Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2017
ReviewState of the Science of Spirituality and Palliative Care Research Part I: Definitions and Taxonomy, Measurement, and Outcomes.
The State of the Science in Spirituality and Palliative Care was convened to address the current landscape of research at the intersection of spirituality and palliative care and to identify critical next steps to advance this field of inquiry. Part I of the SOS-SPC two-part series focuses on questions of 1) What is spirituality? 2) What methodological and measurement issues are most salient for research in palliative care? And 3) What is the evidence relating spirituality and health outcomes? After describing current evidence we make recommendations for future research in each of the three areas of focus. ⋯ Furthermore, the field would benefit from hypothesis-driven outcomes research based on a priori specification of the spiritual dimensions under investigation and their longitudinal relationship with key palliative outcomes, the use of validated measures of predictors and outcomes, and rigorous assessment of potential confounding variables. Finally, results highlight the need for research in more diverse populations.
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J Pain Symptom Manage · Sep 2017
Randomized Controlled TrialLevel of Care Preferences among Nursing Home Residents with Advanced Dementia.
Delivering goal-directed care is a hallmark of high-quality palliative care, but requires an understanding of preferences. ⋯ Most proxies select comfort as the preferred level of care for NH residents with advanced dementia. Discussions regarding prognosis, as well as inquiry about goals of care, are modifiable factors that may promote a preference for comfort care in this population.
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J Pain Symptom Manage · Sep 2017
The conversion ratio from intravenous hydromorphone to oral opioids in cancer patients.
The lack of knowledge of the accurate conversion ratio (CR) between intravenous (IV) and oral hydromorphone and opioid rotation ratio (ORR) between IV hydromorphone and oral morphine equivalent daily dose (MEDD) may lead to poorly controlled pain or overdosing in cancer inpatients. ⋯ Our study found that 1 mg of IV hydromorphone is equivalent to 2.5 mg of oral hydromorphone and 11.46 mg of MEDD. Hydromorphone at doses ≥30 mg/day may require a lower ORR to other opioids.