Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2012
Randomized Controlled TrialEffects of methylphenidate on fatigue and depression: a randomized, double-blind, placebo-controlled trial.
Fatigue is highly prevalent in populations with advanced illness and is often associated with depressed mood. The role of psychostimulant therapy in the treatment of these conditions remains ill defined. ⋯ MP reduced symptoms of fatigue and depression when compared with placebo. The effect of MP on fatigue was dose-dependent and sustained over the duration of the study.
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J Pain Symptom Manage · Jan 2012
Practice patterns and perceptions about parenteral hydration in the last weeks of life: a survey of palliative care physicians in Latin America.
Parenteral hydration at the end of life is controversial and has generated considerable debate for decades. ⋯ The strongest determinant of prescribing patterns was agreement with the clinical/psychological efficaciousness of parenteral hydration. Our results reflect parenteral hydration prescribing patterns and perceptions that substantially differ from the conventional/traditional hospice philosophy. These findings suggest that the decision to prescribe or withhold parenteral hydration is largely based on clinical perceptions and that most palliative care physicians from this region of the world individualize treatment decisions.
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J Pain Symptom Manage · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyProfessional judgments about advance care planning with community-dwelling consumers.
There is limited research on how community-based long-term care (CBLTC) providers' personal characteristics and attitudes affect their decisions to initiate advance care planning (ACP) conversations with consumers. ⋯ This study shows the lack of normative consensus about ACP and highlights the need for consistent educational programs regarding the role of the CBLTC provider in the ACP process.
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J Pain Symptom Manage · Jan 2012
Review Meta AnalysisThe effectiveness of patient-family carer (couple) intervention for the management of symptoms and other health-related problems in people affected by cancer: a systematic literature search and narrative review.
Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. ⋯ In the trials of cancer couple interventions included in the review, a pattern emerged of improvement in the emotional health of cancer patients and their carers when the intervention included support for the patient-family carer relationship. Further investigation is warranted.
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J Pain Symptom Manage · Jan 2012
Multicenter StudyProviding palliative care for cancer patients: the views and exposure of community general practitioners and district nurses in Japan.
The role of general practitioners (GPs) and district nurses (DNs) is increasingly important to achieve dying at home. ⋯ Japanese GPs have little experience in caring for cancer patients dying at home, whereas DNs have more experience. To achieve quality palliative care programs for cancer patients at the regional level, educating GPs about opioids and psychiatric medications, easily available palliative care consultation services, systems to support home care technology, and coordinated systems to alleviate family burden is of importance.