Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2023
Palliative care physicians' perceptions of conditions required to provide early palliative care.
Early palliative care (EPC) is widely recommended but its implementation may be challenging. ⋯ Changes are necessary at the level of palliative care referral systems, providers, resources, and policy to enable implementation of EPC.
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J Pain Symptom Manage · Aug 2023
Implementation Challenges for a Multi-site Advance Care Planning Pragmatic Trial: Lessons Learned.
Advance care planning (ACP) pragmatic trials are needed. ⋯ Implementing a multisite health system-wide ACP program and pragmatic trial, with automated EHR-based cohort identification and intervention delivery, requires a high level of multidisciplinary key advisor engagement, standardization, and monitoring. These activities provide guidance for the implementation of other large-scale, population-based ACP efforts.
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J Pain Symptom Manage · Aug 2023
Living with an Advanced Cancer while Parenting Minor Children: A Needs Assessment Study.
Evidence-based interventions addressing the needs of couples co-parenting young children while facing an advanced cancer diagnosis are lacking. Thus, this study seeks to identify parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents. ⋯ The delivery of optimal supportive care involves a family-focused perspective such as screening for parenting status and referrals to social work services to address the need of tangible resources and manage parenting-related distress.
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J Pain Symptom Manage · Aug 2023
Attitudes of palliative care specialists toward assessing sexual dysfunction in patients with cancer.
The sexual health of patients is frequently neglected. ⋯ Palliative care providers infrequently address the presence of SD among patients with cancer. Additional training and routine screening for SD might help addressing this problem.
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J Pain Symptom Manage · Aug 2023
Evolving Advance Care Planning in a Health Ecosystem: The Kaiser Permanente Experience.
Advance care planning is an integral part of supporting patients through serious illness and end-of-life care. ⋯ More than 6000 physicians, nurses, and social workers have been trained in LCP. Over one million patients have engaged in LCP since its inception, with over 52% of patients age 55+ having a surrogate designated. There is evidence of high treatment concordance with patients' desired wishes (88.9%), with high rates of advance directive completion as well (84.1%).