Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2020
Physician-Predicted Prognosis and Palliative Radiotherapy Treatment Utilization at the End-of-Life: An Audit of a Large Cancer Center Network.
At our institution, clinical pathways capture physicians' prognostication of patients being evaluated for palliative radiotherapy. We hypothesize a low utilization rate of long-course radiotherapy (LCRT) and stereotactic ablative radiotherapy (SAbR) among patients seen at the end of life, especially those with physician-predicted poor prognosis. ⋯ Although most patients were predicted to have a limited prognosis, LCRT and SAbR were commonly prescribed at the end of life.
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J Pain Symptom Manage · Nov 2020
Multicenter StudyMinimal clinically important differences and feasibility of Dyspnea-12 and the Multidimensional Dyspnea Profile in cardiorespiratory disease.
Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). ⋯ D12 and MDP are responsive to change and feasible for use for assessing multidimensional breathlessness in outpatients with cardiorespiratory disease. MCIDs were determined for use as endpoints in clinical trials.
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J Pain Symptom Manage · Nov 2020
Randomized Controlled TrialMeasuring Goal-Concordant Care: Results and reflections from secondary analysis of a trial to improve serious illness communication.
Many consider goal-concordant care (GCC) to be the most important of advance care planning and palliative care. Researchers face significant challenges in attempting to measure this outcome. We conducted a randomized controlled trial to assess the effects of a system-level intervention to improve serious illness communication on GCC and other outcomes. ⋯ Measuring GCC remains a fundamental challenge to palliative care researchers. Ratings attest to the fact that many things matter to patients; however, rankings can better determine what matters most. Insights gained from our experience may guide future research aiming to use this outcome to assess the effect of intervention to improve serious illness care.
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J Pain Symptom Manage · Nov 2020
Complexities and constraints in end of life care for hospitalised prisoner patients.
Managing the care of an increasing and aging prisoner population, including providing palliative and end-of-life care, is a challenge worldwide. There is little known about the views of health professionals who provide palliative care to hospitalized prisoner patients. ⋯ Clarity of correctional service processes, protocols, and aspects of security and related training for health professionals is needed to ensure improved care for prisoners with progressive and life-limiting illness. Further research is required to seek the views of prisoners facing end of life and their families.