Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2023
High Flow Nasal Cannula in patients with cancer at the end of life.
High flow nasal cannula (HFNC) is frequently used to manage dyspnea in patients with cancer near the end of life. Because HFNC is restricted to the in-patient setting, patients on HFNC need to be liberated from it to be discharged from the hospital. ⋯ Only a minority of patients with cancer at the end of life can be liberated from HFNC, and only a minority are discharged alive. This information is important when discussing goals of care with patients and their families before initiating HFNC.
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J Pain Symptom Manage · Apr 2023
Inflammation and performance status: the cornerstones of prognosis in advanced cancer.
In advanced cancer, although performance status (PS), systemic inflammatory response and nutritional status are known to have prognostic value, geographical variations and sociodemographic indexes may also impact survival. ⋯ The established prognostic factors that were compared had similar prognostic capacity in both cohorts. A high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer survival of patients with advanced cancer in the prospective European and Brazilian cohorts.
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J Pain Symptom Manage · Apr 2023
Just-in-Time Decision Making: Preliminary Findings of a Goals of Care Rapid Response Team.
The COVID-19 pandemic placed the issue of resource utilization front and center. Our comprehensive cancer center developed a Goals of Care Rapid Response Team (GOC RRT) to optimize resource utilization balanced with goal-concordant patient care. ⋯ GOC RRT consultations were feasible and associated with care limitation. Adherence to core team participation was fair.
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J Pain Symptom Manage · Apr 2023
Randomized Controlled TrialEffects of Spiritual Care on Well-being of Intensive Care Family Surrogates: A Clinical Trial.
Critical illness of a family member is associated with high emotional and spiritual distress and difficult medical decisions. ⋯ Proactive, semistructured spiritual care delivered by chaplains improves well-being for ICU surrogates. Results provide evidence for inclusion of chaplains in palliative and intensive care teams.