Journal of pain and symptom management
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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
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
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
Increasing Advance Care Planning Completion at an Academic Internal Medicine Outpatient Clinic.
We sought to increase advance care planning (ACP) completion at an academic internal medicine clinic through an electronic health record. ⋯ Implementation of a multi-disciplinary approach can facilitate ACP. However, challenges still arise because in more than half of the cases, advance care efforts led only to a discussion.
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J Pain Symptom Manage · Sep 2017
Isolation and Suffering Related to Serious and Terminal Illness: Metaphors and Lessons from Albert Camus' Novel, The Plague.
Health care providers have much to learn from Albert Camus' great novel, The Plague. The Plague tells the story of a bubonic plague epidemic through the lens of doctor-narrator Rieux. ⋯ Camus' masterful engagement of the metaphor of isolation and its profound impact on suffering emphasizes the important role of community and spiritual perspectives of patients and providers in coping with serious illness, death, and dying. The Plague is relevant today, particularly given the challenges of distancing, alienation, and isolation imposed by not only disease but also by technology and clinical and administrative practices that have unintended consequences of incentivizing separation between patient and healer, thus engendering greater stress and suffering in both.