Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2014
Strategies to support recruitment of patients with life-limiting illness for research: the Palliative Care Research Cooperative Group.
The Palliative Care Research Cooperative Group (PCRC) is the first clinical trials cooperative for palliative care in the U.S. ⋯ The recruitment experience from the multisite PCRC yields new insights into methods for effective recruitment to palliative care clinical trials. These results will inform training materials for the PCRC and may assist other investigators in the field.
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J Pain Symptom Manage · Dec 2014
Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer?
Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis. ⋯ Although the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to focus on reported severity and patient-level factors.
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J Pain Symptom Manage · Dec 2014
Improving the evidence base in palliative care to inform practice and policy: thinking outside the box.
The adoption of evidence-based hierarchies and research methods from other disciplines may not completely translate to complex palliative care settings. The heterogeneity of the palliative care population, complexity of clinical presentations, and fluctuating health states present significant research challenges. The aim of this narrative review was to explore the debate about the use of current evidence-based approaches for conducting research, such as randomized controlled trials and other study designs, in palliative care, and more specifically to (1) describe key myths about palliative care research; (2) highlight substantive challenges of conducting palliative care research, using case illustrations; and (3) propose specific strategies to address some of these challenges. ⋯ Although randomized controlled trials have their place whenever possible, alternative designs may offer more feasible research protocols that can be successfully implemented in palliative care. Therefore, this article highlights "outside the box" approaches that would benefit both clinicians and researchers in the palliative care field. Ultimately, the selection of research designs is dependent on a clearly articulated research question, which drives the research process.
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J Pain Symptom Manage · Dec 2014
How do follow-up care instructions and treatment summaries relate to cancer survivors' cancer-related pain?
Cancer-related pain is a problem for many cancer survivors. Treatment summaries (TS) and follow-up care instructions (FCI) provided after cancer treatment could reduce pain for cancer survivors. ⋯ FCI and TS were related to pain but in the opposite direction than predicted. Those who received TS and FCI were more likely to report pain than those who did not receive FCI and TS. This may be explained by the severity of cancer treatment. It is possible that those who undergo more severe cancer treatments are more likely to receive FCI and TS. Testing this relationship is a logical next step.
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J Pain Symptom Manage · Dec 2014
Complexities in euthanasia or physician-assisted suicide as perceived by Dutch physicians and patients' relatives.
The practice of euthanasia and physician-assisted suicide (EAS) is always complex, but some cases are more complex than others. The nature of these unusually complex cases is not known. ⋯ First, the process toward EAS may be disrupted, causing a complex situation. Second, the course of the process toward EAS is influenced not only by the patient and his/her attending physician but also by the relatives who are involved. Communicating and clarifying expectations throughout the process may help to prevent the occurrence of unusually complex situations.