Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2011
Randomized Controlled TrialCaregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial.
Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. ⋯ Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change.
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J Pain Symptom Manage · Jan 2011
Observational StudyAberrant drug-related behavior observed during clinical studies involving patients taking chronic opioid therapy for persistent pain and fentanyl buccal tablet for breakthrough pain.
Information on aberrant drug-related behaviors in the clinical study setting is limited. ⋯ The incidence of drug abuse events and aberrant drug-related behaviors was relatively low, probably because of the implementation of universal precautions and the controlled clinical study setting. Even in this setting, events occurred, highlighting the limits of screening and the need for ongoing monitoring of aberrant behavior.
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J Pain Symptom Manage · Jan 2011
Perceived success in addressing end-of-life care needs of low-income elders and their families: what has family conflict got to do with it?
The purpose of this study was to examine the predictors of perceived success in addressing the end-of-life care needs of low-income older adults and their family members. Perceived success is defined as the clinician's subjective assessment of the extent to which end-of-life care needs of the patient and family have been met by the interdisciplinary team. The results are drawn from a larger longitudinal multimethod case study designed to understand how end-of-life care is provided to a diverse group of frail elders in an innovative, fully "integrated," managed care program. ⋯ Significant predictors of perceived success for addressing family needs included family care needs (β=0.30, P≤0.001), team and administrative resources (β=0.19, P≤0.01), patient preferences honored (β=0.16, P≤0.05), quality of relationship with patient (β=0.27, P≤0.001) and family (β=0.23, P≤0.01), and family conflict (β=-0.31, P≤0.001). This study provides preliminary evidence of differential correlates and predictors of perceived success for addressing patient and family needs, highlighting the detrimental influence of family conflict. Future research is needed to better understand the kinds of assessment and intervention protocols that might prevent or ameliorate conflict and enhance structures and process-of-care variables to facilitate more successful outcomes.
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J Pain Symptom Manage · Jan 2011
Either called "chemobrain" or "chemofog," the long-term chemotherapy-induced cognitive decline in cancer survivors is real.
In recent years, there is growing evidence in the medical literature to support an association between administration of commonly used chemotherapeutic agents and an increased risk for cognitive impairment. ⋯ Either called "chemobrain" or "chemofog," the long-term CICI in cancer survivors is real. The need for multidisciplinary care interventions toward a timely diagnosis and management of CICI is clearly warranted.
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J Pain Symptom Manage · Jan 2011
Palliative sedation, not slow euthanasia: a prospective, longitudinal study of sedation in Flemish palliative care units.
Palliative sedation remains a much debated and controversial issue. The limited literature on the topic often fails to answer ethical questions concerning this practice. ⋯ This study revealed that palliative sedation is only administered in exceptional cases where refractory suffering is evident and for those patients who are close to the ends of their lives. Moreover, this study supports the argument that palliative sedation has no life-shortening effect.