Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2019
Support Network Factors Associated with Naming a Health Care Decision-Maker and Talking about Advance Care Planning among People Living with Human Immunodeficiency Virus.
Little attention has been given to social environmental factors associated with advance care planning (ACP) among African Americans or people living with advanced HIV (PLHIV). ⋯ The findings revealed aspects of family/support network structures and caregiving function associated with ACP in a population with often vital yet vulnerable networks.
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J Pain Symptom Manage · Dec 2019
Optimising clinical screening for chemotherapy-induced peripheral neuropathy.
Efficient and accurate clinical screening for treatment-related toxicities is a critical component of optimal patient management. A number of alternate screening tools for chemotherapy-induced peripheral neuropathy (CIPN) have been proposed in response to demonstrated limitations with standard clinical screening, although their relative diagnostic value is unclear. ⋯ PRO screening tools provide adequate CIPN screening while avoiding potential biases demonstrated to limit currently used clinician-rated screening tools. Addition of a brief objective test did not add value to PRO screening. Up to 23% of patients would be misidentified through screening, providing quantitative evidence of the limitations of available screening tools. More extensive CIPN evaluations are critical in patients at risk of serious neurotoxicity.
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J Pain Symptom Manage · Dec 2019
Palliative Care-Related Knowledge, Attitudes and Self-Assessment among Physicians in Vietnam.
Palliative care is rarely accessible in low- and middle-income countries, and lack of adequate training for health care providers is a key reason. In Vietnam, the Ministry of Health, major hospitals and medical universities, and foreign physician-educators have partnered to initiate palliative care training for physicians. ⋯ There is a great need among Vietnam's physicians for training in palliative care and especially in nonpain and psychological symptom control. Rational, balanced, and clear opioid-prescribing policies are needed to enable physicians to treat pain without fear of repercussions.
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J Pain Symptom Manage · Dec 2019
A National VA Palliative Care Quality Improvement Project for Improving Intensive Care Unit Family Meetings (ICU-FMs).
We sought to increase intensive care unit-family meeting (ICU-FM) documentation in the electronic health record in Veterans Affairs (VA) hospitals. ⋯ Increasing ICU-FMs is necessary but not sufficient to improve family-reported satisfaction after an ICU death.
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J Pain Symptom Manage · Dec 2019
Stability of Symptom Clusters in Patients with Gastrointestinal Cancers Receiving Chemotherapy.
Limited evidence suggests that patients with gastrointestinal (GI) cancers receiving chemotherapy (CTX) experience an average of 13 co-occurring symptoms. An alternative to counting symptoms is to evaluate for symptom clusters. ⋯ The number and types of symptom clusters appear to be relatively stable over time and across the symptom dimensions. Ongoing assessment and management of these clusters is warranted across the entire course of CTX. The underlying mechanism for these clusters warrants investigation.