Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2022
Brain Death Determination and Communication: An Innovative Approach Using Simulation and Standardized Patients.
Palliative medicine clinicians in hospital settings are often involved in the care of patients dying in critical care settings, with a subset from brain death. Brain death is a complex concept, not only for families, but also for clinicians. There is wide variability in adhering to formalized guidelines for brain death determination. In addition, communication techniques regarding brain death determination are distinct from those used in shared decision-making. There is a need to obtain knowledge and practical skills in brain death determination, including examination and communication. Simulation can provide a low-stakes setting to practice the process of brain death determination and communication. ⋯ Simulation is a practical and constructive method for teaching the challenging concepts and unique communication skills involved in brain death determination.
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J Pain Symptom Manage · Jun 2022
Engaging African American family caregivers in developing a culturally-responsive interview guide: A multiphase process and approach.
Qualitatively eliciting historically marginalized populations' beliefs, values, and preferences is critical to capturing information that authentically characterizes their experiences and can be used to develop culturally-responsive interventions. Eliciting these rich perspectives requires researchers to have highly effective qualitative interviewing guides, which can be optimized through community engagement. ⋯ The purpose of this article is to provide a series of steps, each supported by a case example from our work with African American family caregivers, for developing an interview guide through community engagement. We conclude by highlighting how involving historically marginalized community members in these early stages of research study development can build trust, research partnerships, and acknowledge their contribution to the development of new knowledge.
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J Pain Symptom Manage · Jun 2022
ReviewSurrogates of Patients With Severe Acute Brain Injury Experience Persistent Anxiety and Depression Over the 6 Months After ICU Admission.
Severe Acute Brain Injury (SABI) is neurologically devastating, and surrogates for these patients may struggle with particularly complex decisions due to substantial prognostic uncertainty. ⋯ Surrogates of PMV patients with SABI experience persistently elevated anxiety and depression symptoms over 6 months compared to surrogates of PMV patients without SABI. Further work is needed to understand contributors to prolonged distress in this higher risk population.
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J Pain Symptom Manage · Jun 2022
The Science of Context: Transforming Serious Illness Care Though In Situ Observation.
There is an expression, often attributed to Einstein, “If I had 60 minutes to save the world, I would spend the first 55 trying to figure out what was wrong with it.” Dr. J. Randall (Randy) Curtis’ approach to improving serious illness care has been so effective for exactly this reason. ⋯ Herein, we highlight Randy’s early work using direct observation and describe the trajectory and impact of his ground-up approach to research. In parallel, we describe the influence of his approach on our own work studying serious illness care in surgery and critical care. Although neither of us has had direct mentorship from Randy, we emulate Randy’s pioneering mentorship model in our work together, demonstrating his far-reaching influence.
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J Pain Symptom Manage · Jun 2022
ReviewBibliometric Network Analysis on Rapid-Onset Opioids for Breakthrough Cancer Pain Treatment.
Proper breakthrough cancer pain (BTcP) management is of pivotal importance. Although rapid-acting, oral and nasal transmucosal, fentanyl formulations (rapid-onset opioids, ROOs) are licensed for BTcP treatment, not all guidelines recommend their use. Presumably, some research gaps need to be bridged to produce solid evidence. We present a bibliometric network analysis on ROOs for BTcP treatment. ⋯ In this research area, most articles are published in top-ranked journals. Nevertheless, paramount topics should be better addressed, and the implementation of research networks is needed.