Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2020
Determinants of physicians' attitudes toward the management of infectious diseases in terminally-ill patients with cancer.
Antimicrobials are frequently prescribed to terminally ill patients with cancer; however, physicians' practice patterns regarding antimicrobial use vary widely. This study aimed to systematically identify factors that determine physicians' attitudes toward the management of infectious diseases in terminally ill patients with cancer. ⋯ Physicians have divergent attitudes toward the management of infectious diseases in terminally ill patients with cancer. Reflection by physicians on their own beliefs and perceptions regarding infectious disease management and a "good death" may help provide the best end-of-life care.
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J Pain Symptom Manage · Dec 2020
Palliative and end-of-life care in a small Caribbean country: A mortality follow-back study of home deaths.
Empirical information on circumstances of dying from advanced illness in developing countries remains sparse. Evidence indicates that out-of-hospital end-of-life care can have significant benefits such as increased satisfaction for the patient and caregivers and cost-effective for a health-care system. Services that are aimed to deliver care at private homes may be a good model for low- and middle-income countries or other low-resourced settings. ⋯ The largest part of end-of-life care at home in Trinidad and Tobago is provided by family members, whereas professional caregivers feature less prominently. To ensure quality in end-of-life care, better access to analgesics is needed, and adequate support and education for family members as well as general practitioners are highly recommended.
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J Pain Symptom Manage · Dec 2020
Unravelling fatigue in hemodialysis patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method.
Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias because of their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called memory-experience gap). Experience sampling methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data. ⋯ Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences, which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.