debilitating in cancer patients. ⋯ FPNS was safe, reduced dyspnea at rest, and increased walk distance in before-after comparison. The placebo effect was substantial, which needs to be factored in future study designs.
-
J Pain Symptom Manage · Oct 2016
High levels of geriatric palliative care needs in hip fracture patients before the hip fracture.
Most hip fracture care models are grounded in curative models where the goal is to return the patient to independent function. In many instances, however, hip fractures contribute to continued functional decline and mortality. Although the negative impact of hip fractures is appreciated once they have occurred, what is less understood is what proportion of older adults have high illness burden before experiencing hip fracture and might benefit from geriatric palliative care. ⋯ A significant proportion of older adults have evidence of functional and medical vulnerability before hip fracture. For these individuals, integration of geriatric palliative care may be particularly important for optimizing quality of life and addressing the high morbidity experienced by this population.
-
J Pain Symptom Manage · Oct 2016
Reasons for End-of-Life Hospital Admissions: Results of a Survey Among Family Physicians.
Although the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life. ⋯ To reduce the number of hospital deaths, a combination of structural support for out-of-hospital end-of-life care and a more timely referral to out-of-hospital palliative care services may be needed.
-
J Pain Symptom Manage · Oct 2016
A Prospective Study of Hypodermoclysis Performed by Caregivers in the Home Setting.
Decreased oral intake is very common at the end of life. Dehydration can aggravate symptoms, such as fatigue, myoclonus, and confusion. Intravenous hydration at home can be logistically difficult and expensive. Hypodermoclysis is easy to provide and inexpensive; however, it is rarely used to provide hydration at the end of life in the home setting. ⋯ This preliminary study suggests that subcutaneous hydration could be administered by caregivers at home with minimal burden, equipment, and technical support.