Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2021
Improving end-of-life care for persons living with dementia: Bereaved caregivers' observations and recommendations.
Dementia is a terminal diagnosis that requires significant caregiving support across the trajectory of decline through to death. Experiences and perspectives from bereaved caregivers can help identify ways to improve the end-of-life care experience of persons dying with dementia. ⋯ End-of-life care for PLWD has significant room for improvement. Efforts to train healthcare providers should focus on helping them meet the complex informational, emotional, and social support needs of PLWD and their caregivers across the trajectory of decline.
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J Pain Symptom Manage · Sep 2021
Clinical and Genetic factors associated with the Breast cancer-related Sleep Disorders: The "CAGE-Sleep" study- a cross-sectional study.
Despite being among the most reported concerns in breast cancer patients, sleep disturbances are still poorly assessed and managed in routine clinical practice. Correctly evaluating these symptoms and understanding the underlying clinical and genetic factors would help medical teams develop an adequate treatment strategy for each patient. ⋯ Our study confirms the relationship between anxiety/depression, cycle number, dyslipidemia and DRD2 polymorphism with insomnia and highlights the importance of treating all associated factors to improve the overall QOL of patients.
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J Pain Symptom Manage · Sep 2021
Experience with Advance Care Planning Discussions Among Pregnant Women with Congenital Heart Disease.
Women with adult congenital heart disease (ACHD) have an increased risk of adverse events during pregnancy. Advance care planning may therefore be an appropriate component of prenatal care. ⋯ Advance care planning is not a routine part of prenatal care in ACHD, and its role in this population requires further assessment.
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J Pain Symptom Manage · Sep 2021
Examining Adherence and Dose Effect of an Early Palliative Care Intervention for Advanced Heart Failure Patients.
Research priority guidelines highlight the need for examining the "dose" components of palliative care (PC) interventions, such as intervention adherence and completion rates, that contribute to optimal outcomes. ⋯ Higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF. Future work should focus on identifying the most efficacious "dose" of intervention components and increasing adherence to them.
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J Pain Symptom Manage · Sep 2021
Preferences for more aggressive end-of-life pharmacologic care among racial minorities in a large population-based cohort of cancer patients.
Minority patients receive more aggressive and potentially suboptimal care at the end of life (EOL). We investigated preferences about pharmacologic interventions at the EOL and their potential variation by sociodemographic factors among recently diagnosed cancer patients. ⋯ Black and Hispanic cancer patients were more likely to express preferences toward more aggressive EOL pharmacologic care. These findings were independent of other sociodemographic characteristics, health literacy and trust in the medical profession.