Journal of pain and symptom management
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The Universal Declaration of Human Rights recognizes the inherent dignity, the equal and unalienable rights to be universally protected for all humans irrespective of race, color, gender, language, religion, political or other opinion, national or social origin, property, birth or other status. Though this includes the right to dignity-conserving care for terminally ill unauthorized immigrants, access to quality end-of-life care eludes them. Most of the estimated 11.3 million unauthorized immigrants either entered the country without the knowledge of the U. ⋯ Lack of opportunity for advance care planning discussions and lack of eligibility to hospice services commonly contributes to poor end of life care. As unauthorized immigrants approach the last days of life, they may often die alone, away from their loved ones, with little-to-no psychosocial support in their final moments. This article provides an overview on end-of-life care for unauthorized immigrants and makes recommendations for potential strategies to providing humane care and support to this vulnerable population.
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J Pain Symptom Manage · May 2018
A Systematic Review of Palliative Care Intervention Outcomes and Outcome Measures in Low-Resource Countries.
To meet the growing need for palliative care in low-resource countries, palliative care programs should be evidence based and contextually appropriate. This study was conducted to synthesize the current evidence to guide future programmatic and research efforts. ⋯ Many palliative care intervention models exist to serve patients in low-resource countries. Yet, limited high-quality evidence from low-resource countries is available to document intervention outcomes. Rigorous experimental studies and greater measurement of multidimensional aspects of palliative care are needed to advance the science of palliative care in low-resource settings.
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J Pain Symptom Manage · May 2018
Randomized Controlled TrialThe Role of Inflammation in the Pain, Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer.
Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance. ⋯ The proposed inflammatory model of symptoms was partially supported. Investigators should test interventions that target stress as a contributing factor in co-occurring pain, fatigue, and sleep disturbance and explore other factors that may influence inflammatory biomarker levels within the context of an advanced cancer diagnosis and treatment.
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J Pain Symptom Manage · May 2018
Factors Affecting Palliative Care Development in Africa: In-Country Experts' Perceptions in Seven Countries.
Factors contributing to and impeding palliative care (PC) development in Africa can provide insights into current strategies for advancing PC. ⋯ The key factors underpinning PC development in the seven countries contributed to the beginnings of PC in Africa, fueled by advocates who built on existing strengths to maximize opportunities. However, the current approach is at high risk in terms of its sustainability, and strategies for maximizing existing resources and growing infrastructure support are needed moving forward.
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J Pain Symptom Manage · May 2018
Case ReportsImplementing Routine Palliative Care Consultation Before LVAD Implantation: A Single Center Experience.
Left ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires preimplantation palliative care assessment; however, many palliative care teams have little experience providing this service. ⋯ Although palliative care consultants provided initial evaluation and management of multiple symptoms, there was not a large ongoing need. Integration of palliative services into the care of patients receiving LVADs can be incorporated into the workflow of the cardiothoracic and palliative care teams, resulting in improved ACP for all patients receiving LVADs and better care coordination for patients at the end of life.