Journal of palliative medicine
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Data collection and analysis are vital for strategic planning, quality improvement, and demonstration of palliative care program impact to hospital administrators, private funders and policymakers. Since 2000, the Center to Advance Palliative Care (CAPC) has provided technical assistance to hospitals, health systems and hospices working to start, sustain, and grow nonhospice palliative care programs. CAPC convened a consensus panel in 2008 to develop recommendations for specific clinical and customer metrics that programs should track. ⋯ Clinical metrics include: daily assessment of physical/psychological/spiritual symptoms by a symptom assessment tool; establishment of patient-centered goals of care; support to patient/family caregivers; and management of transitions across care sites. For customer metrics, consensus was reached on two domains that should be tracked to assess satisfaction: patient/family satisfaction, and referring clinician satisfaction. In an effort to ensure access to reliably high-quality palliative care data throughout the nation, hospital palliative care programs are encouraged to collect and report outcomes for each of the metric domains described here.
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Randomized Controlled Trial
Effect of topical morphine (mouthwash) on oral pain due to chemotherapy- and/or radiotherapy-induced mucositis: a randomized double-blinded study.
The objective of the study was to determine if mouthwashes with a morphine-containing solution decrease oral pain associated with radiotherapy- and/or chemotherapy-induced oral mucositis (OM). ⋯ Our results suggest a possible analgesic effect of topical morphine in line with previous studies. However, more efforts must be made for the adjustment of systemic analgesics and the development of new alternatives to treat locally OM-associated pain.
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To research the children's palliative care (CPC) educational needs of health professionals in Uganda. METHODOLOGY DESIGN AND SETTING: Mixed quantitative and qualitative survey set in three hospice sites in Uganda. ⋯ There is educational need for all CPC subject areas across the board, but communication with children is the most pressing. There are disparities between recognized learning needs (technical skills predominating) and unrecognized learning needs (interpersonal and intrapersonals skills predominating). While the broad subject areas for CPC may be similar in resource-rich and resource-poor settings, educational resources developed for the specific context of African and other resource poor settings are required.
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Case Reports
The malignant psoas syndrome revisited: case report, mechanisms, and current therapeutic options.
The malignant psoas syndrome (MPS) is a rare and challenging cancer pain state that is often refractory to rational polymodal analgesic therapy. We describe the first case of cervix cancer-related MPS due to extrinsic psoas muscle infiltration and review the therapeutic trajectory and outcome. The anatomic determinants, pain mechanisms, and current and proposed novel treatment strategies for MPS are discussed.
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A comprehensive whole-person approach might improve processes and outcomes of care for patients with cancer. ⋯ The NEST13+ tool facilitated identification of a wider range of important needs than traditional evaluation, while care outcomes were not improved. Traditional evaluation may need improvement. Future trials of the NEST13+ should focus on more intensive clinician-directed interventions.