Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2016
Review Meta AnalysisGender Differences in Hiccup Patients: Analysis of Published Case Reports and Case-Control Studies.
Although sporadic male predominance in hiccup patients has been reported, the association between gender differences and triggering factors has rarely been evaluated in patients with hiccups. ⋯ We demonstrated male predominance in hiccup patients. This gender difference for hiccups was more pronounced in patients with non-CNS causes, whereas indistinct in patients with CNS causes.
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J Pain Symptom Manage · Feb 2016
Randomized Controlled Trial Comparative StudyBlinded Patient Preference for Morphine Compared to Placebo in the Setting of Chronic Refractory Breathlessness - An Exploratory Study.
Patients' preference for morphine therapy has received little attention in the setting of chronic refractory breathlessness. However, this is one important factor in considering longer term therapy. ⋯ Participants preferred morphine over placebo for the relief of chronic refractory breathlessness. Morphine offers clinically important improvement, but net benefit can be easily outweighed by side effects, reducing net benefits. Side effects require aggressive management to allow more patients to realize benefits.
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J Pain Symptom Manage · Feb 2016
Randomized Controlled TrialThe Social Convoy for Family Caregivers Over the Course of Hospice.
Family caregivers play a central role in the care of those in hospice care. Little is known about the social support networks for those providing this day-to-day care without training. ⋯ This result illustrates the potential importance of ongoing comprehensive assessment of caregiver networks and attention to interventions that may assist in capitalizing on both the quantity of support (numbers of individuals asked to help) and the quality of social support (attending to issues of support burden).
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J Pain Symptom Manage · Feb 2016
Clinical Factors Associated with a Short Survival Time After Percutaneous Nephrostomy for Ureteric Obstruction in Cancer Patients: An Updated Model.
Patients with advanced cancer can develop ureteric obstruction. Percutaneous nephrostomy (PCN) tube insertion can relieve this obstruction and prevent renal failure. PCN is associated with complications and can worsen quality of life. Prognostic models of survival after PCN in cancer patients can help identify the patients who will most likely benefit from this intervention. This work updates a prognostic model to predict overall survival in cancer patients after receiving PCN. ⋯ Survival in patients with malignant ureteric obstruction can range widely from a few days to a few years. The presented prognostic model is an updated model and can be used to identify patients with poor survival after PCN.
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J Pain Symptom Manage · Feb 2016
Methodological Research Priorities in Palliative Care and Hospice Quality Measurement.
Quality measurement is a critical tool for improving palliative care and hospice, but significant research is needed to improve the application of quality indicators. We defined methodological priorities for advancing the science of quality measurement in this field based on discussions of the Technical Advisory Panel of the Measuring What Matters consensus project of the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association and a subsequent strategy meeting to better clarify research challenges, priorities, and quality measurement implementation strategies. ⋯ We then apply these concepts to the key quality domain of advance care planning and address relevance to implementation of indicators in improving care. Developing the science of quality measurement in these key areas of palliative care and hospice will facilitate improved quality measurement across all populations with serious illness and care for patients and families.