Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2021
Multicenter Study Observational StudyVisualizing how to use parenteral opioids for terminal cancer dyspnea: A pilot, multicenter, prospective, observational study.
How physicians use opioids for dyspnea in imminently dying cancer patients (terminal dyspnea) varies markedly, which could hamper quality care. ⋯ The algorithm-based treatment was feasible, and might be as effective and safe as the usual care by palliative care specialists. Its implementation may help physicians provide quality care for terminal dyspnea.
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J Pain Symptom Manage · Oct 2021
Multicenter StudyMeanings emerging from Dignity Therapy amongst Cancer Patients.
Generativity is a process whereby patients nearing the end of life invest in those they will soon leave behind. In recent years, the trajectory of cancer has changed, as new therapies have prolonged survival and patients often live with metastatic disease for several years. For these patients and for the healthcare professionals who care for them it can be useful to understand if the concept of generativity is clinically salient. ⋯ Conversations about generativity could inform clinicians on how to communicate about existential and meaning-based issues across different stages of illness.
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J Pain Symptom Manage · Oct 2021
Multicenter Study Observational StudyClinical predictors for analgesic response to radiotherapy in patients with painful bone metastases.
Radiotherapy (RT) reduces pain in about 60% of patients with painful bone metastases, leaving many patients without clinical benefit. This study assesses predictors for RT effectiveness in patients with painful bone metastases. ⋯ This study supports previous findings that better performance status and type of cancer diagnosis predicts analgesic RT response, and new data showing that soft tissue expansion predicts RT response and that corticosteroids is a negative predictor for RT response in patients with painful bone metastases.
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J Pain Symptom Manage · Sep 2021
Multicenter StudyA Stakeholder-Driven Qualitative Study to Define High Quality End-of-Life Care for Children with Cancer.
Among adults with cancer, measures for high quality end-of-life care (EOLC) include avoidance of hospitalizations near end of life. For children with cancer, no measures exist to evaluate or improve EOLC, and adult quality measures may not apply. ⋯ Childhood cancer stakeholders define high quality EOLC primarily through person-centered measures, characterizing half of existing adult-focused measures as limited in relevance to children. Future research should focus on developing techniques for person-centered quality measurement to capture attributes of greatest importance to children with cancer and their families.
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J Pain Symptom Manage · Sep 2021
Multicenter StudyMeasurement properties of ID-PALL, a new instrument for the identification of patients with general and specialized palliative care needs.
To improve access to palliative care, identification of patients in need of general or specialized palliative care is necessary. To our knowledge, no available identification instrument makes this distinction. ID-PALL is a screening instrument developed to differentiate between these patient groups. ⋯ ID-PALL is a promising screening instrument allowing the early identification of patients in need of general or specialized palliative care. It can be used by nurses and physicians without a specialized palliative care training. Further testing of the finalized clinical version appears warranted.