Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2021
Ask About What Matters: An Intervention to Improve Accessible Advance Care Planning Documentation.
Advance care planning (ACP) informs future medical decision-making, especially for patients with advanced age or serious illness. For clinicians to act on these preferences, or continue the ACP conversation as illness progresses, documentation of ACP discussions must be readily accessible within the electronic health record (EHR). ⋯ An institution-wide intervention significantly increased accessible ACP documentation within a centralized location of the EHR. EHR usability changes improved rates of accessible ACP documentation and subsequent views of this documentation.
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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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J Pain Symptom Manage · Nov 2021
ReviewPalliative medicine specialization in Latin America: A comparative analysis.
Formal recognition of palliative medicine as a specialty has been one of the main drivers in the development of palliative care. ⋯ Despite long-standing efforts to improve quality of care, and significant achievements to date, most Latin American countries have yet to develop palliative medicine as medical specialty. Specialty and sub-specialty training programs remain scarce in relation to regional needs, and the programs that do exist vary widely in duration, structure, and content.
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J Pain Symptom Manage · Nov 2021
Multicenter Study Observational StudyOptimal paracentesis volume for terminally ill cancer patients with ascites.
Patients with malignant ascites often suffer from distressing symptoms, especially in their end-of-life stage. Although paracentesis is the most common treatment modality to alleviate such symptoms, the optimal volume of paracentesis is not known. ⋯ Even small-volume paracentesis could alleviate abdominal distension of terminally ill cancer patients with malignant ascites without shortening the paracentesis interval compared with moderate-volume paracentesis. Small-volume paracentesis was a well-balanced treatment for these patients.