Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2017
Multicenter StudyImpact of Radiation Therapy on Aggressive Care and Quality of Life near Death.
Radiation therapy (RT) is used with palliative intent in patients with advanced stage cancer. Prior studies, primarily in patients with poor performance status (PS), suggest that RT is associated with aggressive medical care, which may impact patients' quality of life near death (QoD) adversely. ⋯ Targeted use of RT in end-of-life cancer care may benefit patients with good PS, but its use may adversely affect patients with poorer PS. Decisions about RT use in this setting should consider likely end-of-life outcomes based on patients' current PS.
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J Pain Symptom Manage · Jan 2017
Multicenter StudyImpact of Palliative Care Screening and Consultation in the ICU: A Multi-hospital Quality Improvement Project.
There are few multicenter studies that examine the impact of systematic screening for palliative care and specialty consultation in the intensive care unit (ICU). ⋯ Receiving a PCC in the ICUs was significantly associated with more frequent DNR code status and hospice referrals, but not 30-day readmissions or hospital utilization. Early PCC was associated with significant LOS and direct cost reductions. Providing PCC early in the ICU should be considered.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialCoping in Patients with Incurable Lung and Gastrointestinal Cancers: A Validation Study of the Brief COPE.
Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple and distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. ⋯ The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers.
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J Pain Symptom Manage · Jan 2017
Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.
The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. ⋯ Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers.
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J Pain Symptom Manage · Jan 2017
Variations in care quality outcomes of dying people: Latent class analysis of an adult national register population.
Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people to understand and evaluate symptom relief as an indicator of quality of care at end of life. ⋯ Interindividual variability and complexity in symptom relief patterns may inform quality of care and its evaluation for dying people across care settings.