Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2021
What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19? A rapid survey.
Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. ⋯ Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
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J Pain Symptom Manage · Feb 2021
Experiences, Personal Attitudes and Professional Stances of Swiss Health Care Professionals towards Voluntary Stopping of Eating and Drinking to Hasten Death: A Cross-Sectional Study.
Voluntary stopping of eating and drinking (VSED) is the self-determined decision of an individual with the decision-making capacity to cause premature death. During the course of VSED, the person is dependent on the support of relatives and health professionals. To date, little is known of the attitudes of Swiss health professionals on this topic. ⋯ Swiss health care professionals support the autonomy and self-determination of patients, which is also reflected in their positive attitude toward VSED, even if they have moral reservations when accompanying patients.
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J Pain Symptom Manage · Feb 2021
Re-ACT: Remote Advanced Communication Training in a Time of Crisis.
We used a quality improvement framework to transform two-day and in-person advanced communication training (ACT) course into a remote ACT (Re-ACT) format to help clinicians improve serious illness conversation (SIC) skills. ⋯ We provided effective and well-received SIC training during a time of crisis. Future work should further define the optimal mix of in-person and remote experiences to teach SIC skills.
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J Pain Symptom Manage · Feb 2021
The Bulle: Support and prevention of psychological decompensation of healthcare workers during the trauma of the COVID-19 epidemic.
The coronavirus disease 2019 pandemic presents unprecedented challenges for the health care system. The pressure on health care staff continues to intensify, accentuated by the confinement (lockdown) of the population and the unprecedented duration of this emergency. Separately and especially together, overwork, degraded conditions of care because of the never-ending emergency, and the risk of exposure to the virus can lead to acute psychological distress or signs of burnout. ⋯ It takes care of caregivers. The Bubble is a program that is simple to set up and that appears to meet professionals' expectations. Making it permanent and enlarging its scale, as a complement to existing programs, might help to support health care personnel in their work.
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J Pain Symptom Manage · Feb 2021
Case ReportsPalliative radiotherapy produced spectacular improvement in a terminally ill colorectal carcinoma patient with severe pain and duodenal bleeding.
Colorectal cancer has a devastating effect on the quality of life, and the treatment of active intestinal bleeding in colorectal cancer is a real challenge at the end of life. This case report presents a spectacular effect of an unusual palliative treatment strategy in a middle-aged home hospice patient with severe pain and persistent duodenal bleeding secondary to its neoplastic infiltration. Palliative radiotherapy (RT) significantly improved pain control, terminated the duodenal bleeding, and allowed successful treatment of deep vein thrombosis, previously impossible because of the bleeding. ⋯ In our patient, RT played a leading role in restoring general fitness and, accordingly, mental state improvement. Our case demonstrates that palliative RT may be a valuable treatment option in cases similar to ours. Still, careful assessment of risks and benefits is always mandatory.