Journal of pain and symptom management
-
J Pain Symptom Manage · Apr 2023
Randomized Controlled TrialEffects of Spiritual Care on Well-being of Intensive Care Family Surrogates: A Clinical Trial.
Critical illness of a family member is associated with high emotional and spiritual distress and difficult medical decisions. ⋯ Proactive, semistructured spiritual care delivered by chaplains improves well-being for ICU surrogates. Results provide evidence for inclusion of chaplains in palliative and intensive care teams.
-
J Pain Symptom Manage · Apr 2023
Randomized Controlled TrialEffects of a Patient Question Prompt List on Question Asking and Self-Efficacy During Outpatient Palliative Care Appointments.
Question prompt lists (QPLs) promote participation during medical appointments, including in the context of serious illness care. However, no studies have used parameters of a theoretical framework to examine the effects of QPL use in outpatient palliative care. ⋯ Despite their promise in previous studies, results of the current study suggest that QPLs may lack potency to shift patient and care partner question asking in palliative care appointments, and that other mechanisms outlined in Self-Efficacy Theory may characterize the relation between question asking and self-efficacy.
-
J Pain Symptom Manage · Apr 2023
The impact of stressful life events after bereavement: a nationwide cross-sectional survey.
Bereaved family members sometimes experience distress due to stressful life events. However, the effects of this distress on depression and grief remain unclear. ⋯ Most family members experienced distress due to stressful life events, which were risk factors for MDD and CG. Assessing risk factors for maladaptation to post-bereavement life changes and enhancing readiness to adapt to them is important.
-
J Pain Symptom Manage · Apr 2023
Inflammation and performance status: the cornerstones of prognosis in advanced cancer.
In advanced cancer, although performance status (PS), systemic inflammatory response and nutritional status are known to have prognostic value, geographical variations and sociodemographic indexes may also impact survival. ⋯ The established prognostic factors that were compared had similar prognostic capacity in both cohorts. A high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer survival of patients with advanced cancer in the prospective European and Brazilian cohorts.
-
J Pain Symptom Manage · Mar 2023
Should benzodiazepines be used for reducing dyspnea in patients with advanced illnesses?
Dyspnea is a common and highly distressing symptom in patients with advanced illnesses. Many patients continue to experience chronic dyspnea despite optimal management of underlying disease(s) and various non-pharmacologic interventions, necessitating the consideration of pharmacologic therapies for palliation of dyspnea. One commonly asked question by clinicians is whether benzodiazepines have a role in the palliation of dyspnea. ⋯ Some investigators may also consider the adjunctive use of benzodiazepines in patients with severe dyspnea despite opioids, particularly if life expectancy is limited. Benzodiazepines also have a role in palliative sedation for refractory dyspnea in the last days of life. More research is needed to confirm the benefit of benzodiazepines in these populations.