Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2022
Predictors of family caregivers' depressive- and prolonged-grief-disorder-symptom trajectories.
Depression and prolonged grief disorder (PGD) are related but distinct constructs with different risk factors and treatments. We aimed to determine commonality and differences in factors predicting membership in depressive- and PGD-symptom trajectories to highlight uniqueness of each construct to guide further care and treatments. ⋯ Commonality and differences in factors predicting membership in PGD- and depressive-symptom trajectories confirm that PGD and depression are related but distinct constructs. Interventions should be tailored to caregivers' unique risk profile for depressive- and PGD-symptom trajectories to reduce the likelihood of suffering both or individual symptom trajectories.
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J Pain Symptom Manage · Apr 2022
ReviewIdentifying core domains to assess the 'quality of death':A scoping review.
There is growing recognition of the value to patients, families, society, and health systems in providing healthcare, including end-of-life care, that is consistent with both patient preferences and clinical guidelines. ⋯ The review affirms the need for a people-centered approach to managing the delicate process and period of accepting and preparing for the end of life. The identified structural and experiential factors pertinent to the "quality of death" will prove invaluable for future efforts aimed to quantify health system performance in the end-of-life period.
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J Pain Symptom Manage · Apr 2022
ReviewHandling missing data and drop out in hospice/palliative care trials through the estimand framework.
Missing data are common in hospice/palliative care randomized trials due to high drop-out because of the demographic of interest. It can introduce bias in the estimate of the treatment effect and its precision. ⋯ When planning a palliative care trial, the estimand should be explicitly stated, including how intercurrent events will be handled in the analysis. This should be informed by the scientific objectives of the trial. The estimand guides the handling of missing data during the conduct and analysis of the trial. Defining an estimand is not a statistical activity, but a multi-disciplinary process involving all stakeholders.
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J Pain Symptom Manage · Apr 2022
Mitigating end-of-life burden: Parallel perspectives of physician-patients & family caregivers.
Patients and family caregivers perceive burden in care at the end of life differently even when the patient is a physican. ⋯ Physician-Patients ' clinical insights drive their attempts to alleviate burden on their families. However, family caregivers still experienced burden. Recognizing the parallel perspectives of burden may inform the type and timing of interventions to effectively minimize burden and provide compassionate care to both patients and families at the end of life.