Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2013
Review Meta AnalysisDo community specialist palliative care services that provide home nursing increase rates of home death for people with life-limiting illnesses? A systematic review and meta-analysis of comparative studies.
Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service, but it is also likely the most costly. ⋯ A meta-analysis found evidence to be inconclusive that community SPCSs that offer home nursing increase home deaths without compromising symptoms or increasing costs. But a compelling trend warrants further confirmatory studies. Future trials should compare the relative efficacy of different models and intensities of SPCSs.
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J Pain Symptom Manage · Feb 2013
Randomized Controlled TrialArmodafinil for sarcoidosis-associated fatigue: a double-blind, placebo-controlled, crossover trial.
Fatigue has been identified in more than one-half of patients with sarcoidosis. Although fatigue is not synonymous with impaired quality of life, most studies of sarcoidosis identify fatigue as a major cause of impaired quality of life. ⋯ Armodafinil treatment led to a significant reduction in fatigue in sarcoidosis patients. This effect was seen even in patients who did not have excessive daytime somnolence.
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J Pain Symptom Manage · Feb 2013
The Manchester cough in lung cancer scale: the development and preliminary validation of a new assessment tool.
Cough is a common distressing symptom in lung cancer patients. Its assessment is hampered by the lack of a validated scale to measure the complex cough experience in this population. ⋯ We have developed a promising tool to assess cough in lung cancer, but this needs validation, and future studies should determine whether this is a sensitive and responsive tool. A fully validated tool can be used in the clinical assessment of cough in cancer patients, and as a unidimensional impact scale in the measurement of cough as an outcome in intervention studies.
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J Pain Symptom Manage · Feb 2013
Lack of energy: an important and distinct component of HIV-related fatigue and daytime function.
Fatigue is a prevalent symptom among adults living with HIV. There is increasing evidence that fatigue and energy are related, yet distinct constructs. Although HIV-related fatigue has been well studied, little is known about perceived energy and how it relates to fatigue, individual characteristics, and other symptoms. ⋯ Lack of energy interferes with daytime function and is not just the inverse of fatigue but a distinct perception that differs from fatigue.
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J Pain Symptom Manage · Feb 2013
Growth of an academic palliative medicine program: patient encounters and clinical burden.
Information regarding the challenges of clinical growth and staffing of palliative care programs is limited. ⋯ Over the 10-year history, there has been an increase in the number of patient consultations seen by our palliative care program. The clinical burden was manageable during the first three years but quickly became too burdensome. Active recruitment of new faculty was required to sustain the increased clinical activity.