Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialPain medication management processes used by oncology outpatients and family caregivers part I: health systems contexts.
Oncology patients with persistent pain treated in outpatient settings and their family caregivers have significant responsibility for managing pain medications. However, little is known about their practical day-to-day experiences with pain medication management. ⋯ Health systems issues related to access to needed analgesics, medication safety in outpatient settings, and the effort expended by oncology patients and their family caregivers require more attention in future research and health-care reform initiatives.
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J Pain Symptom Manage · Nov 2014
Comparative StudyImproving communication on hope in palliative care. A qualitative study of palliative care professionals' metaphors of hope: grip, source, tune, and vision.
Hope is important in palliative care. However, palliative care professionals' perspectives on hope are not well understood. Metaphors of hope are a way of better understanding these perspectives. ⋯ Our findings help to increase the understanding of hope and contribute to improving communication skills in palliative care professionals.
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J Pain Symptom Manage · Nov 2014
Multicenter StudyDoes the working environment influence health care professionals' values, meaning in life and religiousness? Palliative care units compared with maternity wards.
Increased altruism, self-transcendence, and quests for meaning in life (MiL) have been found in palliative care (PC) patients and their families who experience the finiteness of life. Similar changes were observed in healthy subjects who were experimentally confronted with their mortality. ⋯ Basic differences in values, MiL, and religiousness between PC-HCPs and MW-HCPs might have influenced the choice of working environment because no effect of job duration was observed. Longitudinal research is needed to confirm this hypothesis.
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J Pain Symptom Manage · Nov 2014
Randomized Controlled TrialPre-emptive value of methylprednisolone intravenous infusion in patients with vertebral metastases. A double-blind randomized study.
The vertebral column is the most common site of bone metastases irrespective of the primary tumor. Vertebral metastases are a major cause of motor deficit of the lower extremities. The use of radiotherapy is the treatment of choice in these patients. A temporary worsening of pain shortly during the course of palliative radiotherapy is clinically a common problem. Steroid infusion has well-documented neuroprotective effects. ⋯ Pre-emptive methylprednisolone infusion is an effective prophylactic agent in the prevention of radiation-induced pain flare and improves functional motor status after short-term radiotherapy in patients with vertebral metastases.
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J Pain Symptom Manage · Nov 2014
The quality of dying and death in cancer and its relationship to palliative care and place of death.
Health care is increasingly focused on end-of-life care outcomes, but relatively little attention has been paid to how the dying experience is subjectively evaluated by those involved in the process. ⋯ The overall quality of death was rated positively for the majority of these cancer patients. Ratings were highest for home deaths perhaps because they are associated with fewer complications and/or a more extensive support network. For a substantial minority, symptom control and death-related distress at the end of life were problematic, highlighting areas for intervention.