Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2020
Review Meta AnalysisChanging practices in the use of continuous sedation at the end of life. A systematic review of the literature.
The use of continuous sedation until death (CSD) has been highly debated for many years. It is unknown how the use of CSD evolves over time. Reports suggest that there is an international increase in the use of CSD for terminally ill patients. ⋯ The frequency of CSD seems to increase over time, possibly partly because of an extension of indications for sedation, from mainly physical symptoms to also nonphysical symptoms.
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J Pain Symptom Manage · Oct 2020
Review Meta AnalysisThe Diagnostic Accuracy of Critical Care Pain Observation Tool (CPOT) in ICU Patients: A Systematic Review and Meta-Analysis.
The critical care pain observation tool (CPOT) has been widely used to assess pain in ICU patients, and its validity and reliability have been tested in various contexts. ⋯ CPOT has moderate diagnostic parameters with a threshold of two or three, suggesting that it is a fair but not excellent tool. More research on the validity of the CPOT in specific subgroups is needed to broaden its applicability in critical care.
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J Pain Symptom Manage · Jun 2020
Review Meta AnalysisThe effect of music on pain in the adult intensive care unit: A systematic review of randomized controlled trials.
Multimodal analgesic approaches are recommended for intensive care unit (ICU) pain management. Although music is known to reduce pain in acute and chronic care settings, less is known about its effectiveness in the adult ICU. ⋯ Music interventions of 20-30 minutes are efficacious to reduce pain in adult ICU patients able to self-report.
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J Pain Symptom Manage · Apr 2020
Review Meta AnalysisThe effects of opioids on cognition in older adults with cancer and chronic non-cancer pain: A systematic review.
Opioids are prescribed to manage moderate-to-severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment. ⋯ Both improvements and impairments to cognition were observed in studies with higher mean opioid doses. In clinical practice, a brief screening tool assessing attention, language, orientation, psychomotor function, and verbal working/delayed episodic memory may be beneficial to detect worsening cognition in older adults with chronic pain using opioids.
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J Pain Symptom Manage · Mar 2020
Review Meta AnalysisExercise training for improving patient-reported outcomes in patients with advanced-stage cancer: a systematic review and meta-analysis.
Patients with advanced-stage cancer often suffer many physical and psychological symptoms. Exercise has been shown to improve quality of life (QoL), decrease cancer-related symptoms, and maintain or improve functional status in cancer survivors or patients with early stage cancer. However, the effect of exercise on these outcomes in patients with advanced-stage cancer is unclear. ⋯ Exercise serves as an effective intervention to improve QoL and alleviate fatigue, insomnia, dyspnea, and physical and social functions for patients with advanced-stage cancer.