Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2017
Comparative Study Observational StudyComparative effectiveness of usual source of care approaches to improve end-of-life outcomes for children with intellectual disability.
Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. ⋯ Our findings demonstrated that USC plus TCM was more effective at improving end-of-life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed.
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J Pain Symptom Manage · Sep 2017
Distinct Physical Function Profiles in Older Adults Receiving Cancer Chemotherapy.
Although physical function is an important patient outcome, little is known about changes in physical function in older adults receiving chemotherapy (CTX). ⋯ Almost 65% of older oncology patients reported significant decrements in physical function that persisted over two cycles of CTX. Clinicians can assess for those characteristics associated with poorer functional status to identify high-risk patients and initiate appropriate interventions.
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J Pain Symptom Manage · Sep 2017
Why Computerized Adaptive Testing In Pediatric Brain Tumor Clinics.
Monitoring of health-related quality of life and symptoms of patients with brain tumors is needed yet not always feasible. This is partially due to lack of brief-yet-precise assessments with minimal administration burden that are easily incorporated into clinics. Dynamic computerized adaptive testing (CAT) or static fixed-length short forms, derived from psychometrically sound item banks, are designed to fill this void. ⋯ This study demonstrated the comparability of scores from CATs and short forms. Yet the agreement between these two varied across degrees of symptom severity which was a result of the ceiling effects of static short forms. We recommend CATs to enable individualized assessment for longitudinal monitoring.
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J Pain Symptom Manage · Sep 2017
Management of cancer cachexia and guidelines implementation in a comprehensive cancer center: a physician-led cancer nutrition program adapted to the practices of a country.
Cancer-associated cachexia is correlated with survival, side-effects, and alteration of the patients' well-being. ⋯ Our results highlight the great benefits of implementing nutritional guidelines through a physician-led multidisciplinary team in charge of nutritional care in a comprehensive cancer center.
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J Pain Symptom Manage · Sep 2017
Meaningful communication prior to death, but not presence at the time of death itself, is associated with better outcomes on measures of depression and complicated grief among bereaved family members of cancer patients.
Few studies have explored the clinical significance of the family's presence or absence at the moment of a patient's death and meaningful communication (saying "goodbye") in terms of post-bereavement outcomes. ⋯ Many families wished to be present at the moment of the patient's death; however, meaningful communication (saying "goodbye") between the patient and family members, and not their presence or absence itself, was associated with better outcomes on measures of depression or complicated grief. Health care professionals could consider promoting both mutual communication (relating to preparation for death) between family members and patients before imminent death, as well as the family's presence at the moment of death.