Journal of pain and symptom management
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J Pain Symptom Manage · May 2021
Lack of Exposure to Palliative Care Training for Black Residents: A Study of Schools with Highest and Lowest Percentages of Black Enrollment.
The palliative medicine workforce lacks racial diversity with <5% of specialty Hospice and Palliative Medicine (HPM) fellows identifying as black. Little is known about black trainees' exposure to palliative care during their medical education. ⋯ Residents at schools with the highest black medical student enrollment lack access to palliative care training opportunities. Efforts to reduce health disparities and underrepresentation in palliative care must begin with providing palliative-focused training to physicians from under-represented minority backgrounds.
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J Pain Symptom Manage · May 2021
Development of a brief cognitive and behavioural intervention for the management of episodic breathlessness - a Delphi survey with international experts.
Episodic breathlessness is characterized by a severe worsening of breathlessness intensity that goes beyond usual fluctuations. Episodes are usually short; therefore, nonpharmacological strategies (cognitive and behavioral) seem most promising to be beneficial. Which strategies-delivered separately or in combination-might be most effective and feasible remains unclear. ⋯ Using the consented nonpharmacological strategies, a brief cognitive and behavioral intervention was developed that balances between individualization and standardization of the intervention.
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J Pain Symptom Manage · May 2021
Goals of care conversations don't fit in a box': Hospice Staff Experiences and Perceptions of Advance Care Planning Quality Measurement.
With rising concerns about quality of care in hospice, federal agencies recently began mandating quality measurement in hospice, including measures of advance care planning (ACP). ⋯ Hospice staff take ACP quality measurement seriously, but insufficient organizational resources and regulatory bureaucracy create challenges. Efforts to enhance ACP quality measure nuance and assess outcomes are needed to improve care.
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J Pain Symptom Manage · May 2021
"That is care that you just can't fake!": Identifying Best Practices for the Care of Vietnam Veterans at End of Life.
We reviewed the Veterans Health Administration Bereaved Family Survey's open-ended responses to understand end-of-life (EOL) care best practices for Vietnam and pre-Vietnam Veterans. ⋯ Patient-centered EOL care should include assigning a point of contact that follows the patient, educates the family on expectations, ensures the patient's changing needs are met, ensures the family has appropriate support, and communicates updates to the family throughout the patient's care continuum.