Journal of pain and symptom management
-
J Pain Symptom Manage · Jun 2022
Evolution of Investigating Informed Assent Discussions about CPR in Seriously Ill Patients.
Outcomes after cardiopulmonary resuscitation (CPR) remain poor. We have spent 10 years investigating an "informed assent" (IA) approach to discussing CPR with chronically ill patients/families. IA is a discussion framework whereby patients extremely unlikely to benefit from CPR are informed that unless they disagree, CPR will not be performed because it will not help achieve their goals, thus removing the burden of decision-making from the patient/family, while they retain an opportunity to disagree. ⋯ IA is a feasible and reasonable approach to CPR discussions in selected patient populations.
-
J Pain Symptom Manage · Jun 2022
Palliative Care, Patient-Reported Measures, and Outcomes in Hospitalized Patients with Cirrhosis.
Studies of palliative care (PC) in hospitalized patients with cirrhosis have been retrospective, with limited evaluation of patient-reported measures and outcomes. ⋯ PC occurs infrequently and late in those with more severe liver disease and functional impairment. PC may be associated with reduction in utilization and greater completion of advanced directives. Randomized trials are needed to evaluate PC for this population.
-
J Pain Symptom Manage · Jun 2022
HIV Symptom Clusters Are Similar Using the Dimensions of Symptom Occurrence and Distress.
People living with HIV infection (PLWH) in the United States continue to experience a high symptom burden despite improvements in antiretroviral therapy. ⋯ The number and types of symptom clusters were relatively similar across the occurrence and distress dimensions of the symptom experience. Symptom clusters in PLWH may provide insights into the development of targeted interventions for multiple co-occurring symptoms.