Journal of pain and symptom management
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Burnout is frequently a workload-related syndrome among palliative care physicians. Mandatory administrative activities contribute to this workload. The purpose of this study was to measure the amount of time involved in multiple required administrative activities and the cost of this on academic healthcare facilities. ⋯ Academic palliative care physicians are required to complete a number of administrative activities. Institutions do not keep a registry of these activities and do not accommodate for them with a reduction in the annual clinical productivity requirements. We recommend that regulatory agencies and institutions work together to better regulate this list of tasks and their frequency.
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J Pain Symptom Manage · May 2024
Dyspnea-related dimensions and self-efficacy: Associations with well-being in advanced lung cancer.
Dyspnea is a complex, multidimensional symptom comprising sensory-perceptual, affective, and functional domains that commonly persists in patients with lung cancer and impairs mental health and quality of life (QOL). However, data are lacking on how dyspnea's dimensions or self-efficacy to manage dyspnea are associated with patient outcomes. ⋯ Dyspnea-related sensory-perceptual experience and self-efficacy were associated with mental health and QOL outcomes in patients with lung cancer. Examining the individual contributions of dyspnea's multiple dimensions provides a nuanced understanding of its patient impact.
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J Pain Symptom Manage · May 2024
Palliative approach remains lacking in terminal hospital admissions for chronic disease across rural settings: multisite retrospective medical record audit.
Despite clear benefit from palliative care in end-stage chronic diseases, access is often limited, and rural access largely undescribed. This study sought to determine if a palliative approach is provided to people with chronic disease in their terminal hospital admission. ⋯ End-of-life planning and specialist palliative care involvement occurred infrequently for people with chronic disease who died in rural hospitals. Targeted strategies are necessary to improve care for these prevalent and high needs rural populations.
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J Pain Symptom Manage · May 2024
National Palliative Care Strategy in a conflict affected country: a Jordanian demonstration project.
Palliative care (PC) integration is vital, as endorsed by the World Health Organization. Yet, Jordan, a Middle Eastern country with limited resources, faces ongoing challenges despite efforts to improve palliative and home care. Establishing a national PC strategic framework, with government and stakeholder consensus, is essential for ensuring universal access to high-quality palliative care. However, processes for achieving this, particularly in the Middle East, are underreported. ⋯ Jordan's collaborative development of the inaugural National Palliative and Home Care Strategic Framework, endorsed by the government and stakeholders, provides a comprehensive roadmap for PC advancement. While it promises improved services, effective solutions to workforce and opioid access issues are crucial for successful implementation.
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J Pain Symptom Manage · May 2024
IDENTIFICATION OF A HIGHER RISK LYMPHEDEMA PHENOTYPE AND ASSOCIATIONS WITH CYTOKINE GENE POLYMORPHISMS.
Breast cancer-related lymphedema (BCRL) is chronic condition that occurs in 5% to 75% of women following treatment for breast cancer. However, little is known about the risk factors and mechanisms associated with a worse BCRL profile. ⋯ The readily available and clinically relevant phenotypic characteristics associated with a worse BCRL profile can be used by clinicians to identify higher risk patients. If confirmed, these characteristics can be tested in predictive risk models. In addition, the candidate gene findings may guide the development of mechanistically-based interventions to decrease the risk of BCRL.