Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2019
A Model to Improve Behavioral Health Integration Into Serious Illness Care.
Behavioral health problems are highly prevalent among people with serious medical illness. Individuals living with these comorbidities have complex clinical and social needs yet face siloed care, high health care costs, and poor outcomes. Interacting factors contribute to these inequalities including historical separation of behavioral and physical health provision. ⋯ Developed through a mixed methods approach combining literature review, surveys, interviews, and input from an expert advisory panel, it provides a conceptual framework of building blocks for behavioral health integration tailored to serious illness care populations and the range of settings in which they receive care. The model is intended to serve as foundation to support the development and implementation of integrated behavioral health and serious illness care. The key components of the model are described, barriers to implementation discussed, and recommendations for policy approaches to address these barriers presented.
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J Pain Symptom Manage · Sep 2019
Perception of multiple sclerosis impact and treatment efficacy beliefs: mediating effect of patient's illness and self-appraisals.
Patients with multiple sclerosis (MS) experience many negative, seriously aggravating disease symptoms, and hence, research studies are utmost required to improve their coping with symptoms. Our research is an attempt to show ways to increase participation of patients with MS in the treatment and treatment planning process, as well as in managing the symptoms of the disease. ⋯ Our results indicate that worse perception of physical condition in patients with MS is associated with more negative treatment efficacy beliefs, and that this association is mediated by self-efficacy and illness perception. To inhibit the increase of negative treatment efficacy beliefs, health care specialists can work on improving self-efficacy and illness appraisals.
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Many of our experiences in hospice and palliative care medicine are challenging. We support dying patients and their families as they struggle with the transition from life to death and continue to support those in mourning. Many times, in America, it is difficult to even appreciate a glimmer of spiritual grace as our patients die. ⋯ It spanned and interconnected many eclectic faith traditions, theologies, and philosophies, including Taoism, Greek mythology, distributed cognition, mathematics, and Tibetan Buddhism. It resonated strongly with Zen and Christian mysticism. Some of Bruno's being and transformation to nonbeing was obvious; some of it was inscrutable.
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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
When Patients Say They Know About Palliative Care, How Much Do They Really Understand?
Lack of knowledge or misconceptions about palliative care (PC) can serve as barriers to accessing PC for seriously ill patients. Although self-reported rates of PC knowledge have been increasing, little is known about how self-reports relate to actual PC knowledge. ⋯ We found that self-reported PC knowledge may not reflect actual PC knowledge. Physicians should carefully explain PC when introducing it to patients. In addition, this PC information should be provided at a low literacy level to ensure widespread understanding of the service.