Journal of pain and symptom management
-
J Pain Symptom Manage · Nov 2023
ReviewForms or Free-Text?: Measuring Advance Care Planning Activity Using Electronic Health Records.
Advance care planning (ACP) discussions seek to guide future serious illness care. These discussions may be recorded in the electronic health record by documentation in clinical notes, structured forms and directives, and physician orders. Yet, most studies of ACP prevalence have only examined structured electronic health record elements and ignored data existing in notes. ⋯ Additionally, 16.6% of all patients with structured ACP documentation only had documents that were judged as misclassified, incomplete, blank, unavailable, or a duplicate of a previously entered erroneous document. ACP documents scanned into electronic health records represent a limited view of ACP activity. Research and measures of clinical practice with ACP should incorporate information from unstructured data.
-
J Pain Symptom Manage · Nov 2023
"At the end I have a say": Engaging the Chinese Community in Advance Care Planning.
Despite the association of advance care planning (ACP) with improved patient and caregiver outcomes, Chinese American elders have low rates of ACP. ⋯ Community-developed intergenerational events that highlight the value of ACP and address barriers are acceptable and increase ACP engagement in the Chinese community.
-
J Pain Symptom Manage · Nov 2023
A novel approach to managing thirst and dry mouth in palliative care: a prospective randomised cross-over trial.
Thirst and xerostomia are significant and highly distressing symptoms experienced by patients receiving palliative and end-of-life care. ⋯ This trial found that while usual mouth care and the intervention were both able to reduce the intensity of dry mouth and the sensation of thirst, the mint intervention had a greater response.
-
Goals of care conversations for seriously ill hospitalized patients are associated with high-quality patient-centered care. ⋯ In this study of 17 rural and nonrural community hospitals, we found low overall prevalence of goals of care documentation with particularly infrequent documentation occurring within rural hospitals. Future study is needed to assess barriers to goals of care documentation contributing to low prevalence of goals of care conversations in rural hospital settings.