Journal of palliative medicine
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Dyspnea is one of the most common symptoms in advanced cancer patients at the end of their life. It is often multifactorial with diverse malignant, nonmalignant, and cancer treatment related etiologies. ⋯ Here a complex case of progressive dyspnea and its treatments in a patient with advanced pancreatic cancer is described, and its multiple potential contributing causes are identified and clinical responses evaluated. Literature review is conducted on pulmonary drug toxicity and tumor lymphangitic spread, and the role of corticosteroids in relieving dyspnea in the palliative care setting.
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Randomized Controlled Trial
A randomized controlled trial of a goals-of-care video for elderly patients admitted to skilled nursing facilities.
To determine the impact of a video on preferences for the primary goal of care. ⋯ Subjects admitted to SNFs who viewed a video were more likely than those exposed to a verbal narrative to opt for comfort. Concordance between a preference for comfort and a DNR order was low. These findings suggest a need to improve ascertainment of patients' preferences.
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Fatigue is a multidimensional phenomenon that has different meanings according to different societal and cultural settings. This study aims to decipher fatigue in Taiwanese patients with cancer. ⋯ The meaning of fatigue is mainly associated with physical factors among these patients. Education of complexities in fatigue in tandem with psychosocial and spiritual care may help alleviate this symptom, and promote quality of life.