Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2013
Symptom burden predicts nursing home admissions among older adults.
Symptom burden has been associated with functional decline in community-dwelling older adults and may be responsive to interventions. Known predictors of nursing home (NH) admission are often nonmodifiable. ⋯ Symptom burden is an independent risk factor for NH admission. Aggressive management of symptoms in older adults may reduce or delay NH admission.
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J Pain Symptom Manage · Oct 2013
Clinical TrialFactors to inform clinicians about the end of life in severe chronic obstructive pulmonary disease.
Palliative services have historically been offered to terminal patients with cancer, but much less so in other chronic illnesses such as chronic obstructive pulmonary disease (COPD) because of difficulties in predicting the trajectory to death. ⋯ The changes in defined variables and patient-reported outcomes by defined cutpoints were independently associated with increased 12-month mortality in patients with severe COPD. These results may inform clinicians when to initiate end-of-life communications and palliative care.
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J Pain Symptom Manage · Oct 2013
Clinical TrialA prospective study of family conferences: effects of patient presence on emotional expression and end-of-life discussions.
Limited research has taken place examining family conferences (FCs) with patients with advanced cancer and their caregivers in the palliative care setting. ⋯ There was a high frequency of expression of emotional distress by patients and family members in FCs. Patient participation was significantly associated with decreased verbal emotional expression by family members but not the primary caregiver and was associated with fewer discussions regarding prognosis and what dying patients may experience.
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J Pain Symptom Manage · Oct 2013
Functional impairments as symptoms in the symptom cluster analysis of patients newly diagnosed with advanced cancer.
Symptoms and subsequent functional impairment have been associated with the biological processes of disease, including the interaction between disease and treatment in a measurement model of symptoms. However, hitherto cluster analysis has primarily focused on symptoms. ⋯ Functional impairments in patients newly diagnosed with late-stage cancers behave as symptoms during the diagnostic phase. Health care providers need to expand their assessments to include both symptoms and functional impairments. Early recognition of functional changes may accelerate diagnosis at an earlier cancer stage.
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J Pain Symptom Manage · Oct 2013
The interaction of persistent pain and post-traumatic re-experiencing: a qualitative study in torture survivors.
There are limited studies and few theoretical models addressing the interaction between pain and symptoms of post-traumatic stress disorder, with none concerning this interaction in survivors of torture, who frequently report persistent pain. ⋯ The results suggest that the relationship between pain and re-experiencing requires a broad model that considers the impact of a range of individual, social, and environmental factors on the interaction between pain and traumatic stress symptoms in survivors of torture. The study has clinical implications, most notably the need to attempt more integrated treatment of pain and traumatic symptoms where they occur together, and to consider the meaning and impact of pain when treating survivors of torture. Further investigation of the relationship between pain and traumatic stress symptoms in torture survivors is needed, as are studies of combined treatment for pain and trauma.