Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2024
Learning to Trust Yourself: Decision-Making Skills among Parents of Children with Medical Complexity.
Children with medical complexity have substantial medical needs and their caregivers must make many challenging decisions about their care. Caregivers often become more involved in decisions over time, but it is unclear what skills they develop that facilitate this engagement. ⋯ Parents of children with medical complexity change how they approach decision making over time as they acquire relevant skills. These findings can inform the development of interventions to support skill-building among new caregivers.
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J Pain Symptom Manage · Sep 2024
Observational StudyA novel objective measure for terminal delirium: Activity scores measured by a sheet-type sensor.
Delirium is a significant concern in end-of-life care. Continuous monitoring of agitation levels using objective methods may have advantages over existing measurement scales. ⋯ The NSCAN activity significantly correlated with modified RASS agitation scores. Real-time NSCAN data on agitation may aid timely interventions for optimal symptom control. To improve outcomes for patients suffering from terminal delirium, more research on monitoring tools is warranted.
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J Pain Symptom Manage · Sep 2024
Trajectories of Opioid Use Before and After Cancer Diagnosis: A Population-Based Cohort Study.
Opioid use prior to cancer diagnosis increases the likelihood of long-term use during survivorship, however, patterns of use before and after diagnosis are not understood. ⋯ There is considerable heterogeneity in opioid use before and after cancer diagnosis. Our findings suggest noncancer factors drive a significant proportion of postdiagnosis opioid use, but use increased significantly from the month of cancer diagnosis and never returned to prediagnosis levels.
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J Pain Symptom Manage · Sep 2024
"Life…Gets Turned Upside-Down…" Opportunities to Improve Palliative Care for High-Grade Glioma.
Early palliative care referral is recommended broadly in oncology. Yet, few patients with high-grade gliomas (HGG) - highly aggressive brain tumors - receive specialty palliative care consultation. ⋯ Patients with HGG have unique palliative care needs that affect palliative care delivery across care domains. Bidirectional education, enhanced collaboration, and consensus guidelines may help overcome barriers to specialty palliative care referral.
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J Pain Symptom Manage · Sep 2024
Improving Goal-Concordant Care in Intensive Care Unit Admissions from the Emergency Department in a Comprehensive Cancer Center.
As patients approach the end of life, discussion of their treatment goals is essential to avoid unnecessary suffering and deliver care in a manner consistent with their overall values. ⋯ Through our multipronged approach, we significantly improved the rates of ACP documentation among providers admitting patients from the ED to the ICU.