Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2024
Influence of Income and Education on Palliative Care in Acute Myeloid Leukemia Using the NCDB.
Palliative care is integral to symptom management, and we examined its relationship with income, education, and Medicaid expansion in acute myeloid leukemia. This was a retrospective cross-sectional study using the National Cancer Database that included patients with acute myeloid and monocytic leukemias > 18 years of age treated at Commission on Cancer facilities from 2004 to 2016. Univariate and multivariate models were adjusted for demographic variables and facility characteristics. ⋯ Residence in states with Medicaid expansion (January 2014 onward) had greater palliative care utilization. Palliative care use was associated with higher education but underutilized with higher incomes. Increased access with Medicaid expansion suggests the importance of public insurance.
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J Pain Symptom Manage · Apr 2024
Predictive models for palliative care needs of advanced cancer patients receiving chemotherapy.
Early palliative care is recommended within eight-week of diagnosing advanced cancer. Although guidelines suggest routine screening to identify cancer patients who could benefit from palliative care, implementing screening can be challenging due to understaffing and time constraints. ⋯ Our models could forecast specialist palliative care needs for advanced cancer patients on chemotherapy. Using five variables as predictors could replace screening tools and has the potential to contribute to earlier palliative care.
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J Pain Symptom Manage · Apr 2024
Discriminatory healthcare experiences and medical mistrust in patients with serious illness.
Though discrimination in healthcare settings is increasingly recognized, the discriminatory experiences of patients with serious illness has not been well studied. ⋯ In this cross-sectional study of patients with serious illness, discriminatory experiences were associated with worse mistrust in the medical system, particularly for Black and NA/AN participants. These findings suggest that race-conscious approaches are needed to address discrimination and mistrust in marginalized patients with serious illness and their families.
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J Pain Symptom Manage · Apr 2024
Outcomes and experiences of patients and their caregivers after severe stroke requiring tube feeding in Peru.
Evaluate clinical outcomes of stroke survivors in Peru discharged with artificial nutrition via a feeding tube (FT), and explore perspectives and experiences of these patients and their caregivers. ⋯ We identified a high burden of palliative and supportive needs among severe stroke survivors with NGTs and their caregivers suggesting opportunities to improve poststroke care through education, communication, and support.
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J Pain Symptom Manage · Apr 2024
Piloting a Patient Tool to Aid Palliative Care Referrals during Advanced Lung Cancer Treatment.
Patient misperceptions are a strong barrier to early palliative care discussions and referrals during advanced lung cancer treatment. ⋯ The palliative care education and screening tool is acceptable to patients and may address misperceptions and motivate palliative care discussions during treatment.