Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2020
Multicenter StudyMinimal clinically important differences and feasibility of Dyspnea-12 and the Multidimensional Dyspnea Profile in cardiorespiratory disease.
Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). ⋯ D12 and MDP are responsive to change and feasible for use for assessing multidimensional breathlessness in outpatients with cardiorespiratory disease. MCIDs were determined for use as endpoints in clinical trials.
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Keepsakes are a relatively unexplored form of bereavement support that is frequently provided as part of the 3 Wishes Project (3WP). The 3WP is a palliative care intervention in which individualized wishes are implemented in the adult intensive care unit for dying patients and their families. ⋯ Keepsakes are common wishes that clinicians in the intensive care unit are able to provide and sometimes cocreate with families when patients are dying. Both the offering to create the keepsake and receipt of the final product are perceived by family members as helpful.
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J Pain Symptom Manage · Oct 2020
Randomized Controlled Trial Multicenter StudyPatient-reported receipt of goal-concordant care among seriously ill outpatients - prevalence and associated factors.
Goal-concordant care is an important indicator of high-quality care in serious illness. ⋯ Seriously ill outpatients who prioritize a goal of relief of pain and discomfort are less likely to report receipt of goal-concordant care than patients who prioritize extending life. Future interventions designed to improve receipt of goal-concordant care should focus on identifying patients who prioritize relief of pain and discomfort and promoting care aligned with that goal.
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J Pain Symptom Manage · Aug 2020
Multicenter Study Observational StudyA dual-centre observational review of hospital based palliative care in patients dying with COVID-19.
The current coronavirus disease 2019 (COVID-19) pandemic has put significant strain on all aspects of health care delivery, including palliative care services. Given the high mortality from this disease, particularly in the more vulnerable members of society, it is important to examine how best to deliver a high standard of end-of-life care during this crisis. This case series collected data from two acute hospitals examining the management of patients diagnosed with COVID-19 who subsequently died (n = 36) and compared this with national and local end-of-life audit data for all other deaths. ⋯ This brief report suggests a spectrum of mode of dying. Overall, the cohort reflects previously described experiences, with increased frailty (median Clinical Frailty Scale score of 5) and extensive comorbidity burden. This brief report provides clinicians with a contemporaneous overview of our experience, knowledge, and pattern recognition when caring for people with COVID-19 and highlights the value of proactive identification of patients and risk of deterioration and palliation.
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J Pain Symptom Manage · Jul 2020
Multicenter StudyAssociation between heart rate and reversibility of the symptom, refractoriness to palliative treatment, and survival in dyspneic cancer patients.
Dyspnea is one of the most distressing symptoms for terminally ill cancer patients and a predictor of poor prognosis. Identification of simple clinical signs, such as heart rate, indicating clinical course of each patient is of value. ⋯ Heart rate may help clinicians to make the prediction of the patient's clinical course more accurate.