Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Jul 2009
Coordination of palliative cancer care in the community: "unfinished business".
This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. ⋯ The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care.
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Support Care Cancer · Jun 2009
Child and parental adaptation to pediatric stem cell transplantation.
Allogeneic pediatric stem cell transplantation (SCT) is a very intensive treatment with a high mortality and morbidity. The objectives of this study were to assess the (1) self- and proxy-reported health-related quality of life (HRQoL) compared to a norm group, (2) levels of parenting stress compared to a norm group, (3) differences in HRQoL and parenting stress pre- and post-SCT, and (4) effect of child age and parenting stress on self- and proxy-reported HRQoL pre- and post-SCT. ⋯ Ongoing psychosocial assessment post-SCT is necessary to target children with a lowered HRQoL and parents who experience elevated parenting stress who may be in greater need of more supportive care.
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The Edmonton Symptom Assessment System (ESAS) is a tool for self-reporting of symptom intensity, initially developed for advanced cancer patients. It consists of numerical rating scales for nine common symptoms, with the option of adding a tenth. Despite its widespread use in palliative care, few studies have focused on its psychometric properties, with none involving patient perspectives. The purpose of this study was to gather validity evidence for the ESAS, by examining patients' cognitive processes while completing the ESAS, understanding of terminology and numerical ratings, and opinions of the ESAS as a self-reporting tool. ⋯ Modification of the tool and administration process may be warranted, but further study in other populations is needed.
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Support Care Cancer · Jun 2009
Comparative StudyEquipotent doses to switch from high doses of opioids to transdermal buprenorphine.
The aim of this study was to evaluate the equianalgesic ratio of transdermal buprenorphine (TD BUP) with oral morphine and TD fentanyl in a sample of consecutive cancer patients receiving stable doses of 120-240 mg of oral morphine or 50-100 microg of TD fentanyl, reporting adequate pain and symptom control. ⋯ The results of this study suggest that stable patients receiving relatively high doses of oral morphine or TD fentanyl could be safely switched to TD BUP, by using a ratio of 70:1 and 0.6:0.8, respectively, maintaining the same level of analgesia.
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Support Care Cancer · Jun 2009
The palliative performance scale: examining its inter-rater reliability in an outpatient palliative radiation oncology clinic.
The Palliative Performance Scale (PPS) was developed by the Victoria Hospice Society in 1996 to modernize the Karnofsky Performance Scale. Currently, it is being used to measure palliative patient performance status in a variety of settings. Despite its widespread use, only one study has examined the inter-rater reliability of the PPS. ⋯ PPS was shown to have good overall inter-rater reliability in an outpatient palliative setting, but more research is needed to establish the validity and reliability of the tool in a variety of different palliative settings.