Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2017
Review Meta AnalysisThe effectiveness of distraction as procedural pain management technique in paediatric oncology patients: a meta-analysis and systematic review.
Diagnostic tests and treatment regimens for pediatric cancers involve invasive and painful procedures. Effective management of such pain has been shown to be suboptimal in many parts of the world, often because of the cost and limited availability of appropriate medications. Current evidence suggests that distraction (a relatively low-cost technique) is a promising intervention for procedural pain management. There is, however, limited evidence demonstrating its effectiveness in pediatric oncology patients. ⋯ This systematic review demonstrates that distraction is a promising intervention for procedural pain. Future research should assess effectiveness of distraction in varied populations, to explore evidence of cultural influences on pain expression, measurement, and management approaches.
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J Pain Symptom Manage · Oct 2017
Comparative StudyFull title: Policy measures to support palliative care at home: a cross-country case comparison in three European countries.
The proportion of people in need of palliative care worldwide is rising, and the majority wish to receive this care at home. Many countries have created policy measures to support palliative care at home. ⋯ European countries with similar contextual characteristics offer comparable policy measures to support palliative care at home in addition to the available primary care services. However, important differences exist in the criteria for access and the extent of what is offered.
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J Pain Symptom Manage · Oct 2017
Palliative Care Clinicians Caring for Patients Before and After Continuous Flow-Left Ventricular Assist Device.
Left ventricular assist devices (LVADs) are an available treatment option for carefully selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. ⋯ There has been increased emphasis on involving palliative care (PC) specialists in LVAD programs, specifically the DT-LVAD population, from the pre-implantation process through the end of life. Palliative care specialists are well poised to provide education, guidance, and support to patients, families, and clinicians throughout the LVAD journey. This article addresses the complexities of the LVAD population, describes key challenges faced by PC specialists, and discusses opportunities for building collaboration between PC specialists and LVAD teams.
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J Pain Symptom Manage · Oct 2017
Multicenter StudyStability and priority of symptoms and symptom clusters among allogeneic HSCT patients within a 5-year longitudinal study.
Due to toxicity and invasiveness, allogeneic hematopoietic stem cell transplantation causes severe and longstanding symptom burden. Longitudinal studies on symptoms and symptom clusters (SC) would be helpful to optimize symptom control but are rare to date. ⋯ Given its high stability, severity, and impact on QoL, fatigue should have priority in symptom management. The treatment of this symptom could be enhanced by also incorporating interventions addressing dyspnea and loss of appetite.
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J Pain Symptom Manage · Oct 2017
Multicenter StudyEvaluation of Emergency Department Management of Opioid-Tolerant Cancer Patients with Acute Pain.
There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during emergency department (ED) encounters. ⋯ Patients with daily home use less than 200 OMEs generally received adequate initial PRN opioid doses during their ED visit. However, patients with higher home opioid usage were at increased likelihood of being undertreated.