Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2018
Randomized Controlled TrialThemes Addressed by Couples With Advanced Cancer During a Communication Skills Training Intervention.
Couple-based communication interventions have beneficial effects for patients with cancer and their partners. However, few studies have targeted patients with advanced stages of disease, and little is known about how best to assist couples in discussing issues related to life-limiting illness. ⋯ Findings suggest that couples likely would be receptive to an intervention that combines training in communication skills with guidance in focusing on issues related to life completion to assist with transitions at end of life. Such interventions might enhance both individuals' abilities to cope with illness-related symptoms and demands, enjoy the time they have together, and derive meaning from the experience.
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J Pain Symptom Manage · Aug 2018
Transition Points for the Routine Integration of Palliative Care in Patients With Advanced Cancer.
Increasing emphases are being placed on early integration of palliative care for patients with advanced cancers, yet barriers to implementation in clinical practice remain. Criteria to standardize referral have been endorsed, but their application is yet to be tested at the population level. ⋯ Despite calls for integrated palliative care, this occurs late or not at all for many patients with cancer. Our findings demonstrate the application of targeted cancer-specific transition points to trigger integration of palliative care as a standard part of quality oncological care and augment clinician-based referral in routine clinical practice.
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J Pain Symptom Manage · Aug 2018
It Is Not What You Think: Associations Between Perceived Cognitive and Physical Status and Prognostic Understanding in Patients With Advanced Cancer.
Patients with advanced cancer often overestimate their time left to live. Those who have heightened awareness of their cognitive and physical deficits at the end of life may have a better prognostic understanding. ⋯ Patients who reported worse cognitive function and physical well-being were more aware of their terminal illness than those with better cognitive function.
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J Pain Symptom Manage · Aug 2018
From Fear to Confidence: Changing Providers' Attitudes About Pediatric Palliative and Hospice Care.
Children have limited access to hospice care: few existing hospice programs have dedicated pediatric teams, and adult hospice providers feel inadequately trained to care for children. ⋯ A two-day, high-intensity low-cost community-based education program can improve adult providers' knowledge of and skill level with pediatric care, leading to a change in attitude from fear to confidence. This model has the potential to increase access to pediatric hospice care as it uses existing adult hospice infrastructure.