Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2018
Timing of Referral and Characteristics of Uninsured, Medicaid, and Insured Patients Referred to the Outpatient Supportive Care Center at a Comprehensive Cancer Center.
Low-income patients face barriers to palliative care access, which might negatively influence symptom management and advanced care planning. ⋯ Patients with limited or no insurance had significantly higher pain and were more frequently on opioids, younger, nonwhite, and not married. They required higher number of SCC follow-up visits. Insurance status did not affect timing of SCC referral or follow-ups at our cancer center.
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J Pain Symptom Manage · Mar 2018
Identifying opportunities to improve pain among patients with serious illness.
Pain is a common and distressing symptom. Pain management is a core competency for palliative care (PC) teams. ⋯ Pain is common among inpatients referred to PC. Three-quarters of patients with pain improve and improvement in pain is associated with other symptom improvement. Standardized, multisite data collection can identify PC patients likely to have marked and refractory pain, create benchmarks for the field, and identify best practices to inform quality improvement.
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J Pain Symptom Manage · Mar 2018
Survey on Neonatal End-of-Life Comfort Care Guidelines Across America.
Infants of age less than one year have the highest mortality rate in pediatrics. The American Academy of Pediatrics published guidelines for palliative care in 2013; however, significant variation persists among local protocols addressing neonatal comfort care at the end-of-life (EOL). ⋯ Across America, respondents confirmed significant variation and verified many institutions do not formally address neonatal EOL comfort care. Institutions with guidelines commonly appear to lack crucial areas of palliative care including patient symptom management and provider compassion fatigue. The overwhelming majority of respondents felt that their institutions would benefit from further neonatal EOL care training.
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J Pain Symptom Manage · Mar 2018
Body Composition Early Identifies Cancer Patients with Radiotherapy at Risk for Malnutrition.
The side effects of radiotherapy (RT) and the occurrence of comorbidity often result in appetite loss in patients, which leads to serious nutritional problems, significantly affecting the patients' treatment results and disease prognosis. ⋯ Body composition analysis can be used to promptly and effectively monitor changes in the nutritional status of patients with cancer during the cancer treatment period; changes in the body composition at different repetitions differ between patients with dissimilar cancers.
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J Pain Symptom Manage · Mar 2018
Shared decision making in home hospice nursing visits: A qualitative study.
Shared decisions between health care providers and patients and families are replacing the traditional physician-driven plans of care. Hospice philosophy recognizes the patient and family as a unit of care and embraces their role in decision making. ⋯ Hospice staff can benefit from a more purposeful shared decision-making process and a greater focus on assessment of patient and family understanding and ability to implement plans of care.