Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2014
Observational StudyVariations in vital signs in the last days of life in patients with advanced cancer.
Few studies have examined variation in vital signs in the last days of life. ⋯ Blood pressure and oxygen saturation decreased in the last days of life. Clinicians and families cannot rely on vital sign changes alone to rule in or rule out impending death. Our findings do not support routine vital signs monitoring of patients who are imminently dying.
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J Pain Symptom Manage · Oct 2014
Perceptions of health status and survival in patients with metastatic lung cancer.
Cognitive awareness of having a terminal illness is associated with critical treatment decisions and outcomes. However, little is known about the course and correlates of such perceptions in patients with metastatic lung cancer. ⋯ A minority of patients with metastatic NSCLC acknowledged being terminally ill. Those reporting that they were seriously and terminally ill had shorter survival compared with those who did not consider themselves terminally ill, even after adjusting for decline in physical and functional well-being.
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J Pain Symptom Manage · Oct 2014
Propensity scores: a practical method for assessing treatment effects in pain and symptom management research.
When conducting research on pain and symptom management interventions for seriously ill individuals, randomized controlled trials are not always feasible or ethical to conduct. Secondary analyses of observational data sets that include information on treatments experienced and outcomes for individuals who did and did not receive a given treatment can be conducted, but confounding because of selection bias can obscure the treatment effect in which one is interested. Propensity scores provide a way to adjust for observable characteristics that differ between treatment and comparison groups. This article provides conceptual guidance in addition to an empirical example to illustrate two areas of propensity score analysis that often lead to confusion in practice: covariate selection and interpretation of resultant treatment effects.
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J Pain Symptom Manage · Oct 2014
Development and validation of the breakthrough pain assessment tool (BAT) in cancer patients.
The successful management of breakthrough pain depends on a combination of adequate assessment, appropriate (individualized) treatment, and adequate re-assessment. Currently, there is no fully validated clinical assessment tool for breakthrough pain in cancer patients. ⋯ This study provides initial evidence for the validity and reliability of the breakthrough pain assessment tool which may be used to facilitate the management of patients with breakthrough cancer pain in the clinical setting.
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J Pain Symptom Manage · Oct 2014
Research priorities in spiritual care: an international survey of palliative care researchers and clinicians.
Spiritual distress, including meaninglessness and hopelessness, is common in advanced disease. Spiritual care is a core component of palliative care, yet often neglected by health care professionals owing to the dearth of robust evidence to guide practice. ⋯ In this first international survey exploring researchers' and clinicians' research priorities in spiritual care, we found international support for research in this domain. Findings provide an evidence base to direct future research and highlight the particular need for methodologically rigorous evaluation studies.