Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2022
Randomized Controlled TrialA Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the MOTIVATE-HF Randomized Controlled Trial.
Heart failure (HF) patients experience high burden of physical symptoms during their disease trajectory. ⋯ MI reduces the burden of physical HF symptoms, particularly when caregivers are involved in the intervention.
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J Pain Symptom Manage · Feb 2022
Caregivers' death-preparedness states impact caregiving outcomes and patients' end-of-life care.
Preparing family caregivers, cognitively, emotionally, and behaviorally, for their relative's death is an actionable component of high-quality end-of-life care. We aimed to examine the never-before-examined associations of conjoint cognitive prognostic awareness and emotional preparedness for death with caregiving outcomes and end-of-life care received by cancer patients. ⋯ Family caregivers' death-preparedness states were associated with caregiving outcomes and their relative's end-of-life care. Cultivating caregivers' accurate prognostic awareness and improving their emotional preparedness for their relative's death may facilitate more favorable end-of-life-caregiving outcomes and may limit potentially nonbeneficial end-of-life care.
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J Pain Symptom Manage · Feb 2022
Evaluating treatment tolerability using the toxicity index with patient-reported outcomes data.
Summarizing longitudinal symptomatic adverse events during clinical trials is necessary for understanding treatment tolerability. The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) provides insight for capturing treatment tolerability within trials. Tolerability summary measures, such as the maximum score, are often used to communicate the potential negative symptoms both in the medical literature and directly to patients. Commonly, the proportions of present and severe symptomatic adverse events are used and reported between treatment arms among adverse event types. The toxicity index is also a summary measure previously applied to clinician-reported CTCAE data. ⋯ The toxicity index is a useful method when ranking patients from those with the least to most symptomatic adverse event burden. This study showed the toxicity index can be applied to PRO-CTCAE data. Though as a tolerability summary measure, further study is needed to provide a clear clinical or patient-facing interpretation of the toxicity index.
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J Pain Symptom Manage · Feb 2022
The impact of aging on symptom prevalence and management in terminally ill patients with cancer.
With global population aging, the number of older patients with cancer is increasing. However, few data are available on palliative care for these patients. ⋯ We found age to be inversely related to symptom prevalence and medical interventions among terminally ill patients with cancer, contributing to the understanding of the experience of older patients with cancer.
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J Pain Symptom Manage · Feb 2022
Enduring Physical or Mental Suffering of People Requesting Medical Assistance in Dying.
Medical assistance in dying (MAiD) is available in Canada for patients with grievous and irremediable medical conditions causing unbearable physical or mental suffering. It is not known how the 'grievous and irremediable suffering' criteria is being interpreted and documented by physicians. ⋯ MAiD assessors' working definition of 'grievous and irremediable suffering' as documented in their assessments is consistent with the body of literature on this topic. MAiD assessments could be enhanced with more information about existential aspects of suffering and the impact of illness on meaningful life roles.