Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2015
Randomized Controlled Trial Multicenter StudyMeasuring end-of-life care and outcomes in residential care/assisted living and nursing homes.
The two primary residential options for older adults who require supportive care are nursing homes and residential care/assisted living. More than one-quarter of all deaths in the U.S. occur in these settings. Although the information available on end of life in long-term care has been growing, the comparative suitability of various measures to guide this work is unknown. ⋯ Despite these recommendations, measurement selection should be informed not only on the basis of psychometric properties but also by specific clinical and research needs. The data in this manuscript will help researchers, clinicians, and administrators understand the implications of choosing various measures for their work.
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J Pain Symptom Manage · Apr 2015
Randomized Controlled TrialApoyo con Cariño: a pilot randomized controlled trial of a patient navigator intervention to improve palliative care outcomes for latinos with serious illness.
Latinos experience significant health disparities at the end of life compared with non-Latinos. ⋯ A culturally tailored patient navigator intervention was feasible and suggests improved palliative care outcomes for Latinos facing advanced medical illness, justifying a fully powered randomized controlled trial.
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J Pain Symptom Manage · Mar 2015
Randomized Controlled TrialDoctors' decisions when faced with contradictory patient advance directives and health care proxy opinion: a randomized vignette-based study.
Sometimes a written advance directive contradicts the opinion of a health care proxy. How this affects doctors' decision making is unknown. ⋯ Contradictions between advance directives and proxy opinions result in a weak preference for abstention from treatment and increase the difficulty of the decision.
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J Pain Symptom Manage · Feb 2015
Randomized Controlled Trial Comparative StudyMorphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial.
There is wide interindividual variation in response to morphine for cancer-related pain; 30% of patients do not have a good therapeutic outcome. Alternative opioids such as oxycodone are increasingly being used, and opioid switching has become common clinical practice. ⋯ In this population, there was no difference between analgesic response or adverse reactions to oral morphine and oxycodone when used as a first- or second-line opioid. These data provide evidence to support opioid switching to improve outcomes.
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J Pain Symptom Manage · Feb 2015
Randomized Controlled TrialThe role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial.
Postcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle fatigue. ⋯ Postcancer fatigue is neither characterized by abnormally high central muscle fatigue nor by low peripheral muscle fatigue. These findings suggest a difference in the underlying physiological mechanism of postcancer fatigue vs. other fatigue syndromes.