Journal of pain and symptom management
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J Pain Symptom Manage · May 2020
Fatigue in peritoneal dialysis patients and an exploration of contributing factors: a cross-sectional study.
Fatigue is a common and detrimental symptom in dialysis patients; however, our understanding of it and investigation of its contributing factors is still very limited, especially in peritoneal dialysis (PD) patients. ⋯ Fatigue is a common symptom in PD patients, suggesting that increased awareness of this symptom is required. The identification of correlates by extensive exploration of multidimensional factors in this study may help practitioners to identify patients at higher risk and to develop a multidimensional and targeted intervention plan.
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J Pain Symptom Manage · May 2020
Observational StudyPatients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective, Observational Cohort Study of Japanese Patients With Cancer.
Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment. ⋯ After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics.
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It is challenging to provide supportive intensive care to infants in the neonatal intensive care unit (NICU), giving them every chance for survival, while also trying to minimize suffering for both the infant and parents. Parents who believe their infant is suffering may alter treatment goals based on their perceptions; however, it is unknown how parents come to believe that their infant may be suffering. ⋯ Parents used signs exhibited by infants, as well as information they received from the health care team to form their perceptions of suffering. Perceived suffering followed different trajectories and influenced the decisions that parents made for their infant. Soliciting parent perspectives may lead to improvements in the understanding of infant well-being, particularly suffering, as well as how parents rely on these perceptions to make treatment decisions for their infant.
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J Pain Symptom Manage · May 2020
Advanced Cancer Patients' Changes in Accurate Prognostic Understanding and Their Psychological Well-Being.
Clinicians often worry that patients' recognition of the terminal nature of their illness may impair psychological well-being. ⋯ Improved PU may be associated with initial decrements in psychological well-being, followed by patients rebounding to baseline levels. Concerns about lasting psychological harm may not need to be a deterrent to having prognostic discussions with patients.
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There is much in the literature about the benefits of reflective writing for medical practitioners. This article outlines instructions for a novel reflective writing exercise that anyone can do, gives examples for how the exercise has been helpful for the author, and then relates an interdisciplinary discussion that resulted from the use of this exercise when paired with a prompt.