Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2023
Preliminary Validation of the Injustice Experience Questionnaire in Patients with Advanced Cancer.
When diagnosed with advanced cancer, patients may perceive their situation as an injustice. The Injustice Experience Questionnaire (IEQ) is a 12-item measure of perceived unfairness originally developed for patients with chronic pain. The factor structure, reliability, and validity of the IEQ in patients with cancer have not been assessed. ⋯ Findings provide preliminary support for using the IEQ in patients with advanced cancer. Future research should assess the sensitivity of the IEQ to change in an interventional context.
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J Pain Symptom Manage · Apr 2023
Standard Naloxone Prescribing for Palliative Care Cancer Patients on Opioid Therapy: A Single-Site Quality Improvement Pilot to Assess Attitudes and Access.
Limited data exist on when to offer naloxone to cancer patients on opioid therapy. ⋯ Opioid safety education and naloxone prescribing can be done quickly and is well-received by clinicians and patients.
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J Pain Symptom Manage · Apr 2023
Nationwide Study of Continuous Deep Sedation Practices Among Pediatric Palliative Care Teams.
Palliative sedation practices evolved in France when the Claeys-Leonetti law passed in 2016 authorized patient-requested continuous deep sedation (CDS) until death. Its implementation in the pediatric setting is less frequently encountered and can pose several clinical and ethical challenges for health care teams and families. ⋯ Managing patient-requested CDS in pediatrics is challenging due to its rarity, multi-factorial refractory symptoms and drug tolerance despite polytherapy. Few recommendations exist to guide CDS practice for pediatricians. Further studies investigating pediatric CDS practices across various cultural and legal settings, refractory symptom management and specific pharmacology are warranted.
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J Pain Symptom Manage · Apr 2023
Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit.
To describe a physician (MD) and registered nurse (RN) led palliative care consultation team embedded in the medical intensive care unit (MICU). To compare patterns of palliative care consultation, and rates of goals of care documentation and in-ICU mortality before and after the implementation of the embedded team. ⋯ After embedding a palliative care MD/RN team into the MICU, patients received earlier palliative care consultation, were more likely to have medical decision-maker and goals of care documented, and less likely to die in the hospital. Future work will examine how to adapt this model to other ICUs to improve palliative care access for critically ill patients broadly.