Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialPerceived Family Functioning Predicts Baseline Psychosocial Characteristics in U.S. Participants of a Family Focused Grief Therapy Trial.
Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. ⋯ As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care.
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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.
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialRandomized evaluation of cognitive-behavioral therapy and graded exercise therapy for post-cancer fatigue.
Cancer-related fatigue is prevalent and disabling. When persistent and unexplained, it is termed post-cancer fatigue (PCF). Cognitive behavioral therapy (CBT) and graded exercise therapy (GET) may improve symptoms and functional outcomes. ⋯ Combined CBT/GET improves fatigue and functional outcomes for a subset of patients with post-cancer fatigue. Further studies to improve the response rate and the magnitude of the benefit are warranted.
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialUnderstanding Response Rates to Surveys about Family Members' Psychological Symptoms after Patients' Critical Illness.
Achieving adequate response rates from family members of critically ill patients can be challenging, especially when assessing psychological symptoms. ⋯ We identified several predictors of the receipt of surveys assessing psychological symptoms in family of critically ill patients, including family member health status and attachment style. Using these characteristics to inform follow-up mailings and reminders may enhance response rates.
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Accurate estimation of life expectancy in patients with brain metastases is critical for counseling and choosing appropriate therapy. Performance status is the single greatest determinant of overall survival in this population. However, current measures of performance status are subjective and often based on brief clinical encounters. Gait speed is an objective, reliable predictor of overall health and survival. ⋯ Gait speed is associated with overall survival in patients with newly diagnosed brain metastases. Gait speed assessment is simple, objective, and may provide additional prognostic information to improve life expectancy estimation and management decisions.