Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2016
Review Meta AnalysisEffects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis.
Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy (TCM-FEMT) reports controversial results. ⋯ Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.
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J Pain Symptom Manage · Apr 2016
Multicenter StudyCancer Care Professionals' Attitudes Toward Systematic Standardized Symptom Assessment and the Edmonton Symptom Assessment System (ESAS) Following Large-Scale Population-Based Implementation in Ontario, Canada.
Cancer patients experience a high symptom burden throughout their illness. Despite this, patients' symptoms and needs are often not adequately screened for, assessed, and managed. ⋯ Findings show significant albeit variable uptake across disciplines in the use of the ESAS since program initiation. Several barriers to using the ESAS in daily practice were identified. These need to be addressed.
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J Pain Symptom Manage · Apr 2016
How Community Clergy Provide Spiritual Care: Toward a Conceptual Framework for Clergy End-of-Life Education.
Community-based clergy are highly engaged in helping terminally ill patients address spiritual concerns at the end of life (EOL). Despite playing a central role in EOL care, clergy report feeling ill-equipped to spiritually support patients in this context. Significant gaps exist in understanding how clergy beliefs and practices influence EOL care. ⋯ A conceptual framework informed by clergy perspectives of optimal spiritual care can guide EOL educational programming for clergy.
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J Pain Symptom Manage · Apr 2016
Case ReportsLocked-In Syndrome: Case Report and Discussion of Decisional Capacity.
Locked-in syndrome (LIS) is a rare neurologic disorder rendering an individual quadriplegic and anarthric with preserved self-awareness and normal if not near-normal cognition. A lesion to the ventral pons causes the classic form of LIS, and patients can typically interact with their environment with eye/eyelid movements. LIS patients may live for years with preserved quality of life (QoL) and cognitive function, but with severe disability. ⋯ The patient was determined to be decisional during the acute hospitalization, and he elected for life-prolonging care. This case emphasizes the importance of unbiased shared decision making, but also the importance of utilizing a practical framework to assess the decision-making capacity in these patients. We provide a suggested approach to determining decision-making capacity in similar cases or conditions.
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J Pain Symptom Manage · Apr 2016
Multicenter Study Comparative StudyAre Hospice Admission Practices Associated with Hospice Enrollment for Older African Americans and Whites?
Hospices that enroll patients receiving expensive palliative therapies may serve more African Americans because of their greater preferences for aggressive end-of-life care. ⋯ Hospices with larger budgets served a greater proportion of African Americans and whites in their service area. Although larger hospices reported less restrictive admission practices, they also may have provided other services that may be important to patients regardless of race, such as more in-home support or assistance with nonmedical expenses, and participated in more outreach activities increasing their visibility and referral base. Future research should explore factors that influence decisions about hospice enrollment among racially diverse older adults.