Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2020
ReviewA Qualitative Meta-Synthesis of the Experience of Fatigue across Five Chronic Conditions.
Fatigue is a symptom reported by patients with a variety of chronic conditions. However, it is unclear whether fatigue is similar across conditions. Better understanding its nature could provide important clues regarding the mechanisms underlying fatigue and aid in developing more effective therapeutic interventions to decrease fatigue and improve quality of life. ⋯ In adults with heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease, we found that fatigue was characterized by severe energy depletion, which had negative impacts on patients' lives and caused associated symptoms that exacerbated fatigue. Yet, fatigue is commonly misunderstood and inadequately acknowledged.
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J Pain Symptom Manage · Jun 2020
Alterations in Patterns of Gene Expression and Perturbed Pathways in the Gut-Brain Axis Are Associated With Chemotherapy-Induced Nausea.
Despite current advances in antiemetic treatments, approximately 50% of oncology patients experience chemotherapy-induced nausea (CIN). ⋯ Persistent CIN remains a significant clinical problem. Our study is the first to identify novel GBA-related pathways associated with the occurrence of CIN. Our findings warrant confirmation and suggest directions for future clinical studies to decrease CIN occurrence.
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J Pain Symptom Manage · Jun 2020
Randomized Controlled TrialRandomized Controlled Trial of Advance Care Planning Video Decision Aid for the General Population.
Advance care planning (ACP) in a healthy general population could improve the quality of care when a health problem arises. ⋯ A well-constructed video decision support intervention can increase the intention to document ACP in the general population that presumably had little opportunity to discuss ACP with physicians.
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J Pain Symptom Manage · Jun 2020
Deep Natural Language Processing Identifies Variation in Care Preference Documentation.
Documentation of care preferences within 48 hours of admission to an intensive care unit (ICU) is a National Quality Forum-endorsed quality metric for older adults. Care preferences are poorly captured by administrative data. ⋯ Care preference documentation within 48 hours was absent in more than one-third of ICU admissions among patients aged 75 years and older and was more likely to occur in medical vs. cardiac or surgical ICUs.
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J Pain Symptom Manage · Jun 2020
Perspectives Regarding Hospice Services and Transfusion Access: Focus Groups with Blood Cancer Patients and Bereaved Caregivers.
Patients with blood cancers have low rates of timely hospice use. Barriers to hospice use for this population are not well understood. Lack of transfusion access in most hospice settings is posited as a potential reason for low and late enrollment rates. ⋯ Our analysis suggests that although patients with blood cancers value hospice services, they also consider transfusions vital to their QOL. Innovative care delivery models that combine the elements of standard hospice services with other patient-valued services like transfusions are most likely to optimize end-of-life care for patients with blood cancers.