Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2020
Dying from Covid-19: Loneliness, end-of-life discussions and support for patients and their families in nursing homes and hospitals. A national register study.
Preparation for an impending death through end-of-life (EOL) discussions and human presence when a person is dying is important for both patients and families. ⋯ Dying from COVID-19 negatively affects the possibility of holding an EOL discussion and the chances of dying with someone present. This has considerable social and existential consequences for both patients and families.
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J Pain Symptom Manage · Oct 2020
Review Meta AnalysisThe Diagnostic Accuracy of Critical Care Pain Observation Tool (CPOT) in ICU Patients: A Systematic Review and Meta-Analysis.
The critical care pain observation tool (CPOT) has been widely used to assess pain in ICU patients, and its validity and reliability have been tested in various contexts. ⋯ CPOT has moderate diagnostic parameters with a threshold of two or three, suggesting that it is a fair but not excellent tool. More research on the validity of the CPOT in specific subgroups is needed to broaden its applicability in critical care.
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J Pain Symptom Manage · Oct 2020
Randomized Controlled Trial Multicenter StudyPatient-reported receipt of goal-concordant care among seriously ill outpatients - prevalence and associated factors.
Goal-concordant care is an important indicator of high-quality care in serious illness. ⋯ Seriously ill outpatients who prioritize a goal of relief of pain and discomfort are less likely to report receipt of goal-concordant care than patients who prioritize extending life. Future interventions designed to improve receipt of goal-concordant care should focus on identifying patients who prioritize relief of pain and discomfort and promoting care aligned with that goal.
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J Pain Symptom Manage · Oct 2020
Engaging Hospices in Quality Measurement and Improvement: Early Experiences of a Large Integrated Healthcare System.
The quality of hospice care remains highly variable in the U. S. Patients, providers, and health care systems lack a comprehensive method of measuring the quality of care provided by an individual hospice. ⋯ For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14). The hospice RFI process is one health care system's attempt to evaluate hospice quality. Further research will determine whether the scoring system proves to be a sensitive, specific, and reproducible measure of hospice quality, and whether the collaborative can foster quality improvement over time.