Journal of pain and symptom management
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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.
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J Pain Symptom Manage · Oct 2016
Pain and Functional Status in Patients with Ventricular Assist Devices.
Ventricular assist devices (VADs) have been shown to improve survival and overall quality of life, but there are limited data on pain control and functional status in this patient population. ⋯ This study demonstrated that patients with VADs experienced improved pain, functional status, and quality of life over time. These data may be useful to help patients make decisions when they are considering undergoing VAD implantation.
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J Pain Symptom Manage · Oct 2016
Care Consistency with Documented Care Preferences: Methodologic Considerations for Implementing the Measuring What Matters Quality Indicator.
A basic tenet of palliative care is discerning patient treatment preferences and then honoring these preferences, reflected by the inclusion of "Care Consistency With Documented Care Preferences" as one of 10 "Measuring What Matters quality" indicators. Measuring What Matters indicators are intended to serve as a foundation for quality measurement in health care settings. ⋯ Furthermore, we outline methodologic challenges in using this indicator in both research and practice, such as documentation, specificity and relevance, preference stability, and measuring nonevents. Recommendations to strengthen the accuracy of measurement of this important quality marker in health care settings include consistent recording of preferences in the medical record, considerations for selection of treatment preferences for tracking, establishing a protocol for review of preferences, and adoption of a consistent measurement approach.
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J Pain Symptom Manage · Oct 2016
Psychometric characteristics of the Hebrew Version of the Professional Quality of Life (ProQol) Scale.
Exposure to human suffering may have ramifications for the professional quality of life (ProQol) of palliative care teams. The ProQol scale was designed to assess both negative and positive work-related outcomes and has been used recently for the evaluation of work-related outcomes among palliative care workers. However, the assessment of ProQol among Israeli hospice workers is scant. ⋯ Although the findings are consistent with those from studies in other languages, they are different from the original 30-item three-factor structure reported by Stamm. The Hebrew version of the compassion satisfaction subscale was found to be reliable and valid for studies among health care professionals, but further research is needed to improve the BU and secondary traumatic stress subscales.
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J Pain Symptom Manage · Oct 2016
ReviewResource Use and Health Care Costs of COPD Patients at the End of Life: A Systematic Review.
Patients with chronic obstructive pulmonary disease (COPD) in their final months of life potentially place a high burden on health care systems. Concrete knowledge about resources used and costs incurred by those patients at the end of life is crucial for policymakers. ⋯ The high use of health care resources in COPD patients in the final months of life suggests a focus on prolonging life and a tendency toward aggressive care. Limiting potentially inappropriate care and improving the quality of end-of-life care in advanced COPD are, therefore, important public health challenges.