Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
Observational StudyPrevalence and risk factors of breathlessness across Canada: A national retrospective cohort study in home care and nursing home populations.
Breathlessness is a symptom associated with poor clinical outcomes and prognosis. Little is known about its long-term trends and associations with social factors including decline in social activities and caregiver distress. ⋯ The prevalence of clinician-reported breathlessness is higher in home care than in nursing home populations, the former having risen by 10% over the decade. Prevalence of breathlessness is associated with decline in social activities and caregiver distress. Enhanced supports may be required to meet increasing patient need in the community.
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Slow codes, which occur when clinicians symbolically appear to conduct advanced cardiac life support but do not provide full resuscitation efforts, are ethically controversial. ⋯ Slow codes occur in practice, even though many clinicians ethically disagree with their use. The use of cardiac resuscitation attempts in medically futile situations can cause significant moral distress to medical professionals who agree or are forced to participate in them.
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J Pain Symptom Manage · Aug 2021
Impact of continuing medical education for physicians on the quality of cancer pain treatment in China.
The management of cancer pain has gained attention in China since the proposal of the three-step analgesic ladder in 1986 and has been further improved after the Chinese Ministry of Health launched the campaign for "Good Pain Management Ward" in 2011. The Beijing Pain Management Center for Quality Control and Improvement was formed with the intent to improve the quality of pain management by various means such as providing continuing medical education (CME) and conducting evaluation in Beijing, the capital of China. ⋯ CME significantly improved the quality of cancer pain treatment in the participating hospitals. Thus, standard CME courses may be adopted to improve the quality of cancer pain treatment by other regions in China and other countries.
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J Pain Symptom Manage · Aug 2021
Advance Care Planning Among Older Adults of Turkish Origin in Belgium: Exploratory Interview Study.
Although conversations about future medical treatment and end-of-life care are considered to be important, ethnic minorities are much less engaged in advance care planning (ACP). ⋯ The provision of tailored information about ACP to older adults of Turkish origin in Belgium and the promotion of awareness about the importance of ACP among their children (when patients desire), as well as the use of professional interpreters, could facilitate ACP engagement in this population.
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J Pain Symptom Manage · Aug 2021
Multicenter Study Observational StudyHow successful is parenteral oxycodone for relieving terminal cancer dyspnea compared with morphine? A multicenter prospective observational study.
Parenteral morphine is widely used for dyspnea of imminently dying cancer patients (terminal dyspnea). However, the efficacy of other opioids such as oxycodone remains largely unknown. ⋯ Parenteral oxycodone may be equally effective and safe as morphine in the treatment of terminal dyspnea in cancer patients. Future randomized controlled trials should confirm the efficacy and safety of opioids other than morphine for terminal dyspnea.