Journal of pain and symptom management
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J Pain Symptom Manage · May 2020
Do Longitudinally-Collected Symptom Scores Predict Time to Death in Advanced Breast Cancer: A Joint Modelling Analysis.
Patients with advanced breast cancer have low rates of survival that can be associated with symptom burden. ⋯ Patients with advanced breast cancer experience chronic ongoing low symptom burden, which predicts patient time to death. Future research should examine the mechanisms by which patient characteristics, treatment, and supportive and palliative care can have an impact on patient survival.
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J Pain Symptom Manage · May 2020
"Please Keep Mom Alive One More Day" - Clashing Directives of a Dying Patient and Her Surrogate.
All medical care providers are legally and ethically bound to respect their patients' wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment that contradicts the patients' previously stated wishes. Our work discusses the legal and ethical issues surrounding such requests and provides guidance for clinicians to ethically and compassionately respond-without compromising their professional and moral obligations to their patients.
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J Pain Symptom Manage · May 2020
Comfort and Satisfaction with Care of Home-dwelling Dementia Patients at the End-of-Life.
Despite the preference to pass away at home, many dementia patients die in institutions, resulting in a paucity of studies examining end-of-life care outcomes in the home setting. ⋯ Achieving comfort and satisfaction with care for dementia patients dying at home involves an interplay of modifiable factors. Honoring medical intervention preferences, such as those with palliative intent associated with patients' comfort, determined families' satisfaction with care.
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J Pain Symptom Manage · May 2020
Fatigue in peritoneal dialysis patients and an exploration of contributing factors: a cross-sectional study.
Fatigue is a common and detrimental symptom in dialysis patients; however, our understanding of it and investigation of its contributing factors is still very limited, especially in peritoneal dialysis (PD) patients. ⋯ Fatigue is a common symptom in PD patients, suggesting that increased awareness of this symptom is required. The identification of correlates by extensive exploration of multidimensional factors in this study may help practitioners to identify patients at higher risk and to develop a multidimensional and targeted intervention plan.
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J Pain Symptom Manage · May 2020
Observational StudyPatients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective, Observational Cohort Study of Japanese Patients With Cancer.
Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment. ⋯ After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics.