Journal of pain and symptom management
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Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress. ⋯ Severity of anxiety symptoms did not differ between the study sites, suggesting that anxiety may differ from depression and desire for hastened death in the course that it takes over the duration of terminal cancer.
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J Pain Symptom Manage · Nov 2011
Demoralization and depression in patients with advanced cancer: validation of the German version of the demoralization scale.
The concept of demoralization has been widely used to describe states of existential distress and a self-perceived incapacity to deal effectively with a specific stressful situation. ⋯ Results provide further evidence that the DS is a valid and reliable instrument of high clinical relevance in patients with advanced cancer.
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J Pain Symptom Manage · Nov 2011
Case ReportsResponding to surrogate requests that seem inconsistent with a patient's living will.
Clinicians may feel conflicted when a patient's legal decision maker is making decisions that seem inconsistent with a patient's living will. We provide evidence-based information to help clinicians consider whether a surrogate's inconsistent decisions are ethically appropriate. ⋯ When appropriate, clinicians should respect surrogates' interpretations of patient values and take steps to decrease surrogate stress during the decision-making process. Finally, if clinicians are cognizant of their own values and preferences, they may recognize how these may affect their responses to certain clinical cases.
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J Pain Symptom Manage · Nov 2011
Process and outcomes of euthanasia requests under the belgian act on euthanasia: a nationwide survey.
Since 2002, the administration of a lethal drug by a physician at the explicit request of the patient has been legal in Belgium. The incidence of euthanasia in Belgium has been studied, but the process and outcomes of euthanasia requests have not been investigated. ⋯ Under the Belgian Act on Euthanasia, about half of the requests are granted. Factors related to the reason for the request, position of the attending physician toward the request, and advice from the second physician influence whether a request is granted or not.
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J Pain Symptom Manage · Nov 2011
A model for increasing palliative care in the intensive care unit: enhancing interprofessional consultation rates and communication.
Only a minority of patients who die in the medical intensive care unit (MICU) receive palliative care services. At the South Texas Veterans Health Care System Audie L. Murphy Hospital, only 5% of patients who died in the MICU from May to August 2010 received a palliative care consultation. ⋯ Daily pre-rounds between the palliative care and MICU teams increased palliative care services for MICU patients at risk for poor outcomes, who may benefit from a palliative care consultation.