Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2020
Pain-Associated Clusters Among Nursing Home Residents and Older Adults Receiving Home Care in Germany.
There are no available data regarding pain-associated clusters among nursing home residents (NHRs) and older adults receiving home care with chronic pain. ⋯ Overall, differences in pain management exist within the two care settings presented here. There is potential for improvement in both settings. Moreover, there exists a need for clinical interventions aiming at shifting from pain-affected clusters to pain-relieved status.
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J Pain Symptom Manage · Jul 2020
Which Melbourne metropolitan areas are vulnerable to COVID-19 based on age, disability and access to health services? Using spatial analysis to identify service gaps and inform delivery.
Aging adults (65+) with disability are especially vulnerable to coronavirus disease 2019 (COVID-19), and on contracting, they are a cohort most likely to require palliative care. Therefore, it is very important that health services-particularly health services providing palliative care-are proximately available. Treating the Melbourne metropolitan area as a case study, a spatial analysis was conducted to clarify priority areas with a significantly high percentage and number of aging adults (65+) with disability and high barriers to accessing primary health services. ⋯ The geographic dispersion of areas with people vulnerable to COVID-19 with poor access to palliative care and health services is clarified. Unique methods of health service delivery are required to ensure that vulnerable populations in underserviced metropolitan areas receive prompt and adequate care. The spatial methodology used can be implemented in different contexts to support evidence-based COVID-19 and pandemic palliative care service decisions.
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J Pain Symptom Manage · Jul 2020
Suicide Attempt Following Determination of Ineligibility for Assisted Death: A Case Series.
Medical assistance in dying (MAID) and similar right-to-die laws are becoming increasingly common in jurisdictions across North America and elsewhere. To be eligible for MAID in Canada, requesters must have a serious illness, intolerable suffering, and a reasonably foreseeable natural death. They must also undergo two assessments to confirm eligibility. ⋯ All three cases had previous diagnoses of depressive disorders and mild cognitive impairment, and two cases had histories of suicide attempts. In at-risk patients, we speculate that the period surrounding a finding of MAID ineligibility may represent a period of particular vulnerability. Clinicians must be vigilant and prepared for the possibility of heightened risk, including risk of self-harm, after a finding of ineligibility for assisted death.
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J Pain Symptom Manage · Jun 2020
Changes in Attentional Function in Patients From Prior to Through 12 Months After Breast Cancer Surgery: Changes in Attentional Function Following Breast Cancer Surgery.
Although approximately 75% of patients with breast cancer report changes in attentional function, little is known about how demographic, clinical, symptom, and psychosocial adjustment (e.g., coping) characteristics influence changes in the trajectories of attentional function over time. ⋯ Findings can be used to identify patients with breast cancer at higher risk for impaired self-reported cognitive function and to guide the prescription of more personalized interventions.