Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2023
Observational StudyPEDIATRIC PALLIATIVE CARE AT HOME: A PROSPECTIVE STUDY ON SUBCUTANEOUS DRUG ADMINISTRATION.
The subcutaneous route is a useful alternative for drug administration in palliative care. Although there is scientific evidence on its use in adult patients, the literature in pediatric palliative care is almost nonexistent. ⋯ In the pediatric palliative care patients studied, the subcutaneous route is most frequently used for administering morphine and midazolam in continuous infusion. The main complication was induration, especially with longer dwell times or higher infusion rates. However, further studies are required to optimize management and prevent complications.
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J Pain Symptom Manage · Sep 2023
Increasing Trend and Effects of Pediatric Palliative Care on Children with Non-Cancer Diagnoses.
Pediatric palliative care (PPC), especially among noncancer pediatric patients, faces challenges including late referral, limited patient care, and insufficient data for Asian patients. ⋯ High disparities exist between children receiving PPC in cancer versus noncancer patients. The concept of PPC is gradually becoming accepted in noncancer children and is associated with more pain-relief medication and less suffering during end-of-life care.
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J Pain Symptom Manage · Sep 2023
Pediatric Cardiology Condolence Letter Writing: Does a Fellowship Curriculum Impact Practice?
Condolence letter (CL) writing after the death of a child is an important opportunity for humanism. Pediatric cardiology fellowship training now recognizes the importance of palliative care, but rarely includes CL education, despite its fragile patient population. ⋯ Development of condolence expression educational programs in pediatric cardiology training should be expanded.
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J Pain Symptom Manage · Sep 2023
Integrated hospital- and home-based palliative care for cancer patients in Vietnam: People-centered outcomes.
Hospital-based palliative care (PC) linked to palliative home care is rarely accessible in low- and middle-income countries (LMICs). ⋯ Integration of hospital- and home-based PC for cancer patients is feasible and improves people-centered outcomes at low cost in Vietnam. These data suggest that benefits to patients, their families, and the health care system can accrue from integration of PC at all levels in Vietnam and other LMICs.
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J Pain Symptom Manage · Sep 2023
A Worksheet to Facilitate Discussions of Values for Patients with Metastatic Cancer: a Pilot Study.
Individual goals and values should drive medical decision making for patients with serious illness. Unfortunately, clinicians' existing strategies to encourage reflection and communication regarding patients' personal values are generally time-consuming and limited in scope. ⋯ The Values Worksheet was a feasible way to facilitate at-home discussions of goals and values for select patients with metastatic cancer. Further research should focus on identifying which patients are most likely to benefit from the Values Worksheet, and should employ the Worksheet as one tool to facilitate reflection on the questions that arise around serious illness, as an adjunct to serious illness conversations with a physician.