Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
ReviewSugammadex to reverse neuromuscular blockade prior to withdrawal of life support.
In certain end-of-life scenarios, pharmacologic reversal of neuromuscular blockade may be indicated. However, given the depth of blockade frequently necessitated in the ICU setting, rapid reversal of neuromuscular blockade is generally not feasible with conventional reversal agents such as neostigmine that inhibit acetylcholinesterase. ⋯ We report the use of sugammadex to reverse neuromuscular blockade prior to compassionate extubation in three pediatric patients. Its clinical use in children is reviewed, potential applications in the palliative care arena discussed, and dosing algorithms presented.
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J Pain Symptom Manage · Aug 2021
"I wish I could die so I would not be in pain" - a qualitative study of palliative care needs among people with cancer or HIV/AIDS in Vietnam and their caregivers.
Although cancer and HIV/AIDS are common causes of death in Vietnam, limited data exist on their palliative care needs. As palliative care becomes part of Universal Health Coverage, evidence is needed to scale up appropriate care. ⋯ The findings demonstrate common, multidimensional, and severe suffering among people living with cancer or HIV/AIDS and their caregivers in Vietnam. These qualitative data should guide development of optimum clinical assessment tools and palliative care services for these populations.
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J Pain Symptom Manage · Aug 2021
The psychosocial impact of spouse-caregiver chronic health conditions and personal history of cancer on well-being in advanced cancer patients and their caregivers.
Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent. ⋯ Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.
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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
Nurse Perspectives on Urinary Incontinence in the Home Hospice Setting.
To date, no studies have characterized the impacts of urinary incontinence (UI) at the end of life in the home hospice (HH) setting. UI is highly prevalent at the end of life and adversely affects quality of life. ⋯ UI is a prevalent and debilitating condition in HH patients. There is a need for studies to further characterize the impacts of UI on HH patients and their caregivers. Formal training on UI subtypes and management is needed to facilitate proper documentation, research, and improve patient outcomes.