Palliative medicine
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Palliative medicine · Oct 2011
Association between symptoms and their severity with survival time in hospitalized patients with far advanced cancer.
To assess the significance of symptoms and their severity for predicting survival of hospitalized patients with far advanced cancer. ⋯ Fatigue, lack of appetite, feeling sad, and shortness of breath could be predictive factors for survival time of hospitalized patients with far advanced cancer. The more severe these symptoms are, the shorter will be survival time.
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Palliative medicine · Oct 2011
The use of crisis medication in the management of terminal haemorrhage due to incurable cancer: a qualitative study.
Terminal haemorrhage is a rare but devastating event that may occur in certain advanced cancers. The focus of management involves administration of 'crisis medicine' with the intention of relieving patient distress through sedative doses of anxiolytics or opioids. This practice, whilst widely accepted, is based on limited evidence and has never been formally evaluated. ⋯ Anticipatory prescribing of crisis medication rarely benefits the patient and may unintentionally detract from nursing care. Guidelines on the management of terminal haemorrhage should reconsider the emphasis on crisis medication and focus on non-pharmacological approaches to this invariably fatal event.
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Palliative medicine · Oct 2011
What does the answer mean? A qualitative study of how palliative cancer patients interpret and respond to the Edmonton Symptom Assessment System.
The Edmonton Symptom Assessment System (ESAS) is a well-known self-reporting tool for symptom assessment in palliative care. Research has shown that patients experience difficulties in the scoring and interpretation, which may lead to suboptimal treatment. The aims were to examine how palliative care cancer patients interpreted and responded to the ESAS. ⋯ Some patients stated that they scored at random because they did not understand why and how the ESAS was used. The patients' interpretation must be considered in order to minimize errors. The ESAS should always be reviewed with the patients after completion to improve symptom management, thereby strengthening the usability of the ESAS.
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Palliative medicine · Oct 2011
Choosing the unit of measurement counts: the use of oral morphine equivalents in studies of opioid consumption is a useful addition to defined daily doses.
Defined daily dose (DDD) is the most common measurement unit used in drug consumption studies. The DDD for opioids may not reflect their relative clinical potencies. The aim of this study was to explore whether opioid consumption data may be interpreted differently when adding oral morphine equivalent (OMEQ) dose as a measurement unit compared with using DDD. ⋯ OMEQ reflects clinical dosing better than DDD, and can give additional insight into opioid consumption when combined with DDD. Using OMEQ can also lead to different conclusions in opioid consumption studies compared with using DDD alone.