Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2018
"I'd Recommend …" How to Incorporate Your Recommendation Into Shared Decision Making for Patients With Serious Illness.
Patients and families facing serious illness often want and need their clinicians to help guide medical decision making by offering a recommendation. Yet clinicians worry that recommendations are not compatible with shared decision making and feel reluctant to offer them. We describe an expert approach to formulating a recommendation using a shared decision-making framework. We offer three steps to formulating a recommendation: 1) evaluate the prognosis and treatment options; 2) understand the range of priorities that are important to your patient given the prognosis; and 3) base your recommendation on the patient's priorities most compatible with the likely prognosis and available treatment options.
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J Pain Symptom Manage · Apr 2018
The Growing Demand for Hospice and Palliative Medicine Physicians: Will the Supply Keep Up?
The need for hospice and palliative care is growing rapidly as the population increases and ages and as both hospice and palliative care become more accepted. Hospice and palliative medicine (HPM) is a relatively new physician specialty, currently training 325 new fellows annually. Given the time needed to increase the supply of specialty-trained physicians, it is important to assess future needs to guide planning for future training capacity. ⋯ Current training capacity is insufficient to keep up with population growth and demand for services. HPM fellowships would need to grow from the current 325 graduates annually to between 500 and 600 per year by 2030 to assure sufficient physician workforce for hospice and palliative care services given current service provision patterns.
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J Pain Symptom Manage · Apr 2018
Comparative StudyComparison of Indicators for Achievement of Pain Control With a Personalized Pain Goal in a Comprehensive Cancer Center.
The achievement of a personalized pain goal (PPG) is advocated as an individualized pain relief indicator. ⋯ The achievement of PPG was a stricter pain relief indicator than PI and interference and may reflect a real need for pain control.
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J Pain Symptom Manage · Apr 2018
Observational StudyAdvance Care Planning in Community-Dwelling Patients With Dementia.
Little is known about advance care planning (ACP) among community-dwelling patients with dementia. ⋯ Our findings support need for greater ACP discussions between patients and proxies. Discussions regarding goals of care are likely to benefit patients through delivery of care congruent with their wishes and HCPs in terms of greater acceptance of patients' illness.
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J Pain Symptom Manage · Apr 2018
The Structure of the FACT-Cog v3 in Cancer Patients, Students, and Older Adults.
The Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog) version 3 questionnaire is designed to assess perceived cognitive function and impact on quality of life in cancer patients. ⋯ The FACT-Cog can be used in populations other than cancer patients, with modifications to the scoring system. Even when used with cancer patients, it is worth considering scoring specific cognitive domains separately.