Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2024
Discussion of Spirituality in Family Conferences of Infants with Neurologic Conditions.
Spirituality serves as a mechanism to understand and cope with serious illness, yet little is known about how families and clinicians incorporate spirituality in pediatric family conferences. ⋯ Spirituality was discussed in approximately one-third of family conferences. Clinician engagement with spirituality discussion was variable. These findings highlight a need for training on when and how to discuss spirituality in conversations with families of seriously ill infants.
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J Pain Symptom Manage · Sep 2024
Implementing the WHO Indicators for assessing palliative care development in three countries: a Do-It-Yourself approach.
Palliative care is an essential health service, with over 56.8 million people needing it yearly, particularly in low- and middle-income countries. The World Health Assembly has recognized palliative care as an ethical responsibility and called for comprehensive primary health care. The World Health Organization has published a technical report titled "Assessing the Development of Palliative Care Worldwide," as a crucial first step in addressing palliative care. The report includes 14 indicators to help decision-makers identify service provision gaps and inform health priorities, piloted by WHO's ATLANTES in Benin, Morocco, and Uruguay as part of a global assessment. ⋯ The WHO approach has proven effective in identifying health system deficiencies and disseminating information about palliative care evaluation processes. The report provides a 'Do-it-yourself' approach, encouraging self-management without expert guidance.
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J Pain Symptom Manage · Sep 2024
Essential advance care planning intervention features in low-income communities: A qualitative study.
Older adults with low socioeconomic status (SES) participate in advance care planning (ACP) at lower rates than those with higher SES. Community feedback is an essential component of intervention design for communities with fewer social and health resources to ensure that the intervention is relevant and meaningful. ⋯ Our work highlights that intervention preferences were informed by the prior strain and struggle of waiting on other kinds of health and social services. We propose an adapted model for community research collaboration to promote equity in addition to practice and policy recommendations.
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J Pain Symptom Manage · Sep 2024
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.