Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2012
Opioid pain medication orders and administration in the last days of life.
Most patients with serious and life-limiting illness experience pain at some point in the illness trajectory. ⋯ Findings indicate a need for improving availability of opioids for end-of-life care in the inpatient setting. Modifiable factors, such as family presence and goals-of-care discussions, suggest potential targets for intervention to improve recognition of the dying process and proactive planning for pain control.
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J Pain Symptom Manage · Nov 2012
Advancing theory of family conflict at the end of life: a hospice case study.
Although family conflict is a common occurrence for families involved in caregiving for a dying family member, it has not been examined in the hospice context. ⋯ The study findings are discussed in terms of implications for assessment and intervention.
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J Pain Symptom Manage · Nov 2012
Review Meta AnalysisThe role of ondansetron in the management of cholestatic or uremic pruritus--a systematic review.
Pruritus associated with hepatic or renal failure can be a troublesome symptom, refractory to treatment and associated with significant physical and emotional distress and a reduction in quality of life for patients already burdened with chronic disease. Serotonin has been implicated as a possible pathological mediator, and, therefore, 5HT(3) antagonists have been suggested as a possible therapeutic intervention. ⋯ Ondansetron was demonstrated to have negligible effect on cholestatic or uremic pruritus on the basis of a limited number of studies.
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J Pain Symptom Manage · Nov 2012
Randomized Controlled TrialSurvey burden for family members surveyed about end-of-life care in the intensive care unit.
Family surveys are an important source of information about quality of end-of-life care in the intensive care unit (ICU). The burden associated with completing such surveys is not well studied. ⋯ Most families reported no to low burden. Family members who live with their loved one are particularly vulnerable to survey burden and those of older patients report less burden. The association between low quality-of-care ratings and survey burden suggests that the response bias in this type of research is toward overestimating quality of care.