Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2018
Comparative StudyAssessing Symptoms, Concerns, and Quality of Life in Noncancer Patients at End of Life: How Concordant Are Patients and Family Proxy Members?
It has become commonplace to use family caregivers as proxy responders where patients are unable to provide information about their symptoms and concerns to health care providers. ⋯ Understanding discordance between patients and family member reports of symptoms and concerns is a valuable step toward minimizing patient and family burden at end of life.
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PC-FACS (FastArticleCriticalSummaries for Clinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pc-facs@aahpm.org.
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J Pain Symptom Manage · Nov 2018
Hospice Underutilization in the U.S.: The Misalignment of Regulatory Policy and Clinical Reality.
After three and a half decades of experience with the Medicare hospice benefit in the U. S., despite excellent quality outcomes in symptom management, patient and family satisfaction, and reduction in health care costs, only 12%-15% of beneficiaries' days during the last year of life are spent being cared for within the highly cost-effective interdisciplinary coordinated advanced illness care model known as hospice. Although there are many reasons for this, including difficulties in acknowledging mortality among patients, their families, and physicians, a significant cause of low overall hospice utilization and intractably low median lengths of stay, reflective of late admissions, can be attributed to increasingly difficult and highly variable prognostic determinations for most of the leading causes of death among Medicare beneficiaries. ⋯ This clinical conundrum that limits access of seriously ill people to high-value quality care is of profound importance to the U. S. Medicare population and also one with potential relevance to all complex and regulated health systems and to other models of care whose eligibility criteria are based on prognostication.
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J Pain Symptom Manage · Nov 2018
The Children's International Mucositis Evaluation Scale is Valid and Reliable for the Assessment of Mucositis Among Brazilian Children With Cancer.
The Children's International Mucositis Evaluation Scale (ChIMES) is considered a valid and reliable instrument for the assessment of mucositis in pediatric patients aged 0-18 years. ⋯ The Portuguese self-reported and proxy versions of ChIMES were considered to be culturally adapted, valid, and reliable for Brazilian pediatric patients ranging from an age of one month to 18 years and were named ChIMES-BR.
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J Pain Symptom Manage · Nov 2018
Using Routinely Collected Data to Ascertain Concordance With Advance Care Planning Preferences.
One of the key outcomes of advance care planning is whether patients had received care that was consistent with their expressed goals and preferences. ⋯ Administrative data offer a cost-efficient and powerful method for assessing outcomes for a large population-based national program. However, this approach is still at an early stage of development and needs to be further validated before it can be used at scale.