Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2021
Multicenter StudyHow we can improve the quality of care for patients requesting medical assistance in dying: a qualitative study of health care providers.
Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. ⋯ Canadian health care providers described unique challenges in caring for patients who request MAID, along with practices to improve the quality of care.
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J Pain Symptom Manage · Mar 2021
Randomized Controlled TrialStable symptom clusters and evolving symptom networks in relation to chemotherapy cycles.
The existence of stable symptom clusters with variations or changes in cluster membership and the merging of symptom clusters over time urge us to investigate how symptom relationships change over time. ⋯ Stable symptom clusters and evolving networks were identified. The most central symptom was fatigue; however, the paucity of studies that investigated symptom networks and central symptoms calls for further investigations on these phenomena. Identification of central symptoms and underlying mechanisms will guide efficient symptom management. Future studies will need to focus on developing comprehensive interventions for managing symptom clusters or targeting central symptoms.
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J Pain Symptom Manage · Mar 2021
Caregiving Experience and Other Factors Associated with Having End-of-Life Discussions: A Cross-sectional Study of a General Japanese Population.
The factors associated with end-of-life discussion (EOLD) are not well elucidated; an understanding of these factors may help facilitate EOLD. ⋯ For health-care providers, it may be worth recognizing that the care experience of their patient's caregiver might affect the caregiver's own EOLD in the future.
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J Pain Symptom Manage · Mar 2021
Racial/ethnic differences in staff-assessed pain behaviors among newly-admitted nursing home residents.
Nonverbal pain behaviors are effective indicators of pain among persons who have difficulty communicating. In nursing homes, racial/ethnic differences in self-reported pain and pain management have been documented. ⋯ Among residents requiring staff assessment of pain because they are unable to self-report, nursing home staff documented pain and its treatment less often in Non-Hispanic blacks and Hispanics than in non-Hispanic white residents. Studies to understand the role of differences in expression of pain, explicit bias, and implicit bias are needed to inform interventions to reduce disparities in pain documentation and treatment.
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J Pain Symptom Manage · Mar 2021
Psychological Distress in Bereaved Caregivers of Patients with Advanced Cancer.
Individuals caring for patients with advanced cancer (caregivers) experience psychological distress during the patient's illness course. However, data on the prevalence of bereaved caregivers' psychological distress and its relationship with the quality of patient's end of life (EOL) care are limited. ⋯ Many bereaved caregivers of patients with advanced cancer experience symptoms of depression and anxiety, which are associated with their perceptions of distress in their loved ones at the EOL.