Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2024
Using Human-Centered Design to Improve Serious Illness Care for Older Adults with Advanced Dementia.
Older adults with advanced dementia increasingly receive potentially non-beneficial, high-intensity life-sustaining treatments and goal-discordant care in the United States. Interventions to address this issue have shown limited success. ⋯ The HCD process generated ideas at multiple healthcare system levels to address an enduring challenge in serious illness care by involving clinicians, researchers, and designers in intervention design.
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J Pain Symptom Manage · Nov 2024
Evaluation of a Reiki Volunteer Program within Two Cancer Infusion Centers.
Reiki is a biofield therapy from Japan currently used in many US hospitals. Evidence supports Reiki's effectiveness for addressing cancer and treatment-related symptoms such as pain and anxiety. However, no study to date has assessed changes in nausea following Reiki received during infusion treatments or assessed patients from multiple healthcare locations. ⋯ Outpatients receiving Reiki during infusion reported clinically significant improvements in all symptoms, high levels of satisfaction, and a qualitatively positive healing experience. More research is needed to assess long term changes following Reiki, including with an expanded program at additional healthcare locations.
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J Pain Symptom Manage · Nov 2024
ReviewHome Hospitalization in Palliative Care for Advanced Cancer and Dementia: A Systematic Review.
Home hospitalization (HHOSP) is an alternative care model aimed at alleviating pressure on healthcare systems and catering to the increasing patient population. It aligns with the preference for home-based palliative care (PALC) and end-of-life care. ⋯ The findings highlight HHOSP's potential as an alternative for delivering PALC, reducing hospital readmissions, and improving patient and caregiver satisfaction. Despite heterogeneity in study designs and outcomes, HHOSP aligns with patient and caregiver preferences, enhancing the quality of end-of-life care. Further standardized research is needed to optimize HHOSP implementation.
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J Pain Symptom Manage · Nov 2024
Large language models to identify advance care planning in patients with advanced cancer.
Efficiently tracking Advance Care Planning (ACP) documentation in electronic heath records (EHRs) is essential for quality improvement and research efforts. The use of large language models (LLMs) offers a novel approach to this task. ⋯ LLMs can capture ACP domains from EHRs, with sensitivity exceeding NLP methods for complex domains such as goals of care. Future studies should explore approaches for scaling this methodology.
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J Pain Symptom Manage · Nov 2024
Navigating Uncertainty during Family Meetings in the Pediatric Cardiac Intensive Care Unit: A Qualitative Investigation of Team Communication and Family Engagement.
Uncertainty is a known barrier to effective communication during family meetings in the pediatric cardiac intensive care unit (CICU), however, limited data has characterized patterns of communication during these meetings, limiting our ability to make best practice recommendations to clinicians. ⋯ Our results encourage clinicians to communicate uncertainty in an unburied and explicit manner, which may reduce the burden on families to engage in effective communication strategies, such as clarifying and summarizing opaquely stated information.