Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2021
ReviewExploring Factors Associated with Long-Term Opioid Therapy in Cancer Survivors:An Integrative Review.
The prevalence of chronic pain in cancer survivors is double that of the general U.S. ⋯ The studies in this review shed light on the factors associated with LTOT in cancer survivors. LTOT was common in certain populations of cancer survivors and those with a collection of patient-specific characteristics. This review suggests that there is a critical need for specialized research on chronic cancer pain and opioid safety in cancer survivors.
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J Pain Symptom Manage · Feb 2021
CARING ADVANCED CANCER PATIENTS AT HOME DURING COVID-19 OUTBREAK: BURNOUT AND PSYCHOLOGICAL MORBIDITY AMONG PALLIATIVE CARE PROFESSIONALS IN ITALY.
Providing palliative care (PC) at home for patients with advanced cancer has become essential during the COVID-19 emergency. Nevertheless, the home PC professionals (PCPs) faced a challenging situation because of increased number of discharged patients, reduced availability of health-care facilities, and physical/relational barriers between them and patients. ⋯ In the age of COVID-19, the awareness of being at the forefront of containing the pandemic along with the sense of responsibility toward their high-risk patients may arouse PCPs' psychological distress, but, on the other hand, this condition may improve their sense of professional satisfaction and personal accomplishment.
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J Pain Symptom Manage · Feb 2021
Frequency and Characteristics of First-Time Palliative Care Referrals During the Last Day of Life.
Palliative care referrals (PCRs) improve symptom management, provide psychosocial and spiritual support, clarify goals of care, and facilitate discharge planning. However, very late PCR can result in increased clinician distress and prevent patients and families from benefiting from the full spectrum of interdisciplinary care. ⋯ Although only a small proportion of first-time PCR occurred in the last 24 hours of life, the patients had a significant amount of distress, indicating a missed opportunity for timely palliative care intervention. These sentinel events call for specific guidelines to better support patients, families, and clinicians during this difficult time. Further research is needed to understand how to minimize very late PCR.
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J Pain Symptom Manage · Feb 2021
Patient-reported Cognitive and Functional Impairments Among Older Canadians With Cancer; A Population-Based Study.
Cancer is estimated to affect one out of two Canadians throughout their lifetime and to be the cause of death of one out of four Canadians. Although it can affect virtually patients of any age, it disproportionately affects older adults. ⋯ Older adults with an active cancer diagnosis are more likely to report impaired cognitive and functional status compared with older adults without an active cancer diagnosis. More efforts are needed to ensure the integration of validated geriatric assessment tools (incorporating patient-reported elements) in the care of older adults with cancer.
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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.