Journal of pain and symptom management
-
J Pain Symptom Manage · Jul 2012
The Spiritual Needs Assessment for Patients (SNAP): development and validation of a comprehensive instrument to assess unmet spiritual needs.
Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. There is a need for a well-validated, psychometrically sound instrument to describe and measure spiritual needs. ⋯ The results provide preliminary evidence that the SNAP is a valid and reliable instrument for measuring spiritual needs in a diverse patient population.
-
J Pain Symptom Manage · Jul 2012
Symptom clusters in patients with advanced cancer: a reanalysis comparing different statistical methods.
The clinical relevance of symptom cluster research remains questionable if inconsistencies, partially attributable to the varying statistical analyses used, exist. ⋯ The presence and composition of symptom clusters identified varied depending on which statistical analysis method was used. A key step in achieving consistency in symptom cluster research involves the utilization of a common analytical method.
-
J Pain Symptom Manage · Jul 2012
Case ReportsA successful palliative care intervention for cancer pain refractory to intrathecal analgesia.
Intrathecal delivery of opioid medications has been increasingly used to treat cancer pain that is refractory to conventional oral opioid therapy. We present a patient with complex and refractory cancer pain who failed both oral and intrathecal opioid therapy but responded to the interdisciplinary palliative care intervention in the acute palliative care unit. His morphine equivalent daily dose decreased by 94% over a 10-day period, and he had better pain control and improved function. This case highlights the importance of addressing and treating the psychosocial distress that contributes to the total pain expression.
-
J Pain Symptom Manage · Jul 2012
Comparative StudyThe practice of continuous deep sedation until death in Flanders (Belgium), the Netherlands, and the U.K.: a comparative study.
Existing empirical evidence shows that continuous deep sedation until death is given in about 15% of all deaths in Flanders, Belgium (BE), 8% in The Netherlands (NL), and 17% in the U.K. ⋯ Differences in the prevalence of continuous deep sedation appear to reflect complex legal, cultural, and organizational factors more than differences in patients' characteristics or clinical profiles. Further in-depth studies should explore whether these differences also reflect differences between countries in the quality of end-of-life care.
-
J Pain Symptom Manage · Jul 2012
Comparative StudyIdentification of cancer-related symptom clusters: an empirical comparison of exploratory factor analysis methods.
Symptom clusters, important for symptom management strategies, have been determined empirically by various analytical methods. Guidance to select methods from the options available in standard statistical packages is limited. ⋯ The most parsimonious solution resulted from principal axis factoring, but for large numbers of symptoms, AFA may be superior by identifying symptom clusters more useful for symptom management. Interpreting complex symptom relationships may lead to the investigation of pathophysiological mechanisms and intervention opportunities. Future studies should include psychological and cognitive symptoms.