Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2017
ReviewTopical Treatment of Peripheral Neuropathic Pain: Applying the Evidence.
Patients with peripheral neuropathic pain (NP) may only achieve partial pain relief with currently recommended first-line oral treatments, which are also associated with systemic adverse events. Topical treatments are currently considered second- or third-line options, but a recent pharmacologic treatment algorithm has called for broader first-line use of these agents. This has highlighted a need to communicate the benefits associated with topical agents, in particular around the efficacy, targeted local action, and limited systemic availability resulting in minimal systemic adverse events and drug-drug interactions. ⋯ First-line use of topical agents may be of particular benefit in patients where the safety and tolerability of oral therapy is a concern.
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J Pain Symptom Manage · Mar 2017
A cross-sectional study on the symptom burden of patients with spinal tumor: validation of the Chinese version of the MD Anderson Symptom Inventory - Spine Tumor Module (MDASI-SP).
Tumors involving the spine are associated with unique symptoms affecting both patient survival and health-related quality of life. Currently, there is no disease-specific instrument in Chinese to assess the symptom burden of these patients. ⋯ MDASI-SP-C demonstrated satisfactory psychometric properties and could be used to better assess the symptom burden of Chinese-speaking patients with spine tumors for improved management of their medical needs.
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J Pain Symptom Manage · Mar 2017
Predictors of complicated grief and depression in bereaved caregivers: a nationwide prospective cohort study.
Complicated grief and depressive symptoms in bereaved caregivers have been associated with female gender, spousal relation, and preloss psychological distress, but population-based, prospective studies are scarce. ⋯ Severe preloss grief and depressive symptoms were key predictors of postloss complicated grief and depressive symptoms. Systematic assessment may identify caregivers with a high risk profile who need targeted support.
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J Pain Symptom Manage · Mar 2017
Integrating Supportive Care Principles into Dialysis Decision-Making: A Primer for Palliative Medicine Providers.
Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. ⋯ These patients would benefit from the integration of supportive care principles into their care. This article addresses how supportive care specialists can collaborate with nephrology clinicians to provide patient-centered supportive care and identifies resources to assist them in this endeavor.
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J Pain Symptom Manage · Mar 2017
Operationalizing the Measuring What Matters Spirituality Quality Metric in a Population of Hospitalized, Critically Ill Patients and Their Family Members.
Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired. ⋯ Operationalizing the MWM spirituality quality indicator was challenging as elements of a "spiritual screening" or documentation of a "spiritual discussion" were not clearly documented in the EMR. The high prevalence of spirituality among respondents validates the importance of spirituality as a potential quality metric.