Journal of pain and symptom management
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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
Randomized Controlled Trial Multicenter StudyWeb-based tailored psycho-education for breast cancer patients at the onset of the survivorship phase: a multicenter randomized controlled trial.
Many breast cancer patients have unmet informational and psychosocial needs after treatment completion. A psychoeducational intervention may be well suited to support these patients. ⋯ Although the effectiveness was not demonstrated, a subgroup of women treated for breast cancer can probably be supported by the program. The results of the present study are a starting point for further development and use of the program.
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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
Randomized Controlled TrialThe TAILORED Study: A Randomized Controlled Trial to Improve Surrogate Decision Making.
Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. ⋯ TAILORED patients and surrogates who completed the study adopted a more mutual decision-making style, balancing their own wishes with what the surrogate thinks would be best for them. Surrogates reported less stress and more satisfaction. Confidence was high at baseline and did not change. There was a modest increase in caregiver burden. These findings suggest that interventions like TAILORED might positively impact surrogate decision making.
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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.