Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2017
Randomized Controlled TrialLevel of Care Preferences among Nursing Home Residents with Advanced Dementia.
Delivering goal-directed care is a hallmark of high-quality palliative care, but requires an understanding of preferences. ⋯ Most proxies select comfort as the preferred level of care for NH residents with advanced dementia. Discussions regarding prognosis, as well as inquiry about goals of care, are modifiable factors that may promote a preference for comfort care in this population.
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialUnderstanding Response Rates to Surveys about Family Members' Psychological Symptoms after Patients' Critical Illness.
Achieving adequate response rates from family members of critically ill patients can be challenging, especially when assessing psychological symptoms. ⋯ We identified several predictors of the receipt of surveys assessing psychological symptoms in family of critically ill patients, including family member health status and attachment style. Using these characteristics to inform follow-up mailings and reminders may enhance response rates.
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialPerceived Family Functioning Predicts Baseline Psychosocial Characteristics in U.S. Participants of a Family Focused Grief Therapy Trial.
Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. ⋯ As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care.
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J Pain Symptom Manage · Jul 2017
Randomized Controlled TrialRandomized evaluation of cognitive-behavioral therapy and graded exercise therapy for post-cancer fatigue.
Cancer-related fatigue is prevalent and disabling. When persistent and unexplained, it is termed post-cancer fatigue (PCF). Cognitive behavioral therapy (CBT) and graded exercise therapy (GET) may improve symptoms and functional outcomes. ⋯ Combined CBT/GET improves fatigue and functional outcomes for a subset of patients with post-cancer fatigue. Further studies to improve the response rate and the magnitude of the benefit are warranted.
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J Pain Symptom Manage · Jun 2017
Randomized Controlled TrialA Randomized Trial of Yoga for Children Hospitalized with Sickle Cell Vaso-Occlusive Crisis.
Sickle cell disease (SCD) vaso-occlusive crisis (VOC) remains an important cause of acute pain in pediatrics and the most common SCD complication. Pain management recommendations in SCD include nonpharmacological interventions. Yoga is one nonpharmacological intervention that has been shown to reduce pain in some populations; however, evidence is lacking in children with VOC. ⋯ This study provides evidence that yoga is an acceptable, feasible, and helpful intervention for hospitalized children with VOC. Future research should further examine yoga for children with SCD pain in the inpatient and outpatient settings.