Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2017
Self-Reported Bothersome Symptoms Across Different Socioepidemiological Groups of People Living with HIV Attending French Hospitals: Results from the ANRS-VESPA2 Survey.
Twenty years after the advent of combined antiretroviral therapies (ARTs), there is a growing need for up-to-date information about the daily experience of people living with HIV (PLWH). ⋯ Combining new biomedical strategies with coping mechanisms and providing better support to socially vulnerable PLWH may improve this population's quality of health and daily life.
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J Pain Symptom Manage · Jul 2017
Terminally Ill Taiwanese Cancer Patients' and Family Caregivers' Agreement on Patterns of Life-Sustaining Treatment Preferences Is Poor to Fair and Declines Over a Decade: Results from Two Independent Cross-Sectional Studies.
Temporal changes have not been examined in patient-caregiver agreement on life-sustaining treatment (LST) preferences at end of life (EOL). We explored the extent of and changes in patient-caregiver agreement on LST-preference patterns for two independent cohorts of Taiwanese cancer patient-family caregiver dyads recruited a decade apart. ⋯ Patients and family caregivers had poor-to-fair agreement on LST-preference patterns, and agreement declined significantly over a decade. Encouraging an open dialogue between patients and their family caregivers about desired EOL care would facilitate patient-caregiver agreement on LST-preference patterns, thus honoring terminally ill cancer patients' wishes when they cannot make EOL-care decisions.
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J Pain Symptom Manage · Jul 2017
Effects of End-of-Life Discussions on the Mental Health of Bereaved Family Members and Quality of Patient Death and Care.
End-of-life discussions are crucial for providing appropriate care to patients with advanced cancer at the end of their lives. ⋯ End-of-life discussions may contribute to reducing depression and complicated grief in bereaved family members and enable patients to experience quality end-of-life care and a good death.
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J Pain Symptom Manage · Jul 2017
"I Just Felt Like I Was Stuck in the Middle": Physician Assistants' Experiences Communicating with Terminally Ill Patients and their Families in the Acute Care Setting.
Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance practice providers such as physician assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs' current experiences in their daily practices. ⋯ Interventions aimed at improving PA communication with terminally ill patients and their families should target institutional structures, systems, and culture around roles and responsibilities in addition to skill and knowledge gaps to be most effective.
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J Pain Symptom Manage · Jul 2017
Is higher acceptance associated with less anticipatory grief among patients in palliative care?
Patients in palliative care can experience substantial psychological suffering. Acceptance-based interventions from approaches such as Acceptance and Commitment Therapy have demonstrated effectiveness in helping people cope with a range of life challenges. However, there is a dearth of research examining mechanisms of therapeutic change for patients in palliative care. ⋯ The present study provides preliminary data suggesting that interventions that target acceptance may be indicated in patients in palliative care.