Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2019
Latent Class Analysis of Specialized Palliative Care Needs in Adult Intensive Care Units from a Single Academic Medical Center.
In the intensive care unit (ICU), 14% of patients meet criteria for specialized palliative care, but whether subgroups of patients differ in their palliative care needs is unknown. ⋯ Based on the initial reason for consultation, we identified four classes of palliative care needs among critically ill patients, and GCAD patients were least likely to be high utilizers. These findings may help inform allocation of palliative care resources for this population.
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J Pain Symptom Manage · Jan 2019
Design and Implementation of Patient Portal-Based Advance Care Planning Tools.
Electronic health record-based portal tools may help patients engage in advance care planning (ACP). We designed and implemented portal-based ACP tools to enable patients to create a medical durable power of attorney (MDPOA). ⋯ Patients demonstrated willingness to use the portal to complete an MDPOA and rated the new ACP tools as highly usable. Future work will optimize population-based outreach strategies to engage patients in ACP through the portal.
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J Pain Symptom Manage · Jan 2019
Multicenter StudyHeart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?
Heart rate variability is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to homeostasis. ⋯ Our results suggest a less complex autonomic response to noxious stimuli in VS/UWS patients. Such method may help to better understand sympathovagal response to potentially painful stimulation in brain-injured patients.
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J Pain Symptom Manage · Jan 2019
Changes in the Care Setting of First Consults to Palliative and Supportive Care over a 7-Year Period.
Optimal benefits from palliative care (PC) are achieved when first consults (PC1) occur early, in the outpatient setting. Late PC1, like those in the intensive care unit (ICU), limit these benefits. ⋯ PC1 total annual number has increased, and the proportion of PC1 at ICU, a very late clinical setting, is decreasing. Further efforts are needed to integrate PC in hematologic cancer care.
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J Pain Symptom Manage · Jan 2019
Randomized Controlled TrialTriggered Palliative Care for Late-stage Dementia: a Pilot Randomized Trial.
Persons with late-stage dementia have limited access to palliative care. ⋯ Specialty palliative care consultation for hospitalized patients with late-stage dementia is feasible and promising to improve decision-making and some treatment outcomes.