Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2016
Observational StudyPalliative Care Specialist Consultation Is Associated with Supportive Care Quality in Advanced Cancer.
Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. ⋯ Early palliative care specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence.
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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.
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J Pain Symptom Manage · Oct 2016
Cognitive impairment in a subset of breast cancer patients following systemic therapy - results from a longitudinal study.
Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function. ⋯ Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.
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J Pain Symptom Manage · Oct 2016
Walls and Barriers. Polish Achievements and the Challenges of Transformation: Building a Hospice Movement in Poland.
In this review, the authors discuss the creation and development of hospice-palliative care in Poland and present attempts to move from religious care into spiritual companionship, using examples of concrete activities and challenges, which-like subsequent walls and barriers-have appeared inside and around us.
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J Pain Symptom Manage · Oct 2016
Emerging Collaboration Between Palliative Care Specialists and Mechanical Circulatory Support Teams: A Qualitative Study.
Despite national requirements mandating collaboration between palliative care specialists and mechanical circulatory support (MCS) teams at institutions that place destination therapy ventricular assist devices, little is known about the nature of those collaborations or outcomes for patients and families. ⋯ Although the structure of collaboration varies between institutions, collaboration between MCS teams and palliative care specialists is increasing and often preceded the Centers for Medicare & Medicaid Services requirement. Overall impressions of palliative care specialists are highly positive, with perceptions of improved patient and family experience and decreased burden on MCS team members.