Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2019
Randomized Controlled TrialEfficacy of a decision aid consisting of a video and booklet on advance care planning for advanced cancer patients: randomized controlled trial.
Few randomized controlled trials of advance care planning (ACP) with a decision aid (DA) show an effect on patient preferences for end-of-life (EOL) care over time, especially in racial/ethnic settings outside the U.S. ⋯ ACP interventions that included a video and an accompanying book improved preferences for EOL care.
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J Pain Symptom Manage · Dec 2019
Patterns of palliative care beliefs among adults in the United States: analysis of a national cancer database.
Palliative care (PC) is associated with increased quality of life for individuals with life-limiting illnesses. Despite growing recognition of the need for public advocacy and involvement, data on public perception of PC are limited. We sought to examine patterns of beliefs, sociodemographic differences, and the impact of information source on perceptions of PC. ⋯ Six in every 10 American adults knowledgeable about PC have at least one documented misperception, with differential beliefs by sociodemographic groups. Source of information had little impact on PC beliefs. These findings may help focus future measures to educate the public about the role of PC in health care and address gaps in knowledge.
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J Pain Symptom Manage · Dec 2019
Palliative Care-Related Knowledge, Attitudes and Self-Assessment among Physicians in Vietnam.
Palliative care is rarely accessible in low- and middle-income countries, and lack of adequate training for health care providers is a key reason. In Vietnam, the Ministry of Health, major hospitals and medical universities, and foreign physician-educators have partnered to initiate palliative care training for physicians. ⋯ There is a great need among Vietnam's physicians for training in palliative care and especially in nonpain and psychological symptom control. Rational, balanced, and clear opioid-prescribing policies are needed to enable physicians to treat pain without fear of repercussions.
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J Pain Symptom Manage · Dec 2019
ReviewCancer Pain in People with Intellectual Disabilities:Systematic Review and Survey of Health Care Professionals.
Owing to life expectancy improvements for people with intellectual disabilities, their risk of developing cancer is increasing. Pain is an inevitable aspect of cancerous diseases. However, as pain experience and expression can be atypical in people with intellectual disabilities, this population is vulnerable to late diagnosis of cancer and undertreatment of cancer pain. ⋯ Cancer pain in people with intellectual disabilities is a topic lacking specific and comprehensive research within scientific literature. We suggest this is due to inherent difficulties regarding the complex interplay of comorbidities and communication issues in people with intellectual disabilities.
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J Pain Symptom Manage · Dec 2019
Optimising clinical screening for chemotherapy-induced peripheral neuropathy.
Efficient and accurate clinical screening for treatment-related toxicities is a critical component of optimal patient management. A number of alternate screening tools for chemotherapy-induced peripheral neuropathy (CIPN) have been proposed in response to demonstrated limitations with standard clinical screening, although their relative diagnostic value is unclear. ⋯ PRO screening tools provide adequate CIPN screening while avoiding potential biases demonstrated to limit currently used clinician-rated screening tools. Addition of a brief objective test did not add value to PRO screening. Up to 23% of patients would be misidentified through screening, providing quantitative evidence of the limitations of available screening tools. More extensive CIPN evaluations are critical in patients at risk of serious neurotoxicity.