Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2020
Randomized Controlled TrialEarly-Integrated Palliative home care and standard care for end-stage COPD (EPIC): A Phase II pilot RCT testing feasibility, acceptability and effectiveness.
Although early integrated palliative home care (PHC) is believed to be beneficial for patients with chronic obstructive pulmonary disease (COPD), trials testing this hypothesis are rare and show inconclusive results. ⋯ Our intervention on early integrated PHC for end-stage COPD is feasible and accepted but did not yield the anticipated preliminary effectiveness. Before moving to a Phase III trial, enhanced coordination of care, more GP involvement, more intensive training for PHCNs in COPD support, and revision of the trial design, for example, of targeted outcomes in line with individual patient goals and care preferences should be done.
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J Pain Symptom Manage · Feb 2020
Natural Language Processing Accurately Measures Adherence to Best Practice Guidelines for Palliative Care in Trauma.
The Trauma Quality Improvement Program Best Practice Guidelines recommend palliative care (PC) concurrent with restorative treatment for patients with life-threatening injuries. Measuring PC delivery is challenging: administrative data are nonspecific, and manual review is time intensive. ⋯ NLP performs with similar accuracy with manual review but with improved efficiency. NLP has the potential to accurately identify PC delivery and benchmark performance of best practice guidelines.
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J Pain Symptom Manage · Feb 2020
Development and Validation of the Palliative Care Attitudes Scale (PCAS-9): A Measure of Patient Attitudes toward Palliative Care.
Palliative Care is underutilized, and research has neglected patient-level factors including attitudes that could contribute to avoidance or acceptance of Palliative Care referrals. This may be due in part to a lack of existing measures for this purpose. ⋯ Findings support the overall reliability, validity, and generalizability of the PCAS-9 in serious illness samples and have implications for increasing Palliative Care utilization via clinical care and future research efforts.
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J Pain Symptom Manage · Feb 2020
Coping skills training and acceptance and commitment therapy for symptom management: Feasibility and acceptability of a brief telephone-delivered protocol for patients with advanced cancer.
Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers-availability of interventions in community clinics as well as financial and illness-related factors-to accessing psychosocial interventions. ⋯ Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.
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J Pain Symptom Manage · Feb 2020
Traumatic Events Among Cancer Patients that Lead to Compassion Fatigue in Nurses: A Qualitative Study.
Cancer care nurses are frequently exposed to patients' traumatic experiences and are at high risk of compassion fatigue. ⋯ This study identified the components and frequencies of traumatic events among patients with cancer that lead to the onset of nurse compassion fatigue. Such information will aid in understanding the triggers of compassion fatigue, allowing for possible preparation to reduce the risk of this occupational hazard.