Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2024
ReviewEnhancing End-of-Life Care with Home-Based Palliative Interventions: A Systematic Review.
Home-Based Palliative Care (HPC) interventions have emerged as a promising approach to deliver patient-centered care in familiar surroundings, aligning with patients' preferences and improving quality of life (QOL). ⋯ HPC interventions demonstrate significant benefits in addressing the complex needs of patients with advanced illnesses. These findings underscore the importance of integrating HPC into healthcare systems to optimize outcomes and promote quality end-of-life care. Future research should focus on expanding access to HPC services, enhancing interdisciplinary collaboration, and incorporating patient preferences to further improve care delivery in this vulnerable population.
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J Pain Symptom Manage · Nov 2024
Case ReportsCompassionate Ventilator Release In Patients With Neuromuscular Disease: A Two-Case Comparison.
Dyspnea, the subjective sensation of breathlessness, is a distressing and potentially traumatic symptom. Dyspnea associated with mechanical ventilation may contribute to intensive care unit (ICU) associated post-traumatic stress disorder and impaired quality of life. Dyspnea is both difficult to alleviate and a cause of significant distress to patients, their loved ones, and care providers People living with neuromuscular disease, such as amyotrophic lateral sclerosis (ALS) or myasthenia gravis (MG), often rely on a ventilator at late stages of illness due to complications of progressive respiratory muscle weakness and paralysis. ⋯ Although limited recommendations have been published specific to patients with ALS, no guidelines currently exist for the terminal liberation from mechanical ventilation in patients experiencing respiratory muscle insufficiency from a neuromuscular disease. Further research on this topic is needed, including creation of a protocol for ventilator release in patients with neuromuscular disease. The following case reports detail the dissimilar EOL experiences of two patients with different forms of neuromuscular disease.
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J Pain Symptom Manage · Nov 2024
Start of the COVID-19 pandemic and palliative care unit utilization: a retrospective cohort study.
People with noncancer diagnoses have poorer access to palliative care units (PCUs) or hospices compared to those with cancer diagnoses. The COVID-19 pandemic disrupted how specialist palliative care services were delivered and utilized. ⋯ Despite historically poor PCU/hospice access, the COVID-19 pandemic created circumstances that may have enabled unprecedented utilization in individuals with noncancer diagnoses in our cohort.
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J Pain Symptom Manage · Nov 2024
Parent-Clinician Communication and Prolonged Grief in Parents Whose Child Died from Cancer.
Parent-clinician communication is essential for high-quality end-of-life (EOL) care in children with cancer. However, it is unknown how parent-clinician communication affects parents' experience in the first two years after their child's death. ⋯ Early bereaved parents report severe prolonged grief symptoms. Interventions focused on providing adequate prognostic information and improving preparation for EOL may mitigate parental prolonged grief symptoms in the first two years of their bereavement.