Journal of pain and symptom management
-
J Pain Symptom Manage · Oct 2016
The Impact of Plasma Cholinergic Enzyme Activity and Other Risk Factors for the Development of Delirium in Patients Receiving Palliative Care.
Delirium is an important complication in palliative care patients. One of the potential risk factors for cognitive disorders is deterioration in cholinergic neurotransmission. Anticholinergic medications are known to be important owing to the association of their metabolites with significant morbidity, which is often the result of cumulative effects of medications (anticholinergic burden). Additionally, cholinergic enzymes are possible candidates reflecting the cholinergic situation in patients. However, the role of cholinesterases (CHE) for delirium in palliative care patients is unknown. ⋯ Special care might be necessary with anticholinergic medication to minimize risk for delirium in palliative cancer patients.
-
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.
-
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.
-
J Pain Symptom Manage · Oct 2016
Death-related anxiety in patients with advanced cancer: Validation of the German version of the Death and Dying Distress Scale (DADDS-G).
Distress and anxiety about issues related to death and dying is commonly experienced in patients with advanced disease and a limited life expectancy. ⋯ Results provide further evidence that the DADDS-G is a valid and reliable instrument of high clinical relevance for use in patients with advanced cancer.