Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2018
Congruence Between Latent Class and K-modes Analyses in the Identification of Oncology Patients with Distinct Symptom Experiences.
Risk profiling of oncology patients based on their symptom experience assists clinicians to provide more personalized symptom management interventions. Recent findings suggest that oncology patients with distinct symptom profiles can be identified using a variety of analytic methods. ⋯ Both analytic methods can be used to identify subgroups of oncology patients with distinct symptom profiles. Additional research is needed to determine which analytic methods and which dimension of the symptom experience provide the most sensitive and specific risk profiles.
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J Pain Symptom Manage · Feb 2018
Cancer pain with a neuropathic component: a cross-sectional study of its clinical characteristics, associated psychological distress, treatments and predictors at referral to a cancer pain clinic.
In patients with cancer pain, identifying a neuropathic pain component (NPC) may inform the selection of subsequent therapeutic interventions. ⋯ One in three patients with cancer have an NPC, which is independently associated with recent chemotherapy, surgery, adjuvant analgesic use, episodic incident and breakthrough pain, longer pain duration, higher pain intensity, and pelvic or perineal pain location.
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J Pain Symptom Manage · Feb 2018
Characteristics of Older Adults in Primary Care Who May Benefit from Primary Palliative Care in the United States.
Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. ⋯ In the U.S., approximately 8% primary care visits among older adults was related to advanced illness conditions. Advanced illness visits were most common among those most likely to be socioeconomically vulnerable and highlight the need to focus efforts for high-quality palliative care for these populations.
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J Pain Symptom Manage · Feb 2018
Homing in on the Social: Systems-level Influences on Overly Aggressive Treatments at the End of Life.
The American Medical System is programmed to a default setting of aggressive care for the terminally ill. Institutional norms of decision making have been shown to promote high-intensity care, regardless of consistency with patient preferences. There are myriad factors at a system, clinician, surrogate, and patient level that drive the culture of overly aggressive treatments in American hospitals. ⋯ Institutional cultures, social norms, and systemic defaults influence both normative beliefs regarding standards of care and treatments plans that may not benefit seriously ill patients.
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J Pain Symptom Manage · Feb 2018
Patterns and Outcomes of Care in Children with Advanced Heart Disease Receiving Palliative Care Consultation.
Although access to subspecialty pediatric palliative care (PPC) is increasing, little is known about the role of PPC for children with advanced heart disease (AHD). ⋯ PPC involvement for children with AHD focuses on goals of care and psychosocial support. Findings suggest that PPC involvement at end of life supports goal-concordant care. Further research is needed to clarify the impact of PPC on patient outcomes.