Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2016
Randomized Controlled TrialThe Influence of Race/Ethnicity and Education on Family Ratings of the Quality of Dying in the ICU.
Racial and ethnic differences in end-of-life care may be attributable to both patient preferences and health-care disparities. Identifying factors that differentiate preferences from disparities may enhance end-of-life care for critically ill patients and their families. ⋯ Minority race/ethnicity was associated with lower family ratings of quality of dying. This association was mediated by factors that may be markers of patient and family preferences (living will, death in the setting of full support); family member minority race/ethnicity was directly associated with lower ratings of quality of dying. Our findings generate hypothesized pathways that require future evaluation.
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J Pain Symptom Manage · Dec 2015
Randomized Controlled TrialComplex Decongestive Lymphatic Therapy With or Without Vodder II Manual Lymph Drainage in More Severe Chronic Postmastectomy Upper Limb Lymphedema: A Randomized Non-Inferiority Prospective Study.
Complex decongestive lymphatic therapy (CDT) has been the method of choice in conservative management of lymphedema. Although effective, it is time consuming and manual lymph drainage (MLD) usually requires skilled therapists. ⋯ These results indicate that parallel (immediate and delayed) results may be obtained by CDT without the use of Vodder MLD and CB may be an essential part of lymphedema management.
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J Pain Symptom Manage · Nov 2015
Randomized Controlled Trial Multicenter Study Comparative StudyFentanyl Buccal Tablet vs. Oral Morphine in Doses Proportional to the Basal Opioid Regimen for the Management of Breakthrough Cancer Pain: A Randomized, Crossover, Comparison Study.
Fentanyl products have shown superiority to oral opioids for the management of breakthrough cancer pain (BTcP). However, these studies did not use appropriate patient selection, and drugs have been compared by using different rationales. ⋯ When used in doses proportional to the basal opioid regimen, FBT showed a clear superiority and was well tolerated when compared with OM during the first 30 minutes, which is the approximate target for a timely intervention required for a BTcP medication.
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J Pain Symptom Manage · Oct 2015
Randomized Controlled Trial Multicenter Study Comparative StudyPractical Dyspnea Assessment: Relationship Between the 0-10 Numerical Rating Scale and the Four-Level Categorical Verbal Descriptor Scale of Dyspnea Intensity.
Measurement of dyspnea is important for clinical care and research. ⋯ There is strong correlation between VDS and NRS measures for dyspnea. Proposed practical cutpoints for the relationship between the dyspnea VDS and NRS are 0 for none, 1-4 for mild, 5-8 for moderate, and 9-10 for severe.
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J Pain Symptom Manage · Sep 2015
Randomized Controlled TrialImproving Adherence to Cancer Treatment by Addressing Quality of Life in Patients with Advanced Gastrointestinal Cancers.
Many patients with potentially curable cancer do not complete their prescribed treatment regimens because of the toxicity. There is evidence that the common endpoints of many of these toxicities are amenable to quality of life (QOL)-directed interventions. ⋯ A structured multidisciplinary QOL-directed intervention delivered to patients undergoing CR may increase the proportion of patients who complete CR as planned and reduce unplanned hospitalizations. Utilization is an important outcome in QOL-directed intervention trials.