The American journal of hospice & palliative care
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Am J Hosp Palliat Care · May 2014
Training mid-level providers on palliative care: bringing advanced directives and symptom assessment and management to community oncology practices.
Palliative care services are not available in most outpatient oncology practices. A program training 11 mid-level providers from oncology practices on advanced directive discussions and supportive symptom assessment and management performed by palliative care specialists was completed. ⋯ Main barriers included uncertainties about reimbursement, patients' lack of knowledge about palliative care, and lack of access to supportive services. This program successfully promoted advanced directive discussions and supportive/palliative care symptom assessment and management to community oncology practices, which will hopefully translate into improved quality of life for patients with metastatic cancer.
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Am J Hosp Palliat Care · May 2014
The role of analgesic adjustment strategies in achieving analgesic efficacy in opioid-tolerant hospice patients in China.
Diverse strategies of analgesic adjustment are often, respectively, used to sustain analgesic efficiency for opioid-tolerant patients with different refractory factors of pain. In order to select effective analgesic adjustment strategy for hospice patient without knowing explicit causes of diminishing analgesic efficiency, a retrospective data of 743 patients among 3760 hospice patients were analyzed. ⋯ For opioid-tolerant hospice patients, the analgesic adjustment strategy can be selected for individual patient. After repeated analgesic adjustments, opioid tapering may also occur.
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Am J Hosp Palliat Care · May 2014
The determinants of patients in a palliative care unit being discharged home in Japan.
In Japan, regarding the place of end-of-life care, many people preferred the home. However, there is a discrepancy between patients' wishes and the actual circumstances. The primary aim of this study was to explore the factors that determine discharge home of patients in a palliative care unit. ⋯ Palliative prognostic index was significantly lower in group 1 than in group 2 (P = .032). Regarding routes of feeding, oral intake was significantly higher in group 1 than in group 2 (P = .043). That is to say, factors determining discharge home of patients may be influenced by the patient's prognosis and the necessity of a feeding device.
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Am J Hosp Palliat Care · May 2014
Clinical TrialUse of methylphenidate for the management of fatigue in Chinese patients with cancer.
REASON FOR THE STUDY: Studies on methylphenidate for cancer-related fatigue showed conflicting results. This prospective study aims to determine whether methylphenidate is useful for relieving fatigue in Chinese patients with cancer. Chinese Version of Brief Fatigue Inventory (BFI-C) was administered on days 1, 8, and 29. Methylphenidate dose on day 1 was 5 mg daily then adjusted after day 8 according to response and side effects tolerance. ⋯ Methylphenidate may be useful for management of cancer-related fatigue in selected Chinese patients.
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Am J Hosp Palliat Care · May 2014
Factors affecting the place of death among hospice home care cancer patients in Taiwan.
Some patients who receive hospice home care still end up dying in hospital. The significance of the variables possibly affecting the place of death in patients with terminal cancer who received hospice home care was examined. ⋯ For a better hospice care service, it is essential to inquire patients or their relatives on preferred place of death while concerning the influences of other factors.