Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2021
Association of Hospice Care Services with the Utilisation of Life-sustaining Treatments during End-of-life Care among Cancer Patients: A Nationwide 11-year Cohort Study.
The impact of hospice care services on the utilization of life-sustaining treatments during end-of-life care in terminally ill patients has not been extensively studied. ⋯ Hospice care services were associated with a lower likelihood of receiving life-sustaining treatments during the last three months of life in patients with cancer.
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J Pain Symptom Manage · Feb 2021
Implementing Goals of Care Conversations: Lessons from High and Low Performing Sites from a VA National Initiative.
The Veterans Health Administration (VA) National Center for Ethics in Healthcare implemented the Life-Sustaining Treatment Decisions Initiative, including policy and practice standards, clinician communication training, a documentation template, and central implementation support to foster advance care planning via goals-of-care conversations for seriously ill veterans in 2014, spreading nationally to other Veterans Health Affairs (VA) sites in 2017. ⋯ Learning health care systems need multilevel interdisciplinary implementation approaches to support communication about serious illness, from broad-based system-level training and education to build communication skills, to focusing on characteristics of successful individual champions who listen to critics and are tenacious in addressing concerns.
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J Pain Symptom Manage · Feb 2021
Associations of uncertainty with psychological health and quality of life in older adults with advanced cancer.
Older adults with advanced cancer face uncertainty related to their disease and treatment. ⋯ Uncertainty among older patients with advanced cancer is associated with worse psychological health and QoL. Tailored uncertainty management strategies are warranted.
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J Pain Symptom Manage · Feb 2021
Epidemiology of Fear, Sadness and Anger Expression in Palliative Care Conversations.
Advancing the science of serious illness communication requires methods for measuring characteristics of conversations in large studies. Understanding which characteristics predict clinically important outcomes can help prioritize attention to scalable measure development. ⋯ Fear, anger, and sadness are commonly expressed in hospital-based palliative care consultations with people who have advanced cancer. Anger is an epidemiologically useful predictor of important clinical outcomes.
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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.