Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2021
Clinician Identified Barriers and Strategies for Advance Care Planning in Seriously Ill Pediatric Patients.
Parents desire more opportunities for advance care planning (ACP), however, large-scale adoption of ACP for seriously ill children remains unrealized. Little is known about current approaches to ACP and strategies to circumvent existing barriers to ACP provision. ⋯ Despite ubiquitous recognition of the importance of ACP communication, various clinician- and parent-level barriers were identified which impede ACP in children with serious illness and their families. Improvement strategies should focus on formal clinician training on how to conduct and document longitudinal ACP discussions to ensure care is aligned with family goals and values.
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J Pain Symptom Manage · Sep 2021
Observational StudyThe challenges of caring for people dying from COVID-19: a multinational, observational study (CovPall).
Systematic data on the care of people dying with COVID-19 are scarce. ⋯ Palliative care services were often overwhelmed, yet felt ignored in the COVID-19 response. Palliative care needs better integration with health care systems when planning and responding to future epidemics/pandemics.
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J Pain Symptom Manage · Sep 2021
Healthcare professionals' work-related stress in palliative care: a cross-sectional survey.
Providing palliative care can lead to work-related stress and ultimately to burnout. The need for palliative care will further increase due to population aging and people living longer with life-threatening diseases. Therefore, a healthy palliative care workforce is vital. ⋯ Symptoms of burnout are quite prevalent among healthcare professionals providing palliative care in the Netherlands. Healthcare professionals have a need for team and organisation approaches to maintain a healthy work-life balance.
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J Pain Symptom Manage · Sep 2021
The Serious Illness Population: Ascertainment via Electronic Health Record or Claims Data.
Palliative care can improve the lives of people with serious illness, yet clear operational definitions of this population do not exist. Prior efforts to identify this population have not focused on Medicare Advantage (MA) and commercial health plan enrollees. ⋯ These results demonstrate the feasibility of identifying adults with SMC in a commercially insured population, including MA enrollees; yet separate use of EHR or claims result in populations that differ. Future research should examine methods to combine these data sources to optimize identification and support population management, quality measurement, and research to improve the care of those living with serious illness.
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J Pain Symptom Manage · Sep 2021
Patient-Provider Communication, Decision-Making, and Psychosocial Burdens in Palliative Radiotherapy: A Qualitative Study on Patients' Perspectives.
Patient-provider communication impacts how patients with cancer make decisions about treatment. ⋯ Most patients prefer shared decision-making regarding RT initiation but prefer their radiation oncologists to make decisions regarding treatment intensity. Communication that empowers patients in their desired level of engagement for RT decision-making may help patients make informed decisions, contribute toward a proactive decisional mindset, and reduce their perception of psychosocial burdens.