Journal of pain and symptom management
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J Pain Symptom Manage · May 2019
Stability of Symptom Clusters in Patients With Lung Cancer Receiving Chemotherapy.
Patients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research. ⋯ Findings provide insights into the most common symptom clusters in patients with lung cancer undergoing CTX. Most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.
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J Pain Symptom Manage · May 2019
Chronic pain, functional status, and life satisfaction are associated with patients living with HIV discussing advanced care planning with their family or friends.
In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV from a universally fatal disease to a serious chronic illness, warranting discussions between patients and their loved ones about advance care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones. ⋯ These results suggest that interventions to increase ACP among PLWHAs and their loved ones should target males. The findings also suggest PLWHAs with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over health care decisions may be primed for ACP.
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J Pain Symptom Manage · May 2019
Symptom Burden and Palliative Care Needs among High Risk Veterans with Multi-morbidity.
Palliative care research has focused on patients with disease-specific conditions. However, older patients with multimorbidity may have unmet palliative care needs. ⋯ Outpatients with multimorbidity have high symptom burden, unaddressed symptoms, poor quality of life, and unmet palliative care needs. Our findings support standardization of comprehensive symptom assessment and management in primary care for veterans with multimorbidities, which may ameliorate symptoms and improve quality of life.
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J Pain Symptom Manage · May 2019
Comparative StudyEnd-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients.
At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. ⋯ Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.
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J Pain Symptom Manage · May 2019
Pediatric Perioperative DNR Orders: A Case Series in a Children's Hospital.
Do-not-resuscitate (DNR) orders are common among children receiving palliative care, who may nevertheless benefit from surgery and other procedures. Although anesthesia, surgery, and pediatric guidelines recommend systematic reconsideration of DNR orders in the perioperative period, data regarding how clinicians evaluate and manage DNR orders in the perioperative period are limited. ⋯ Opportunities exist to improve how DNR orders are managed during the perioperative period.