Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2025
ReviewRacism in Pediatric Serious Illness and Palliative Care: A Scoping Review of Qualitative Research.
Racial disparities in health outcomes have historically impacted Black and Native American children with serious illness, yet little is known about how racism shapes the healthcare experiences of these families. To improve care experiences for this population, we must understand the myriad of ways that racism may impact their experiences with serious illness. ⋯ Our findings highlight the pressing need for further qualitative research to explore the lived experiences of racially minoritized families-especially studies focusing on the experiences of Native American families.
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J Pain Symptom Manage · Jan 2025
Use of Essential Medicines for Pain Relief and Palliative Care: a global consensus process.
The WHO Model List of Essential Medicines includes 24 medications under the section Medicines for Pain and Palliative Care (EML). The Lancet Commission on Pain and Palliative Care developed the Lancet Essential Package (LEP), including 35 medications designed to alleviate serious health-related suffering worldwide. ⋯ We were able to partly achieve our goal, with limited evidence and a wide range of clinical practice described by the experts. This highlights an important gap in critical information which affects mostly the provision of palliative care at the primary care. Both limited availability and lack of training on the adequate use of essential medications may affect how clinicians manage symptoms, possibly relying on personal experience or trial and error, rather than evidence-based information.
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J Pain Symptom Manage · Jan 2025
Developing a Scale for Home-Visit Nurses to Start End-of-life Discussions with Cancer Patients.
Home-visit nurses find it challenging to determine the appropriate time to initiate end-of-life discussions with cancer patients. ⋯ The reliability and validity of the T-EOLD is acceptable, as it is an appropriate scale that home-visit nurses can use to determine the time to initiate end-of-life discussions with cancer patients. However, further study is required to examine T-EOLD's clinical utility, both nationally and internationally.
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J Pain Symptom Manage · Jan 2025
Advance Care Planning Bundle: Using Technical and Adaptive Solutions to Promote Goal Concordant Care.
Advance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system. ⋯ Implementation of technical and adaptive tools as a bundle for Advance Care Planning shows promise to improve and sustain goal-aligned care. Quality Improvement in ACP is a complex, iterative process involving both structural change and behavioral adaptation.
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J Pain Symptom Manage · Jan 2025
Variation in Palliative Care Program Performance for Patients with Metastatic Cancer.
While specialist palliative care is associated with improved end-of-life quality metrics for patients with advanced cancer, its effectiveness may differ between hospitals. ⋯ We found variation in most end-of-life quality metrics for patients with metastatic cancer. Further work is needed to better understand why variations exist and whether such variations reflect a difference in quality of care.