Journal of pain and symptom management
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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.
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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.
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J Pain Symptom Manage · Nov 2023
Discomfort with suffering and dying, a cross-sectional survey of the general public.
Death and the process of dying have become increasingly medicalized and professionalized. The associated cultural estrangement from death may affect how comfortable we feel about death and dying. This study examines the general public's discomfort with another person's suffering and dying, and whether these feelings are associated with specific personal characteristics or experiences. ⋯ A considerable level of discomfort is present within the general public about the suffering and dying of others and this may increase social stigma and a tendency to avoid seriously ill people and their social surroundings. Our findings suggest that interventions may help shift this societal discomfort if they incorporate a focus on cultural and experiential exposure and increasing knowledge about palliative care.
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J Pain Symptom Manage · Nov 2023
Clinical TrialSupportive Care for Dual Caregivers who Care for their Partner with Cancer and their Young Children.
Advanced cancer patients and their spouses who parent minor children report parenting concerns and increased psychological distress. This single-arm trial examined the feasibility and initial evidence for efficacy of a novel parent support program. ⋯ The initial testing of our parenting intervention yielded promising results regarding feasibility and an initial signal of intervention efficacy. Thus, a randomized controlled trial for further testing is warranted.
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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.