Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
Patterns of Specialty Palliative Care Utilization Among Patients Receiving Palliative Radiotherapy.
Palliative radiation therapy (RT) is frequently used to ameliorate cancer-associated symptoms and improve quality of life. ⋯ Fewer than half of patients receiving palliative RT utilized specialty PC. Initiatives are needed to increase PC, especially for patients with lung cancer and neurological symptoms, and to empower radiation oncologists to refer patients to specialty PC.
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J Pain Symptom Manage · Aug 2021
Randomized Controlled TrialPredictors of Response to an Evidence-based Behavioral Cancer Pain Management Intervention: An Exploratory Analysis from a Clinical Trial.
Interventions that teach patients cognitive and behavioral strategies for managing cancer pain have demonstrated effectiveness. Systematic reviews of such interventions call for research to inform their implementation in practice, including investigations into which patients are most likely to benefit. ⋯ Our findings elucidate several subgroups of patients who may be especially likely to benefit from PCST, informing both targeted implementation efforts and opportunities to improve delivery for diverse patients.
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J Pain Symptom Manage · Aug 2021
ReviewSugammadex to reverse neuromuscular blockade prior to withdrawal of life support.
In certain end-of-life scenarios, pharmacologic reversal of neuromuscular blockade may be indicated. However, given the depth of blockade frequently necessitated in the ICU setting, rapid reversal of neuromuscular blockade is generally not feasible with conventional reversal agents such as neostigmine that inhibit acetylcholinesterase. ⋯ We report the use of sugammadex to reverse neuromuscular blockade prior to compassionate extubation in three pediatric patients. Its clinical use in children is reviewed, potential applications in the palliative care arena discussed, and dosing algorithms presented.
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J Pain Symptom Manage · Aug 2021
The psychosocial impact of spouse-caregiver chronic health conditions and personal history of cancer on well-being in advanced cancer patients and their caregivers.
Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent. ⋯ Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.