Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2025
Association of Palliative Care Timing with End-of-Life Quality in Children with Heart Disease.
Children with heart disease are at risk for early mortality and parents often perceive suffering at end-of-life (EOL). Involvement of pediatric palliative care (PPC) is a proposed quality measure at the EOL in children with cancer, and early PPC involvement is associated with other quality measures. The impact of early PPC involvement on EOL quality is unknown in children with heart disease. ⋯ Our findings may indicate that quality indicators extrapolated from pediatric oncology do not apply to children with heart disease, as they have notably different disease trajectories and intervention options. We recommend defining high-quality EOL care indicators for children with heart disease as a priority.
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J Pain Symptom Manage · Jan 2025
Implementation of Ambulatory Kidney Supportive Care in a Safety Net Hospital.
Chronic kidney disease (CKD) disproportionately impacts lower socioeconomic groups and is associated with many symptoms and complex decisions. Integration of Kidney Supportive Care (KSC) with CKD care can address these needs. To our knowledge, this approach has not been described in an underserved population. ⋯ We describe a feasible ambulatory care model of KSC in a safety net setting that can serve as a framework for the development of other noncancer palliative care ambulatory clinics. Future work will optimize our model.
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J Pain Symptom Manage · Jan 2025
Preparing Surrogates for Decision-Making: Development and Pilot Testing of PREPARE For THEIR Care.
Surrogate decision-makers have expressed the need for better preparation around communication and medical decision-making. ⋯ In this pilot study, the prepare for their care program resulted in high user satisfaction and improved pre-to-post surrogate readiness to engage in ACP. Larger trials are needed to evaluate the impact of the program on surrogate readiness and confidence.
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J Pain Symptom Manage · Jan 2025
ReviewEarly Integration of Palliative Care in Non-Oncological Patients: A Systematic Review.
Palliative care (PALC) is traditionally linked to end-of-life cancer care but also benefits advanced nononcological diseases. ⋯ The impact of early PALC on health outcomes in nononcological diseases is inconsistent. Addressing barriers to early PALC integration and conducting further high-quality research are essential for optimizing care pathways and enhancing patient outcomes.
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J Pain Symptom Manage · Jan 2025
Correlates of Perceived Illness Severity and Terminality in Advanced Lung and Prostate Cancer.
While prognostic awareness has been commonly assessed as perceived illness terminality in patients with advanced cancer, both perceptions of illness severity and terminality may be correlated with symptom burden and quality of life. ⋯ Our findings suggest that perceiving cancer as serious, not just terminal, is related to symptom burden and quality of life. Results point to the need for interventions to improve prognostic understanding and coping with the disease.