Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2021
Pre-post Evaluation of Collaborative Oncology Palliative Care for Patients with Stage IV Cancer.
The Collaborative Care Model improves care processes and outcomes but has never been tested for palliative care. ⋯ Collaborative oncology palliative care is efficient and feasible. While it did not increase overall goals-of-care discussions, it was effective to increase overall advance care planning and hospice use for patients with Stage IV cancer.
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J Pain Symptom Manage · Sep 2021
"Going home [is] just a feel-good idea with no structure": A qualitative exploration of patient and family caregiver needs when transitioning from hospital to home in palliative care.
Hospital-to-home transitions, particularly at the end of life, can be challenging for patients and their family caregivers. Therefore, there is a need to better understand gaps in expectations and experiences of these transitions. Theory can inform the creation of an intervention aimed at improving the hospital-to-home transition. ⋯ Our substantive grounded theory highlighted potentially measurable constructs that can be further tested. Future interventions should target the enablers/disablers to ensure health and well-being and practical needs are met in the transition.
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J Pain Symptom Manage · Sep 2021
Long-term daily administration of aprepitant for the management of intractable nausea and vomiting in children with life-limiting conditions: a case series.
Nausea and vomiting is a common symptom in children through their end of life journey. Aprepitant, a NK-1 antagonist, has become a potent weapon in the fight against chemo-induced nausea and vomiting. However, its use in palliative care for refractory nausea and vomiting has been limited due to limited experience or evidence of continuous use. Emerging evidence suggests that continuous use is not only safe, but also effective in patients with nausea and vomiting refractory to multiple lines of antiemetic therapy. ⋯ Our review suggests a role for aprepitant in management of refractory nausea and vomiting, demonstrating safety and efficacy. This case series is the first report of aprepitant use in this manner in the paediatric palliative care setting.
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J Pain Symptom Manage · Sep 2021
Clinical and Genetic factors associated with the Breast cancer-related Sleep Disorders: The "CAGE-Sleep" study- a cross-sectional study.
Despite being among the most reported concerns in breast cancer patients, sleep disturbances are still poorly assessed and managed in routine clinical practice. Correctly evaluating these symptoms and understanding the underlying clinical and genetic factors would help medical teams develop an adequate treatment strategy for each patient. ⋯ Our study confirms the relationship between anxiety/depression, cycle number, dyslipidemia and DRD2 polymorphism with insomnia and highlights the importance of treating all associated factors to improve the overall QOL of patients.
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J Pain Symptom Manage · Sep 2021
Improving end-of-life care for persons living with dementia: Bereaved caregivers' observations and recommendations.
Dementia is a terminal diagnosis that requires significant caregiving support across the trajectory of decline through to death. Experiences and perspectives from bereaved caregivers can help identify ways to improve the end-of-life care experience of persons dying with dementia. ⋯ End-of-life care for PLWD has significant room for improvement. Efforts to train healthcare providers should focus on helping them meet the complex informational, emotional, and social support needs of PLWD and their caregivers across the trajectory of decline.