Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2023
Observational StudyDecisional-regret trajectories from end-of-life decision making through bereavement.
Regret plays a central role in surrogate decision making. Research on decisional regret in family surrogates is scarce and lacks longitudinal studies to illustrate the heterogenous, dynamic evolution of decisional regret. ⋯ Surrogates heterogeneously suffered decisional regret from EOL decision making through bereavement as evident by four identified distinct decisional-regret trajectories. Early identification and prevention of increasing/prolonged decisional-regret trajectories is warranted.
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J Pain Symptom Manage · Jul 2023
Specialist palliative care referral practices among oncologists, cardiologists, respirologists: a comparison of national survey studies.
Although patients with nonmalignant diseases have palliative care needs similar to those of cancer patients, they are less likely to receive specialist palliative care (SPC). Referral practices of oncologists, cardiologists, and respirologists could provide insight into reasons for this difference. ⋯ For cardiologists and respirologists in 2018, perceived availability of SPC services was poorer, timing of referral later, and frequency of referral lower than among oncologists in 2010. Further research is needed to identify reasons for differences in referral practices and to develop interventions to overcome them.
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J Pain Symptom Manage · Jul 2023
ReviewPsychiatric Comorbidities and Outcomes in Palliative and End-of-Life Care: A Systematic Review.
Although psychiatric comorbidities are common among individuals at end of life, their impact on outcomes is poorly understood. ⋯ Psychiatric comorbidity is associated with significant differences in care utilization and clinical outcome among patients at end of life. In particular, patients with psychiatric comorbidity and serious illness are at high risk of poor quality of life and high symptom burden. Our finding that psychiatric comorbidity is associated with increased utilization of palliative care likely reflects the complexity and clinical needs of patients with serious illness and mental health needs. These data suggest that greater integration of mental health and palliative care services may enhance quality-of-life among patients at end of life.
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J Pain Symptom Manage · Jul 2023
ReviewSelf-acupressure for symptom management in cancer patients: A systematic review.
Acupressure is a popular nonpharmacological intervention that is increasingly proven to effectively alleviate symptoms in patients with cancer. However, the effects of self-acupressure on cancer symptom management are less clear. ⋯ The limited evidence from this review precludes the definitive conclusions on intervention effectiveness for cancer symptoms. Future research should consider developing the standard protocol for intervention delivery, improving the methodology of self-acupressure trials, and conducting large-scale research to advance the science of self-acupressure for cancer symptom management.
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J Pain Symptom Manage · Jul 2023
ReviewRelieving perception of thirst and xerostomia in patients with palliative and end-of-life care needs: a rapid review: Running title: Thirst and xerostomia in palliative patients.
Thirst and dry mouth are interlinked symptoms that frequently cause significant distress for patients with life-limiting conditions. ⋯ Evidence from this review suggests that thirst interventions established within the ICU setting may prove effective for treatment of terminally ill patients receiving specialist palliative care.