Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2020
Preferences for end-of-life care and decision-making among older and seriously ill inpatients: a cross-sectional study.
Older and seriously ill Australians are often admitted to hospital in the last year of their life. The extent to which these individuals have considered important aspects of end-of-life (EOL) care, including location in which care is provided, goals of care, and involvement of others in decision making, is unclear. ⋯ Most inpatients would prefer EOL care that maintains quality and relieves suffering compared with life extension and to receive this care at home. Family involvement in resolution and documentation of EOL decisions should be prioritized.
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J Pain Symptom Manage · Feb 2020
Coping skills training and acceptance and commitment therapy for symptom management: Feasibility and acceptability of a brief telephone-delivered protocol for patients with advanced cancer.
Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers-availability of interventions in community clinics as well as financial and illness-related factors-to accessing psychosocial interventions. ⋯ Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.
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J Pain Symptom Manage · Feb 2020
Development and Validation of a Uremic Pruritus Treatment Algorithm and Patient Information Toolkit in Patients with Chronic Kidney Disease (CKD) and End Stage Kidney Disease (ESKD).
Uremic pruritus (UP) affects up to half of all patients with kidney disease and has been independently associated with poor patient outcomes. UP is a challenging symptom for clinicians to manage as there are no validated guidelines for its treatment. ⋯ A treatment algorithm and patient information toolkit for managing UP in patients with kidney disease were developed and validated through expert review. Further research will be conducted on implementation of the treatment algorithm and evaluating patient-reported outcomes.