Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2018
Randomized Controlled Trial Multicenter StudyResults of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as Adjunctive Therapy in Advanced Cancer Patients With Chronic Uncontrolled Pain.
Prior Phase 2/3 studies found that cannabinoids might provide adjunctive analgesia in advanced cancer patients with uncontrolled pain. ⋯ Nabiximols might have utility in patients with advanced cancer who receive a lower opioid dose, such as individuals with early intolerance to opioid therapy.
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J Pain Symptom Manage · Feb 2018
ReviewA systematic review of the patient and carer related factors affecting the experience of pain for advanced cancer patients cared for at home.
Effective pain management is a priority in the palliative care of advanced cancer patients. A body of research is emerging examining the factors that influence the management and experience of pain for such individuals. Identifying such factors should allow for the development of targeted interventions to improve pain management in the home while ultimately reducing unnecessary suffering for the patient. ⋯ There is a lack of quantitative research in the area of factors influencing the experience of pain for advanced cancer patients cared for at home. Such findings would be useful in developing theories of change that would underpin interventions aimed at improving pain outcomes for this population.
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J Pain Symptom Manage · Feb 2018
ReviewHow well do current measures assess the impact of advance care planning on concordance between patient preferences for end of life care and the care received: A methodological review.
Research has begun to focus on whether Advance Care Planning (ACP) has the capacity to influence care, and to examine whether ACP can be effective in meeting patients' wishes at the end of their lives. Little attention has been paid, however, to the validity and clinical relevance of existing measures. ⋯ Methodological variations and weaknesses compromise the validity of study results, and prevent meaningful comparisons between studies or synthesis of the results. Effectively evaluating whether ACP interventions enhance a patient's capacity to receive the care they want requires harmonization of research. This demands standardization of methods across studies, validating of instruments, and consensus based on a consistent conceptual framework regarding what constitutes a meaningful outcome measure.
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J Pain Symptom Manage · Feb 2018
Randomized Controlled TrialWhich physicians' behaviors on death pronouncement affect family-perceived physician compassion? A randomized, scripted, video-vignette study.
Although the death of a loved one is a devastating family event, little is known about which behaviors positively affect families' perceptions on death pronouncements. ⋯ To convey compassion on death pronouncement, we recommend that physicians initiate prompt examination, explain that the physician has received a sign-out, perform examination respectfully, ascertain the time of death with a wristwatch, and reassure the families that the patient did not experience pain.
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J Pain Symptom Manage · Feb 2018
Psychometric Analysis of the Parenting Concerns Questionnaire in Women with Metastatic Cancer.
Parenting concerns are a major source of distress for patients with advanced cancer. However, validated tools to measure this construct in advanced cancer patients are lacking. ⋯ The PCQ assesses a unique aspect of psychological distress in cancer patients. It demonstrated adequate reliability and convergent validity, but its original three-factor structure was not supported in a population of patients with metastatic cancer. The PCQ would benefit from further testing and refinement to enhance its representation of parenting concerns in metastatic cancer.