Journal of pain and symptom management
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J Pain Symptom Manage · May 2024
Randomized Controlled TrialA randomized controlled trial of betamethasone on fatigue in patients with advanced cancer.
Fatigue is one of the most uncomfortable physical symptoms seen in patients with advanced cancer. Previous studies have reported on the efficacy of corticosteroids from Western countries. ⋯ The impact of betamethasone 4 mg/d on alleviating fatigue in patients with advanced cancer in the last weeks of life did not reach statistical significance in the EORTC-QLQ-C15-PAL as the primary endpoint, however, it was significant in the NRS, the secondary endpoint.
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J Pain Symptom Manage · May 2024
Observational StudyComparison of pharmacological treatments for agitated delirium in the last days of life.
Antipsychotics are often used in managing symptoms of terminal delirium, but evidence is limited. ⋯ Haloperidol with as-needed benzodiazepine, chlorpromazine, or levomepromazine may be effective and safe for terminal agitation. Chlorpromazine and levomepromazine may have an advantage of no need to change medications.
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J Pain Symptom Manage · May 2024
Difficulties of Cancer Patients' Relatives in End-of-Life Discussions: Validation of a Questionnaire.
Despite the potential benefits and the desire for end-of-life communication, it rarely occurs in the familial context. Relatives play a significant role in the communication process; thus, it is crucial to understand the difficulties that they face. ⋯ The results indicate that the DEOLD-FI-r is a valid and reliable instrument for the systematic assessment of difficulties in family end-of-life communication. By focusing on relatives, it complements the already validated patient-version.
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J Pain Symptom Manage · May 2024
Parenteral hydration in dying patients with cancer - a national registry study.
Clinically assisted hydration during end-of-life care among patients with cancer is controversial; practice varies between clinical settings and countries, and there is a lack of evidence. ⋯ There is an association between parenteral hydration and increased breathlessness in patients with cancer. Provision of parenteral hydration is more prevalent in men, younger patients, and those with hematological malignancies or ovarian cancer, and most widespread in acute hospital settings.
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J Pain Symptom Manage · May 2024
Disability and Place of Death in Older Americans: The Moderating Role of Household Wealth.
Home-based deaths are increasing, yet, how wealth influences where people die in the presence of disability remains unknown. ⋯ Receiving higher intensity of help with I/ADLs was associated with lower likelihood of dying in a hospital, and higher likelihood of dying at home, particularly among older adults with greater wealth.