Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2021
Distinct death-preparedness states by combining cognitive and emotional preparedness for death and their evolution for family caregivers of terminally ill cancer patients over their last 6 months of life.
To identify caregivers' death-preparedness states by combining cognitive and emotional preparedness for their loved one's death as well as their evolution over cancer patients' last 6 months, which have never been explored. ⋯ Caregivers of cancer patients heterogeneously experienced combined cognitive and emotional preparedness for death. About 40% of caregivers consistently had sufficient death preparedness over their loved one's dying process. Evaluating these different aspects of death preparedness could be an important approach in high-quality end-of-life care by not only cultivating caregivers' cognitive PA, but also facilitating their emotional preparedness for the patient's death, thus helping caregivers prepare well for their loved one's forthcoming death.
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J Pain Symptom Manage · Sep 2021
Development and Pilot Test of a Culturally Relevant Toolkit to Enhance Advance Care Planning with Chinese American Patients.
First-generation Chinese American patients have low engagement in advance care planning (ACP). Among the causes may be clinician uncertainty about traditional cultural values. ⋯ An ACP toolkit may facilitate culturally relevant ACP discussions by increasing clinician competency and patient engagement. Further studies of this approach are needed.
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J Pain Symptom Manage · Sep 2021
Pre-post Evaluation of Collaborative Oncology Palliative Care for Patients with Stage IV Cancer.
The Collaborative Care Model improves care processes and outcomes but has never been tested for palliative care. ⋯ Collaborative oncology palliative care is efficient and feasible. While it did not increase overall goals-of-care discussions, it was effective to increase overall advance care planning and hospice use for patients with Stage IV cancer.
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J Pain Symptom Manage · Sep 2021
"Going home [is] just a feel-good idea with no structure": A qualitative exploration of patient and family caregiver needs when transitioning from hospital to home in palliative care.
Hospital-to-home transitions, particularly at the end of life, can be challenging for patients and their family caregivers. Therefore, there is a need to better understand gaps in expectations and experiences of these transitions. Theory can inform the creation of an intervention aimed at improving the hospital-to-home transition. ⋯ Our substantive grounded theory highlighted potentially measurable constructs that can be further tested. Future interventions should target the enablers/disablers to ensure health and well-being and practical needs are met in the transition.
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J Pain Symptom Manage · Sep 2021
Long-term daily administration of aprepitant for the management of intractable nausea and vomiting in children with life-limiting conditions: a case series.
Nausea and vomiting is a common symptom in children through their end of life journey. Aprepitant, a NK-1 antagonist, has become a potent weapon in the fight against chemo-induced nausea and vomiting. However, its use in palliative care for refractory nausea and vomiting has been limited due to limited experience or evidence of continuous use. Emerging evidence suggests that continuous use is not only safe, but also effective in patients with nausea and vomiting refractory to multiple lines of antiemetic therapy. ⋯ Our review suggests a role for aprepitant in management of refractory nausea and vomiting, demonstrating safety and efficacy. This case series is the first report of aprepitant use in this manner in the paediatric palliative care setting.