Journal of pain and symptom management
-
J Pain Symptom Manage · Sep 2021
Compassion inequities and opioid use disorder: A matched case-control analysis examining inpatient management of cancer-related pain for patients with opioid use disorder.
The opioid epidemic spurred guidelines intended to reduce inappropriate prescribing. Although acute cancer-related pain was excluded from these recommendations, studies demonstrate reduced opioid prescribing for patients hospitalized with advanced cancer. ⋯ Our results suggest that patients with OUD receive lower quality inpatient management of cancer-related pain. Provider education and early involvement of pain specialists are crucial in delivering equitable and compassionate end-of-life care for patients with OUD.
-
J Pain Symptom Manage · Sep 2021
Racial Disparities of Possessing Healthcare Power Attorney and Living Will among Older Americans: Do SES and Health Matter?
Most previous studies considered advance directives (AD) as one outcome, which conceals possible variations of individuals' decisions on two AD documents-living will (LW) and durable power of attorney for health care (PA). ⋯ The findings highlight the importance of examining the completions of two AD documents and indicate the necessity of developing distinct and concrete strategies to promote the completion of PA and LW.
-
J Pain Symptom Manage · Sep 2021
ReviewThe use of telemedicine for home-based palliative care for children with serious illness: a scoping review.
There is potential value to home-based palliative care for children with serious illness delivered via telemedicine (TM HBPC). Evidence to guide optimal design and delivery of TM HBPC is urgently needed. ⋯ TM HBPC is a promising strategy to increase access to palliative care for children with serious illness. However, the current review found a need for more robust information describing implementation and effectiveness of TM HBPC models, adaptation across care settings, and maintenance over time to guide and facilitate broader dissemination.
-
J Pain Symptom Manage · Sep 2021
Distinct death-preparedness states by combining cognitive and emotional preparedness for death and their evolution for family caregivers of terminally ill cancer patients over their last 6 months of life.
To identify caregivers' death-preparedness states by combining cognitive and emotional preparedness for their loved one's death as well as their evolution over cancer patients' last 6 months, which have never been explored. ⋯ Caregivers of cancer patients heterogeneously experienced combined cognitive and emotional preparedness for death. About 40% of caregivers consistently had sufficient death preparedness over their loved one's dying process. Evaluating these different aspects of death preparedness could be an important approach in high-quality end-of-life care by not only cultivating caregivers' cognitive PA, but also facilitating their emotional preparedness for the patient's death, thus helping caregivers prepare well for their loved one's forthcoming death.
-
J Pain Symptom Manage · Sep 2021
Development and Pilot Test of a Culturally Relevant Toolkit to Enhance Advance Care Planning with Chinese American Patients.
First-generation Chinese American patients have low engagement in advance care planning (ACP). Among the causes may be clinician uncertainty about traditional cultural values. ⋯ An ACP toolkit may facilitate culturally relevant ACP discussions by increasing clinician competency and patient engagement. Further studies of this approach are needed.