Journal of pain and symptom management
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The importance of advance care planning (ACP) has been increasingly recognized by health systems. However, 46%-76% of patients report engaging in ACP with lawyers, whereas only a minority report doing so with physicians. In the U. ⋯ Aligning medical and legal approaches to ACP is important to ensuring the quality and value of those efforts. As an important first step toward this goal, we convened an interprofessional panel of medical and legal experts to elucidate the state of medical-legal ACP and begin to identify strategies to improve and align practices within and across professions. This article describes the historical disconnects between the medical and legal practice of ACP, recommendations and products of the interprofessional panel, and recommendations for future medical-legal collaboration.
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J Pain Symptom Manage · Aug 2020
Observational StudyAssessment of the Decision-Making Capacity for Clinical Research Participation in Patients with Advanced Cancer in the Last Weeks of Life.
Few studies have examined how clinicians assess decision-making capacity for research in the last weeks of life. ⋯ Most patients in the palliative and supportive care unit lacked decision-making capacity for participation in clinical research. Clinician impression had high accuracy. Few patients with normal MDAS were found to be incapable with MacCAT-CR assessment.
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J Pain Symptom Manage · Aug 2020
Psychometric evaluation of the patient-related Nausea and Vomiting Management Barriers Questionnaire (NVMBQ).
The Nausea and Vomiting Management Barriers Questionnaire (NVMBQ) measures patient-related barriers to antiemetic medication. ⋯ The NVMBQ provides a good basis for assessing patient-related barriers to chemotherapy-induced nausea and vomiting management. We will use the resulting and translated NVMBQ in a larger study to assess the relationships between chemotherapy-induced nausea and vomiting, patient-related barriers, and current antiemetic regimens.
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J Pain Symptom Manage · Aug 2020
Mild to moderate cognitive impairment does not affect the ability to self-report important symptoms in cancer patients: a prospective longitudinal multi-national study (EPCCS).
Patients with advanced cancer commonly suffer from both distressing symptoms and cognitive impairment, but the effect of cognitive impairment on the reliability and validity of symptom self-report is unknown. ⋯ In advanced cancer, self-report of nine major symptoms was reliable and valid also in people with mild-to-moderate cognitive impairment.
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J Pain Symptom Manage · Aug 2020
Beliefs and perceptions about parenteral nutrition and hydration by family members of patients with advanced cancer admitted to palliative care units: a nationwide survey of bereaved family members in Japan.
There has been a growing consensus that parenteral nutrition and hydration is to be forgone in terminally ill patients with cancer. However, it remains unclear what the beliefs and perceptions of parenteral nutrition and hydration by the family members are. ⋯ This study showed that beliefs and perceptions about parenteral nutrition and hydration were important in the family members in palliative care.