Articles: palliative-care.
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J Pain Palliat Care Pharmacother · Mar 2023
ReviewComprehensive Diagnosis and Management of Malignant Bowel Obstruction: A Review.
Malignant bowel obstruction is a common complication of advanced gastrointestinal, gynecologic, and genitourinary tumors. Patients present with nausea, vomiting, abdominal pain, and constipation. Cross-sectional imaging is essential to make a diagnosis of bowel obstruction. ⋯ Parenteral nutrition is an option and should typically be used in surgical patients with good functional and nutritional status with limited tumor burden or curative intent. Palliative care and hospice should be discussed in patients with advanced malignancy who present with peritoneal carcinomatosis or multiple levels of obstruction. Overall prognosis of malignant bowel obstruction is poor, and median survival ranges from 26 to 192 days.
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J Pain Symptom Manage · Mar 2023
ReviewSelf-perceived Burden for People with Life-threatening Illness: A Qualitative Systematic Review.
The perception of being a burden to others is a significant concern for people with life-threatening illness. It is unclear what underpins the concept of "self-perceived burden". ⋯ SPB is not a static perception but a fluctuating and complex 'process' based on uncertainty. More diverse understandings and following interventions to achieve a better balance of care should be sought.
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J Pain Symptom Manage · Mar 2023
National Survey Using CFIR to Assess Early Outpatient Specialty Palliative Care Implementation.
The American Society of Clinical Oncology (ASCO) recommends that outpatient specialty palliative care (OSPC) be offered within eight weeks of an advanced cancer diagnosis. To meet the rising demand, there has been an increase in the availability of OSPC services at National Cancer Institute (NCI)-designated cancer centers; however, many OSPC referrals still occur late in the disease course. ⋯ Most barriers were modifiable in nature and related to the "Inner Setting" domain of the CFIR, which highlights the need for careful strategic planning by leadership when implementing early OSPC.
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Randomized Controlled Trial
Feasibility of a Palliative Care Intervention within Routine Care of Hepatocellular Carcinoma: A Pilot Randomized Controlled Trial.
Background: Patients with hepatocellular cancer (HCC) are at risk for poor quality of life (QoL) and high symptom burden, coupled with limited treatment options. Palliative care (PC) can play an important role in reducing the suffering of this population, but remains underutilized. Aim: To demonstrate feasibility of an outpatient PC intervention within HCC care. ⋯ Post-intervention, symptom burden and QoL improved in the intervention arm and remained same or worsened in the control group. All FACT-Hep scores decreased numerically among controls and increased numerically among patients in the PC intervention group. Conclusion: Outpatient PC intervention within routine HCC care is feasible, and can potentially improve QoL and symptoms.
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J Pain Symptom Manage · Mar 2023
Predictors of documented goals-of-care discussion for hospitalized patients with chronic illness.
Goals-of-care discussions are important for patient-centered care among hospitalized patients with serious illness. However, there are little data on the occurrence, predictors, and timing of these discussions. ⋯ Among hospitalized patients with serious illness, documented goals-of-care discussions identified by NLP were more common among patients with older age and increased burden of acute or chronic illness, and less common among racially or ethnically minoritized patients. This suggests important disparities in goals-of-care discussions.