Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2021
Epidemiology of Fear, Sadness and Anger Expression in Palliative Care Conversations.
Advancing the science of serious illness communication requires methods for measuring characteristics of conversations in large studies. Understanding which characteristics predict clinically important outcomes can help prioritize attention to scalable measure development. ⋯ Fear, anger, and sadness are commonly expressed in hospital-based palliative care consultations with people who have advanced cancer. Anger is an epidemiologically useful predictor of important clinical outcomes.
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J Pain Symptom Manage · Feb 2021
National Trends in Hospice Facility Deaths in the United States, 2003-2017.
Hospice facilities are increasingly preferred as a location of death, but little is known about the characteristics of patients who die in these facilities in the U.S. ⋯ Hospice facility deaths increased among all patient groups; however, striking differences exist by age, sex, race, marital status, education level, cause of death, and geography. Factors underlying these disparities should be examined.
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J Pain Symptom Manage · Feb 2021
Letter Controlled Clinical TrialFeasibility of an online integrative oncology treatment program during COVID-19.
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J Pain Symptom Manage · Feb 2021
A Retrospective Study of Rapid Symptom Response in Bleeding Gynecologic Malignancies with Short Course Palliative Radiation Therapy: Less is More.
Advanced gynecologic malignancies can cause significant vaginal bleeding. Radiotherapy (RT) is often used to palliate symptoms, but limited data exist concerning the optimal dose and expected time to bleeding hemostasis in this population. ⋯ Women receiving SCRT for bleeding gynecologic malignancies achieved rapid symptom control (often during treatment) with minimal rebleeding. In a population whose median survival is four months, SCRT effectively addresses symptomatic disease while minimizing patient burden and toxicity.
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J Pain Symptom Manage · Feb 2021
Frequency and Characteristics of First-Time Palliative Care Referrals During the Last Day of Life.
Palliative care referrals (PCRs) improve symptom management, provide psychosocial and spiritual support, clarify goals of care, and facilitate discharge planning. However, very late PCR can result in increased clinician distress and prevent patients and families from benefiting from the full spectrum of interdisciplinary care. ⋯ Although only a small proportion of first-time PCR occurred in the last 24 hours of life, the patients had a significant amount of distress, indicating a missed opportunity for timely palliative care intervention. These sentinel events call for specific guidelines to better support patients, families, and clinicians during this difficult time. Further research is needed to understand how to minimize very late PCR.