Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2019
Pilot study to improve goals of care conversations among hospitalists.
Many hospitalized patients receive care that is not concordant with their goals. Teaching communication skills that better align goals and treatment can improve the care that patients receive. ⋯ Teaching hospitalists to have GOC conversations translated into better skills and outcomes for patients. This pilot study shows promise and should be tested in a larger trial.
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Palliative care (PC) for seriously ill surgical patients, including aligning treatments with patients' goals and managing symptoms, is associated with improved patient-oriented outcomes and decreased health care utilization. However, efforts to integrate PC alongside restorative surgical care are limited by the lack of a consensus definition for serious illness in the perioperative context. ⋯ We identified a consensus definition for serious illness in surgery. Opportunities remain in measuring the prevalence, identifying health trajectories, and developing screening criteria to integrate PC with restorative surgical care.
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J Pain Symptom Manage · Nov 2019
Dying with unrelieved pain - prescription of opioids is not enough.
Fear of pain resonates with most people, in particular, in relation to dying. Despite this, there are still people dying with unrelieved pain. ⋯ Despite almost complete prescription of opioids PRN for patients with pain, patients die with unrelieved pain. Health care providers, hospitals in particular, need to focus more on pain in dying patients. An EoL conversation is one achievable intervention.
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J Pain Symptom Manage · Nov 2019
Agreement of nursing home staff with palliative care principles: a PACE cross-sectional study among nurses and care assistants in five European countries.
To provide high-quality palliative care to nursing home residents, staff need to understand the basic principles of palliative care. ⋯ The level of agreement of nursing home staff with basic principles of palliative care was only moderate and differed between countries. Efforts to improve the understanding of basic palliative care are needed.
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J Pain Symptom Manage · Nov 2019
Review Meta AnalysisThe effect of exercise on quality of life, fatigue, physical function and safety in advanced solid tumor cancers: a meta-analysis of randomized control trials.
People with metastatic cancers experience poor quality of life (QoL), fatigue, and decreased physical function. Exercise improves these symptoms in the curative setting, but the efficacy and safety of exercise in the metastatic setting is uncertain. ⋯ Exercise is associated with clinically meaningful improvements in QoL, function, and 6-MWT in some patients with metastatic cancer. Despite poor reporting of safety, there was no signal of increased harm from exercise in this setting.