Journal of pain and symptom management
-
J Pain Symptom Manage · Oct 2020
Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people.
Chronic breathlessness is associated with poorer quality of life (QoL). This population study aimed to define dimensions of QoL and duration and dominant causes of breathlessness that most diminished QoL. ⋯ This is the first study to report on chronic breathlessness and impairment across dimensions of QoL and differences by its duration. Mobility, usual activity, and pain drive these reductions.
-
J Pain Symptom Manage · Oct 2020
Goals-of-Care Consultation Associated with Increased Hospice Enrollment Among Propensity-Matched Cohorts of Seriously Ill African American and White Patients.
African Americans are less likely to receive hospice care and more likely to receive aggressive end-of-life care than whites. Little is known about how palliative care consultation (PCC) to discuss goals of care is associated with hospice enrollment by race. ⋯ In propensity-matched cohorts of seriously ill patients, PCC to discuss goals of care was associated with significant increases in hospice enrollment at discharge among both African Americans and whites. Research is needed to understand how PCC influences decision making by race, how PCC is associated with postdischarge hospice outcomes such as disenrollment and hospice lengths of stay, and if PCC is associated with improving racial disparities in end-of-life care.
-
J Pain Symptom Manage · Oct 2020
Racial and Ethnic Differences in Communication and Care for Children with Advanced Cancer.
Racial and ethnic disparities in end-of-life care are well documented among adults with advanced cancer. ⋯ Parental understanding of prognosis is limited across racial and ethnic groups; racial and ethnic minorities are disproportionately affected. Perhaps as a result, minority children experience higher rates of high-intensity medical care. Work to improve prognostic understanding should include focused work to meet needs of minority populations.
-
J Pain Symptom Manage · Oct 2020
Terminally ill cancer patients' emotional preparedness for death is distinct from their accurate prognostic awareness.
Emotional preparedness for death (hereafter called death preparedness) and prognostic awareness (PA), a distinct but related concept, each contributes to patients' practical, psychological, and interpersonal preparations for death. However, the distinction between these two concepts has never been investigated. ⋯ The distinction between death preparedness and accurate PA was supported by their poor agreement, lack of reciprocal associations, and two different sets of predictors. Health care professionals should not only cultivate cancer patients' accurate PA but also facilitate emotional preparation for death to achieve a good death and improve end-of-life care quality.