Journal of pain and symptom management
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As our population ages, there will be an increasing number of patients with life-limiting disease who may be referred for major elective surgery and more pressingly may present acutely, requiring major emergency surgical intervention. Owing to the high risk of perioperative and postoperative complications associated this group of patients, it is paramount that specific advance care planning that encompasses a patient's goals of care and resuscitative status be clarified before undergoing surgery in this acute period. ⋯ Furthermore, it will help to prevent futile and inappropriate treatments that do not respect a patient's wishes and their clinical status. In this case discussion, we explore the key themes about the challenge of perioperative advance care planning for patients with life-limiting disease and provide a framework to help guide conversation in this crucial period.
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J Pain Symptom Manage · Sep 2019
Consensus Building on Health Indicators to Assess PC Global Development With an International Group of Experts.
International consensus on indicators is necessary to standardize the global assessment of palliative care (PC) development. ⋯ The first list including 25 of the best indicators to evaluate PC development at a national level has been identified.
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J Pain Symptom Manage · Sep 2019
Randomized Controlled TrialTo what extent do the NRS and CRQ capture change in patients' experience of breathlessness in advanced disease? Findings from a mixed-methods double blind randomised feasibility trial.
Chronic or refractory breathlessness is common and distressing. To evaluate new treatments, outcome measures that capture change in patients' experience are needed. ⋯ This study found that the NRS using the question "How bad has your breathlessness felt at its worst over the past 24 hours?" captured change across multiple domains, and therefore may be an appropriate primary outcome measure in trials in this population. Future work should confirm the construct validity of this question.
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PC-FACS(FastArticleCriticalSummaries for Clinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pcfacs@aahpm.org.