Journal of palliative medicine
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Despite the urgent need for a quality training system in palliative care, learning needs among physicians in palliative care specialty training have not been systematically explored in Japan. ⋯ Physicians in palliative care specialty training had markedly unmet needs regarding training on comprehensive contents, education, and research support; they considered increasing the number of comprehensive quality training programs as a potential solution. Our findings may help physicians in palliative care training, faculty physicians, training programs, academic societies, and the government to develop collaborative efforts to fulfill the unmet needs of trainees.
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Honoring the wishes of cancer patients is a responsibility of oncologists; however, end-of-life care (EOLC) discussions are frequently delayed past the point of usefulness. ⋯ A seven-item patient-centric PRO instrument was able to separate advanced malignancy patients into cohorts who their physicians deemed were at differing stages in their cancer journey with increasing needs for advance care planning. A study to determine if the threshold scores identified in this pilot correlate with palliative/EOL consultation frequency and patient survival is underway.
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As the field of Pediatric Palliative Care continues to develop, it is important to consider the scope of practice and the utility of collaboration with other specialties, including child and adolescent psychiatry. The integration of psychiatry and palliative medicine has been explored in adult practice, but has not yet been elaborated in pediatrics. ⋯ Case examples are used to define specific professional skills and roles, and to describe shared and distinct clinical approaches used by pediatric palliative care and child psychiatry. Effective collaboration provides opportunities for cross-disciplinary educational exchange and enhanced care of children and families with comorbid mental health issues and serious illness.
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Cancer-related neuropathic pain is resistant to treatment with multiple medications and results in reduced patient quality of life. ⋯ These results suggest that opioid switching to oral methadone not only achieves pain relief but also curtails substantial adjuvant analgesic use.