Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2024
Predictive Biomarkers of Dyspnea Response to Dexamethasone and Placebo in Cancer Patients.
In the Alleviating Breathlessness in Cancer Patients with Dexamethasone (ABCD) trial, dexamethasone did not improve dyspnea more than placebo in unselected cancer patients. However, it is unclear if patients with greater inflammation would be more likely to derive a treatment response. ⋯ Cytokines decreased with dexamethasone, but not placebo. Higher baseline cytokine levels may identify patients likely to respond to dexamethasone and less likely to respond to placebo.
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J Pain Symptom Manage · Aug 2024
Comparative StudyComparison of Prognostic Abilities of Palliative Prognostic Index, Laboratory Prognostic Score, and Palliative Prognostic Score.
Few studies have compared the prognostic value of scoring systems based on physical and blood parameters in terminally ill patients with cancer. ⋯ The prognostic abilities of PPI, LPS, and PaP were comparable. The most adequate estimation occurred for patients with AS for 14-59 days. A more accurate prognostic model is needed for patients with longer survival.
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J Pain Symptom Manage · Aug 2024
Multicenter StudyOutcomes of a Multi-Site Mentored Implementation Approach to Promoting Goals of Care Conversations.
The Preference-Aligned Communication and Treatment (PACT) Project is a multisite quality improvement effort that has been shown to increase the frequency of goals of care (GOC) conversations in hospitalized patients with serious illness. ⋯ A multisite mentored implementation quality improvement intervention for seriously ill hospitalized patients resulted in care aligned with goals and decreased resource utilization at the end of life.
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J Pain Symptom Manage · Aug 2024
"At Least I Can Push this Morphine":PICU Nurses' Approaches to Suffering Among Dying Children.
Parents of children who die in the pediatric intensive care unit (PICU) carry memories of their child's suffering throughout a lifelong grieving experience. Given their prolonged time at the bedside, PICU nurses are poised to attend to dying children's suffering. ⋯ While physical suffering may be remedied with direct nursing care, holistically attending to EOL suffering in the PICU requires both bolstering external processes and strengthening PICU nurses' internal resources. Improving psychosocial training and optimizing interprofessional care systems could better support dying children and their families.