Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2014
Review Meta AnalysisCancer-related pain and symptoms among nursing home residents: a systematic review.
Many older nursing home (NH) residents with cancer experience pain and distressing symptoms. Although some develop cancer during their time in the institution, an increasing number are admitted during their final stages of their lives. Numerous studies have evaluated various treatment approaches, but how pain and symptoms are assessed and managed in people with cancer with and without dementia is unclear. ⋯ This review clearly reports a high prevalence of pain and reduced drug prescribing and treatment among NH residents with cancer. This issue appears to be most critical among people with severe dementia, emphasizing the need for better guidance and evidence on pain assessment for these individuals.
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J Pain Symptom Manage · Oct 2014
Multicenter Study Controlled Clinical TrialImpact of a clinical pharmacist-led guidance team on cancer pain therapy in China: a prospective multicenter cohort study.
Cancer treatment capacity in China is severely limited relative to the enormous size of the population; and many aspects of treatment, such as opioid protocols for pain control, are not standardized. To improve the quality of drug treatment, clinical pharmacists are taking a more active role in patient care. ⋯ The CPGTs significantly improved standardization, efficiency, and efficacy of cancer pain therapy in China. In a country where clinical pharmacy is still developing, this is a valuable service model that may enhance cancer treatment capacity and efficacy while promoting recognition of the clinical pharmacy profession.
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J Pain Symptom Manage · Oct 2014
Review Case ReportsPatients who lack capacity and lack surrogates: can they enroll in hospice?
Patients who lack capacity and lack surrogates are among the most vulnerable patients we care for in palliative care. In the case we present here, we have considered how to make end-of-life decisions for a patient who lacks both capacity and surrogates, who has a terminal illness, and who is not a candidate for disease-modifying treatments. We first define and characterize this population of patients through a review of the literature and then explore some decision-making quandaries that are encountered at the end of life. Finally, we make recommendations on how best to proceed with decision making for this vulnerable population.
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J Pain Symptom Manage · Oct 2014
Psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 in cancer patients.
Multidimensional questionnaires estimating cancer-related fatigue (CRF) as a symptom cluster or a clinical syndrome primarily have been used and validated in English-speaking populations. However, cultural issues and language peculiarities can affect CRF assessment ⋯ The Polish version of the MFI-20 is well accepted by patients, reliable, and a valid instrument to assess CRF in Polish cancer patients.