Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2016
Randomized Controlled TrialFamily Caregiver Depressive Symptom and Grief Outcomes from the ENABLE III Randomized Controlled Trial.
Little is known about whether early palliative care (EPC) support for family caregivers (CGs) impacts depressive symptoms and grief after care recipients die. ⋯ CGs' depressive symptom and complicated grief scores 8-12 weeks after care recipients' deaths were not statistically different based on the timing of EPC support. The impact of timing of CG EPC interventions on CGs bereavement outcomes requires further investigation.
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J Pain Symptom Manage · Sep 2016
Symptom Burden and End-of-Life Treatment Preferences in the Very Old.
End-of-life (EOL) treatment preferences among the very old (age 85+) may differ from preferences in younger aged populations because of high levels of symptom burden and disability and high risk of mortality. It is unclear if symptom burden or level of disability is more important for such preferences. ⋯ Preferences for more aggressive EOL treatment were not related to daily symptom distress but were significantly more likely to be endorsed among those with better mobility, suggesting that disability is an independent predictor of EOL treatment preferences in the very old.
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J Pain Symptom Manage · Sep 2016
Randomized Controlled TrialFactors Affecting Patients' Preferences for and Actual Discussions About End-of-Life Care.
Discussions about end-of-life care are often difficult for patients and clinicians, and inadequate communication poses a barrier to patients receiving the care they desire. ⋯ The occurrence of, and desire for, patient-clinician communication about end-of-life care is associated with patient factors including communication barriers and facilitators and symptoms of depression and anxiety. Understanding these factors may facilitate design of effective communication interventions.
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J Pain Symptom Manage · Sep 2016
Understanding Treatment Effect Terminology in Pain and Symptom Management Research.
Within health services and medical research, there is a wide variety of terminology related to treatment effects. Understanding differences in types of treatment effects is especially important in pain and symptom management research where nonexperimental and quasiexperimental observational data analysis is common. ⋯ Our goal is to facilitate appropriate reporting and interpretation of study results and to help investigators understand what information a decision maker needs when deciding whether to implement a treatment. Greater awareness of the reasons why treatment effects may differ across studies of the same patients in the same treatment settings can help policy makers and clinicians understand to whom a study's results may be generalized.
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J Pain Symptom Manage · Sep 2016
Trend In and Correlates of Undergoing Radiotherapy in Taiwanese Cancer Patients' Last Month of Life.
A significant proportion of cancer patients at end of life (EOL) undergo radiotherapy, but this evidence is not from nationwide population-based studies. ⋯ Approximately one-tenth of Taiwanese cancer patients underwent EOL radiotherapy with a decreasing trend over time. Undergoing EOL radiotherapy was associated with demographics, disease characteristics, physician specialty, and primary hospital's characteristics and EOL care practice patterns. Clinical and financial interventions should target hospitals/physicians that tend to aggressively treat at-risk cancer patients at EOL to carefully evaluate the appropriateness and effectiveness of using EOL radiotherapy.