Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2021
Pediatric Death by Neurologic Criteria: The Ever-Changing Landscape and the Expanding Role of Palliative Care Professionals.
Pediatric palliative care providers are especially suited to support families and medical teams facing a potential diagnosis of brain death, or death by neurologic criteria (DNC), when a child suffers a devastating brain injury. To support pediatric palliative care providers' effectiveness in this role, this article elucidates the clinical determination of DNC and the evolution of the ethical and legal controversies surrounding DNC. ⋯ We describe these conceptual definitions and legal challenges then explore some potential reasons why families may dispute a determination of DNC. We conclude that working with patients, families, and healthcare providers facing DNC carries inherent and unique challenges suited to intervention by interdisciplinary palliative care teams.
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J Pain Symptom Manage · Nov 2021
ReviewPalliative care development in Asia Pacific region: A review of assessment indicators.
Organizations such as Asia Pacific Hospice Palliative Care Network functions to promote quality palliative care development through training and education, research collaboration and variety relevant projects and events for all in the Asia and Pacific region. ⋯ Palliative care development is largely influenced by policies and funding structures as well as by cultural views and beliefs of stakeholders. It is expected that individuals, stakeholders and practitioners in Asia Pacific might have differing views and cultural beliefs when compared to the European or western counterparts. The lack of details and documentation in the region and inadequate reporting measures impacts on the development of strong palliative care framework.
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J Pain Symptom Manage · Nov 2021
ReviewA systematic review of measures of breakthrough pain and their psychometric properties.
Breakthrough pain (BTP) is common in cancer and other conditions yet there is a lack of validated BTP measurement tools. ⋯ The BAT is recommended to characterise BTP in adults with cancer; its applicability to other conditions is unknown. The remaining tools need further evaluation. Only the Breakthrough Pain Questionnaire for Children was designed for children with cancer, but no psychometric properties were evaluated. There is a need for a tool to assess and characterise BTP in children with non-cancer diagnoses and those who cannot self-report.
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When caring for a grieving patient, professional chaplains may assess the patient's spiritual suffering, address questions of meaning and purpose, and identify sources of comfort, love, and strength. In the setting of a pandemic, with heightened precautions and limited visitation by loved ones, all members of the clinical team are called to utilize compassionate listening and communication skills to address the pervasive isolation and grief of those in their care. This article uses a chaplain's personal narrative to explore the challenges of facilitating grief support with a newly bereaved patient who cannot speak. It presents the Biblical concept of kol d'mama daka, the "still small voice," as an image of the power of silence and revelation that comes when clinicians employ deep listening and compassion.