Journal of pain and symptom management
-
J Pain Symptom Manage · Aug 2022
Distinguishing symptom patterns in adults newly diagnosed with cancer: a latent class analysis.
Socio-demographic differences, including place of residence, socio-economic status, ethnicity, and gender, have been associated with various inequities in cancer care outcomes. ⋯ The results indicated that there were substantial differences in symptom patterns at the time of the initial oncology visit, which were associated with both clinical diagnoses and socio-demographic differences. These results point to the importance of taking the social situation of patients into account, and not just diagnosis, to better understand differences in symptom patterns of people living with cancer.
-
J Pain Symptom Manage · Aug 2022
Clinicians' Perceptions of Collaborative Palliative Care Delivery in Chronic Kidney Disease.
Guidelines recommend palliative care for patients with chronic kidney disease (CKD), who experience a high pain and symptom burden, and receive intensive treatments that often do not align with their values. A lack of scalable specialty palliative care services has prompted calls for attention to primary palliative care, delivered in primary care and nephrology settings. ⋯ Interventions to address gaps in palliative care delivery for people living with CKD should incorporate systematic identification of patients with palliative care needs and structural mechanisms to meeting those needs via specialty and primary palliative care.
-
J Pain Symptom Manage · Aug 2022
Project ECHO in the Caribbean: Building a Virtual Community for Palliative Care Education Needs.
Despite a growing need, palliative care education tools tailored to providers in the Caribbean remain extremely limited. We conducted a mixed methods analysis of the first Project ECHO (Extension for Community Healthcare Outcomes) model adapted for palliative care providers in the Caribbean. ⋯ They described significant improvements in their sense of community (1.23, P ≤ 0.01), confidence in palliative care skills (0.64, P ≤ 0.01), and knowledge for each monthly topic. Our findings suggest that the ECHO model has been successfully adapted to the needs of palliative care providers in the Caribbean, though further capacity building, public policy, and research are needed to broaden access to palliative care across the region.
-
J Pain Symptom Manage · Aug 2022
Care for a Dying Patient: EMS Perspectives on Caring for Hospice Patients.
EMS providers frequently encounter patients in end-of-life situations. These situations can become ethically challenging depending on the nature of the event, availability of advance directives, and overall understanding of the situation by the patient and caregivers. This is particularly true for patients who are enrolled in Hospice, a specific form of end-of-life care available to patients with a terminal illness and expected lifespan of less than six months. ⋯ Educational gaps may be narrowed with additional end-of-life specific curricular components, with EMS providers expressing a strong desire for such training.
-
J Pain Symptom Manage · Aug 2022
Observational StudyPalliative Care and Documented Suicide: Association Among Veterans with High Mortality Risk.
Palliative care consultations (PCCs) are associated with reduced physical and psychological symptoms that are related to suicide risk. Little is known, however, about the association between PCCs and death from suicide among patients at high risk of short-term mortality. ⋯ While acknowledging the importance of specialized mental health care in reducing suicide among high-risk patients, interventions delivered in the context of PCCs may also play a role.