Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2022
Patients with acute respiratory failure at risk for high-intensity, costly care.
Patients with underlying chronic illness requiring mechanical ventilation for acute respiratory failure are at risk for poor outcomes and high costs. ⋯ Among patients with underlying chronic illness and acute respiratory failure, we identified characteristics associated with the highest costs of care. Identifying these patients may be of interest to healthcare systems and hospitals and serve as one indication to invest resources in palliative and supportive care programs that ensure this care is consistent with patients' goals.
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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.
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J Pain Symptom Manage · Apr 2022
Factors related to end-of-life care discussions among community-dwelling people in Japan.
End-of-life discussions regarding healthcare preferences are important to ensure a dignified end of life. ⋯ The results showed that roughly 41% of the surveyed community-dwelling respondents had engaged in end-of-life discussions. The findings suggest that providing emotional support to relieve anxiety regarding one's health and the awareness of death, and having the opportunity to interact with others to discuss end-of-life issues, promote the engagement in such discussions in Japan. This study suggests that it is necessary to create an environment that provides social support and engenders awareness of the importance of end-of-life discussions while the community-dwelling people are still healthy.
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J Pain Symptom Manage · Apr 2022
Botulinum toxin injection for intractable pain in cancer patients with psoas muscle invasion.
Muscle invasion (MI) in patients with far-advanced cancer is often accompanied with pain. Conventional treatments used for pain relief may be associated with several side effects. ⋯ BTI relieved the intractable pain in these cases for at least 9-12 weeks without any reported side effects. We suggest that BTI can be an alternative method to relieve intractable pain associated with MI in patients with far-advanced cancer.
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J Pain Symptom Manage · Apr 2022
Goals of Care Documentation: Insights from A Pilot Implementation Study.
The Life Sustaining Treatment Decision Initiative is a national effort by the Veterans Health Administration to ensure goals of care documentation occurs among all patients at high risk of life-threatening events. ⋯ Older and seriously ill patients were most likely to have goals of care documented. Association between a documented goals of care conversation and perceived patient care experience were largely unsupported. Site-level largely contributed to understanding the likelihood of documentation and care experience.