Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
Randomized Controlled TrialPalliative Long-term Abdominal Drains Versus Large Volume Paracentesis in Refractory Ascites due to Cirrhosis (REDUCe Study): Qualitative Outcomes.
Palliative care remains suboptimal in end-stage liver disease (ESLD). ⋯ Patients and nurses expressed acceptability of palliative LTAD in ESLD and preference for this approach in enabling care at home. Proceeding to a definitive trial is feasible.
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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
Identifying Prevalence of and Risk Factors for Abnormal Urine Drug Tests in Cancer Pain Patients.
Opioids have become a mainstay treatment for severe cancer pain. Although opioid prescribing has decreased, opioid mortality continues to rise. Utilizing urine drug tests (UDT) can help monitor medication adherence and identify use of unprescribed or illicit substances. ⋯ This study demonstrates that oncologic pain patients are not a risk-free population for abnormal UDT, thus recommends a UDT with initial opioid prescriptions and annually thereafter, with more frequent tests for patients suspected to be at higher risk for misuse.
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J Pain Symptom Manage · Aug 2021
Observational StudyAssessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.
Palliative care triggers have been used in the intensive care unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. ⋯ A trigger-based model, geared to the needs of the specific ICU, may be one way of improving integration of palliative care into the ICU, especially in sub-Saharan Africa.
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J Pain Symptom Manage · Aug 2021
Korean Version of the Patient Dignity Inventory: Translation and Validation in Patients with Advanced Cancer.
The goal of palliative care is to maximize the quality of life and thus maintain the dignity of patients facing problems associated with a life-threatening illness. The Patient Dignity Inventory (PDI) is an instrument used to measure various sources of distress that can impact patients' sense of dignity at the end of life. ⋯ Our findings indicate that the PDI-K is a valid and reliable instrument to measure dignity-related distress in patients with advanced cancer. This tool provides a four-factor Korean language alternative to the PDI.