Journal of pain and symptom management
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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.
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J Pain Symptom Manage · Jun 2022
Pragmatic Clinical TrialWhat's in the sauce? The Specific Benefits of Palliative Care for Parkinson's Disease.
Increasing evidence demonstrates the benefits of palliative care among individuals with Parkinson's disease and related disorders (PDRD), but the critical components that contribute to therapeutic effects are not well understood. ⋯ Specific benefits of an integrated palliative approach in PDRD include improvement in patient holistic self-impressions, care partner self-efficacy, and non-motor symptoms.
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J Pain Symptom Manage · Jun 2022
Mixed-methods evaluation of three natural language processing modeling approaches for measuring documented goals-of-care discussions in the electronic health record.
Documented goals-of-care discussions are an important quality metric for patients with serious illness. Natural language processing (NLP) is a promising approach for identifying goals-of-care discussions in the electronic health record (EHR). ⋯ NLP holds promise for identifying EHR-documented goals-of-care discussions. However, the rarity of goals-of-care content in EHR data limits performance. Our findings highlight opportunities to optimize NLP modeling approaches, and support further exploration of different NLP approaches to identify goals-of-care discussions.