Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2010
Review Meta AnalysisFactors associated with congruence between preferred and actual place of death.
Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their preferred location. Specialized (physician, hospice, and palliative) home care visits may increase home deaths, but factors associated with congruence have not been systematically reviewed. ⋯ Of the remaining three studies without specialized home care for all patients, two reported 43%-46% congruence among hospital inpatients, and one elicited patient preference "if everything were possible," with 30% congruence. Physician support, hospice enrollment, and family support improved congruence in multiple studies. Research in this important area must consider potential sources of bias, the method of eliciting patient preference, and the absence of a single ideal place of death.
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J Pain Symptom Manage · Mar 2010
Comparative StudyPrevalence, severity, and correlates of sleep-wake disturbances in long-term breast cancer survivors.
Current evidence shows that sleep-wake disturbances are a persistent problem linked to poor quality of life in women surviving breast cancer. Information regarding correlates of sleep-wake disturbances in long-term survivors is sparse. ⋯ Knowledge of prevalence, severity, and correlates of sleep-wake disturbances provides useful information to health care providers during clinical evaluations for treatment of sleep-wake disturbances in BCS.
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Pain and fatigue are recognized as critical symptoms that impact the quality of life of cancer patients. The barriers to pain and fatigue relief have been classified into three categories: patient, professional, and system barriers. ⋯ The "Passport to Comfort" intervention was effective in reducing patient barriers to pain and fatigue management as well as in increasing patient knowledge regarding pain and fatigue. This intervention demonstrates innovation by translating the evidence-based guidelines for pain and fatigue as developed by the National Comprehensive Cancer Network into practice.
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J Pain Symptom Manage · Mar 2010
Families' perceptions of veterans' distress due to post-traumatic stress disorder-related symptoms at the end of life.
To define the frequency of post-traumatic stress disorder (PTSD)-related symptoms among veterans who are near the end of life and to describe the impact that these symptoms have on patients and their families. ⋯ PTSD-related symptoms may be common and severe among veterans near the end of life and may have a negative effect on families' perceptions of the quality of care that the veteran received.
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J Pain Symptom Manage · Mar 2010
Psychometric and clinical assessment of the 10-item reduced version of the Fatigue Scale-Child instrument.
Fatigue is one of the most debilitating conditions associated with cancer and anticancer therapy. The lack of reliable and valid self-report instruments has prevented accurate assessment of fatigue in pediatric oncology patients. The purpose of this study was to identify the most sensitive and specific score, that is, the "cut score," on the Fatigue Scale-Child (FS-C) to identify those children with high cancer-related fatigue in need of clinical intervention. ⋯ We then assessed the 10-item FS-C for its psychometric properties and applied the receiver operating characteristics curve analysis to the FS-C responses from 221 children (aged 7-12 years) receiving anticancer treatment. The cut score identified with 75% sensitivity and 73.5% specificity was 12; 73 (33%) patients scored 12 or higher. Findings from this validated instrument provide a needed guide for clinicians to interpret fatigue scores and provide clinical interventions for this debilitating condition to their pediatric patients with cancer.