Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2019
Randomized Controlled TrialExtent and Determinants of Terminally Ill Cancer Patients' Concordance Between Preferred and Received Life-Sustaining Treatment States: An Advance Care Planning Randomized Trial in Taiwan.
Promoting patient value-concordant end-of-life care is a priority in health care systems but has rarely been examined in randomized clinical trials. ⋯ Our advance care planning intervention did not facilitate concordance between terminally ill cancer patients' preferred and received LST states, but patient value-concordant end-of-life care may be facilitated by interventions to cultivate accurate prognostic awareness, improve quality of life, support depressive patients, and clarify anxious patients' overexpectations of LST efficacy.
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J Pain Symptom Manage · Jul 2019
Prevalence, Severity and Correlates of Symptoms of Anxiety and Depression at the Very End of Life.
Rates of psychological symptoms for patients with serious illness are high, but there has been limited research investigating psychological symptoms at the very end of life (EOL). ⋯ Psychological symptom management at the very EOL is essential to providing comprehensive hospice care. Our study revealed that nearly half of all home hospice patients experience moderate-to-severe symptoms of anxiety and/or depression in the last week of life. Future research is needed to improve psychological symptom management at the very EOL to improve the quality of life for both patients and their families.
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J Pain Symptom Manage · Jul 2019
Are We Evolving Toward Greater and Earlier Use of Palliative Home Care Support? A Trend Analysis Using Population-Level Data From 2010 to 2015.
The need for increased use and earlier initiation of palliative home care has been advocated by several international organizations. ⋯ This population-level study found a slight trend toward more and earlier initiation of PHCS between 2010 and 2015. However, uptake of PHCS remained below estimated needs in the population and the proportion of people receiving PHCS in their very late life remained stable over time.