Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2017
A survey to evaluate facilitators and barriers to quality measurement and improvement: Adapting tools for implementation research in palliative care programs.
Although critical for improving patient outcomes, palliative care quality indicators are not yet widely used. Better understanding of facilitators and barriers to palliative care quality measurement and improvement might improve their use and program quality. ⋯ This novel, adaptable instrument assesses palliative care team perspectives on barriers and facilitators for quality measurement and improvement in palliative care programs. Next steps include evaluation of the survey's construct validity and how survey results correlate with findings from program quality initiatives.
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J Pain Symptom Manage · Dec 2017
ReviewAdvance Care Planning in Palliative Care for People with Intellectual Disabilities: a Systematic Review.
Advance care planning (ACP) is defined as a person-centered, ongoing process of communication that facilitates patients' understanding, reflection, and discussion of goals, values, and preferences for future care. There is evidence for the general palliative care population that ACP increases compliance with patients' end-of-life preferences and improves quality of care near the end of life. ⋯ There are some indications that ACP could be useful for people with ID, but more knowledge is needed about whether and how ACP should be used.
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J Pain Symptom Manage · Dec 2017
ReviewPatient and caregiver-reported assessment tools for palliative care: summary of the 2017 AHRQ Technical Brief.
Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. ⋯ Few to no tools address the spiritual, ethical, or cultural domains or patient-reported experience with end-of-life care. While some data exist on psychometric properties of tools, the responsiveness of different tools to change and/or comparisons between tools have not been evaluated. Future research should focus on developing or testing tools that address domains for which few tools exist, evaluating responsiveness, and comparing tools.
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J Pain Symptom Manage · Dec 2017
Comparative StudyEnd-of-Life Experience of Older Adults Dying of End-Stage Renal Disease: a Comparison with Cancer.
Older adults with end-stage renal disease (ESRD) are a rapidly growing group of seriously ill patients. Yet, despite a mortality rate almost twice that of cancer, less is known about the impact of ESRD on patients' end-of-life experience. ⋯ Older adults dying of ESRD had lower rates of advance care planning and higher treatment intensity near the end of life than similar patients dying of cancer; both groups had similarly high rates of symptoms. Efforts are needed to make treatment more supportive and alleviate suffering for older adults with ESRD and their families near the end of life.
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J Pain Symptom Manage · Dec 2017
Neuropathic pain and Nerve Growth Factor in Chemotherapy-Induced Peripheral Neuropathy: prospective clinical-pathological study.
Neuropathic pain can be present in patients developing chemotherapy-induced peripheral neuropathy (CIPN). Nerve growth factor (NGF) is trophic to small sensory fibers and regulates nociception. ⋯ Serum NGF increases in cancer patients receiving taxane or platinum with painful CIPN, suggesting that it might be a potential biomarker of the presence and severity of neuropathic pain in this population. Long-term comprehensive studies to better define the course of NGF in relation with neurological outcomes would be helpful in the further design of therapies for CIPN-related neuropathic pain.