Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2013
Review Meta AnalysisEpisodic breathlessness in patients with advanced disease: a systematic review.
Although episodic breathlessness (EB) is reported to be highly prevalent in advanced disease, our understanding about it is limited. ⋯ EB is a common symptom in patients with advanced disease, but information about characteristics and experiences is limited. As there is no common terminology, an agreed definition is needed to foster research to develop effective treatments for EB.
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J Pain Symptom Manage · Mar 2013
Randomized Controlled TrialDelivery strategies to optimize resource utilization and performance status for patients with advanced life-limiting illness: results from the "palliative care trial" [ISRCTN 81117481].
Evidence-based approaches are needed to improve the delivery of specialized palliative care. ⋯ A single case conference added to current specialized community-based palliative care reduced hospitalizations and better maintained performance status. Comparatively, patient/caregiver education was less effective; GP education was not effective.
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J Pain Symptom Manage · Mar 2013
Factor analysis of the Pittsburgh Sleep Quality Index in breast cancer survivors.
Sleep is a significant problem in breast cancer survivors (BCS) and measured frequently using the Pittsburgh Sleep Quality Index (PSQI). Thus, it is important to evaluate its factor structure. The two-process model of sleep regulation was the theoretical framework for this study. ⋯ Results were inconsistent with current PSQI scoring that assumes a single global factor and with previously published literature. Although a new two-factor model best fit the data, further quantitative and qualitative analyses are warranted to validate our results in other populations before revising PSQI scoring recommendations. Additional recommendations are described for research.
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J Pain Symptom Manage · Mar 2013
Putting on a happy face: emotional expression in parents of children with serious illness.
Communication is widely acknowledged as a crucial component of high-quality pediatric medical care, which is provided in situations in which parents typically experience strong emotions. ⋯ The inverse relationship between parents' positive emotional expression and their self-reported positive affect should remind both researchers and clinicians to be cognizant of the possibilities for emotional miscues, and consequent miscommunication, in the pediatric care setting.
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Clinicians prescribe and administer oxygen in response to reports of dyspnea, in the face of dropping oxygen saturation, as a "routine" comfort intervention, or to support anxious family members. Oxygen may produce nasal irritation and increase the cost of care. ⋯ The routine application of oxygen to patients who are near death is not supported. The n-of-1 trial of oxygen in clinical practice is appropriate in the face of hypoxemic respiratory distress.