Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2025
"Mr. Smith Has No Mealtimes": Minimal Comfort Feeding for Patients with Advanced Dementia.
While Comfort Feeding Only is appropriate for patients with advanced dementia, its emphasis on assiduous hand-feeding that may prolong life for years fails to accommodate the preferences of those who do not want to continue living with this illness. Some have proposed advance directives to completely halt the provision of oral nutrition and hydration once a person has reached an advanced stage of dementia. ⋯ Rather than offering food and liquids proactively as with Comfort Feeding Only, caregivers provide nutrition and hydration only in response to signs of hunger and thirst. While further study is required to define and negotiate challenges in operationalizing this approach, MCF provides a framework that resolves competing ethical and clinical considerations in caring for those with advanced dementia.
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J Pain Symptom Manage · Feb 2025
Randomized Controlled Trial Multicenter StudyParent Views on Parent & Child-reported Outcomes in Pediatric Advanced Cancer: A Qualitative Study.
Research on concurrent parent and patient-reported outcomes has primarily focused on reaching agreement. However, little is known about how to interpret and address discrepancies, which are not uncommon, between both viewpoints. ⋯ gov NCT03408314.
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J Pain Symptom Manage · Feb 2025
ReviewValidation of Pediatric Self-Report Pain Scales in Sub-Saharan Africa: A Systematic Review.
Pediatric self-report pain scales must be validated in cultural/language contexts to provide optimal pain management. Sub-Saharan Africa included vast numbers of people groups, cultures, and languages. ⋯ 5 countries in Sub-Saharan Africa have a self-report pediatric pain scale validated in their national language/context. Validation methods varied widely from qualitative to quantitative, including convergent, discriminant and face validity. Given the burden of pediatric pain in sub-Saharan Africa, further work is required to provide culturally appropriate and language-specific pain tools.
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J Pain Symptom Manage · Feb 2025
Pediatric Palliative Care Simulation Improves Resident Learning Outcomes: an 11-Year Review.
Many general pediatrics residents lack sufficient opportunities to conduct difficult conversations with families, particularly about end-of-life care. Simulation learning is an effective means of practicing professional skills. A pediatric palliative care (PPC) physician is uniquely suited to mentor residents and fellows learning to lead difficult conversations through simulation. Co-facilitation of the simulated difficult conversation by a bereaved parent or family member enhances the learning experience. ⋯ Simulations with bereaved parent actors improved general pediatrics residents' performance and comfort during difficult conversations and are transportable to diverse settings.