Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2019
Multicenter StudyMulticenter Study of the psychometric properties of the new Demoralization Scale (DS-II) in Spanish-speaking advanced cancer patients.
Demoralization is a state of existential distress in patients with advanced illness, typically with coping difficulties, feelings of loss of sense, and purpose in life and despair, among other things. The New Demoralization Scale (DS-II) is an evaluation tool for this syndrome, which has recently been reformulated on a shorter scale. ⋯ The Spanish version of the new Kissane DS-II demoralization scale has shown to be valid, reliable, and feasible with adequate psychometric properties.
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J Pain Symptom Manage · Feb 2019
Multicenter Study Observational StudyPalliative Care Clinician Overestimation of Survival in Advanced Cancer: Disparities and Association with End-of-Life Care.
Clinicians frequently overestimate survival time in serious illness. ⋯ Overestimation is common in PC, associated with lower hospice use and a potentially mutable source of racial/ethnic disparity in EOL care.
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J Pain Symptom Manage · Feb 2019
Multicenter StudyModerating effects of forgiveness on relationship between empathy and health-related quality of life in hemodialysis patients: a structural equation modeling approach.
Health-related quality of life (QOL) is a recommended clinical tool to assess hemodialysis patients and a primary end point to observe the effectiveness of overall disease management. Empathy is associated with positive outcomes such as pain relief and reduced anxiety and distress. Numerous studies have tested the relationships among empathy, forgiveness, and QOL; however, a mechanism of forgiveness has not been fully explored in hemodialysis patients. ⋯ The results imply that empathy significantly directly and indirectly influences health-related QOL. Empathy among hemodialysis patients should be monitored and effectively managed to improve positive effects on their health-related QOL. Nurses should consider implementing empathy interventions with an emphasis on building forgiveness strategies to help hemodialysis patients improve their health-related QOL.
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J Pain Symptom Manage · Feb 2019
Randomized Controlled Trial Multicenter StudyDid a goals-of-care discussion happen? Differences in the occurrence of goals-of-care discussions as reported by patients, clinicians, and in the electronic health record.
Goals-of-care discussions are associated with improved end-of-life care for patients and therefore may be used as a process measure in quality improvement, research, and reimbursement programs. ⋯ Different approaches to assess goals-of-care discussions give differing results, yet each may have advantages. Patient report is most likely to correlate with patient-reported receipt of goal-concordant care.
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J Pain Symptom Manage · Feb 2019
Multicenter Study Observational StudyPrevalence and characteristics of patients being at risk of deteriorating and dying in primary care.
Understanding the prevalence and characteristics of primary care outpatients being at risk of deteriorating and dying may allow general practitioners (GPs) to identify them and initiate end-of-life discussions. ⋯ Among primary care outpatients aged over 65 years, 17.3% were at risk of deteriorating and dying regardless of their estimated survival time, and many outpatients at risk were not receiving optimal multidisciplinary care.