Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2014
Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service.
Since the development of palliative care in the 1980s, "do not resuscitate" (DNR) has been promoted worldwide to avoid unnecessary resuscitation in terminally ill cancer patients. ⋯ DNR designation was late in terminally ill cancer patients. DNR-designated cancer patient indicators were high PPI scores, patients' prognostic awareness, family's diagnostic and prognostic awareness, and longer durations of care by the PCCS.
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J Pain Symptom Manage · Feb 2014
Review Meta AnalysisA meta-analysis of randomized trials: immediate stent placement vs. surgical bypass in the palliative management of malignant biliary obstruction.
Many patients with unresectable pancreatic and peripancreatic cancer require treatment for malignant biliary obstruction. ⋯ Nearly all patients with unresectable pancreatic cancer benefit from some procedure to manage biliary obstruction. Patients with low surgical risk benefit more from surgery because the risk of recurrence and subsequent hospital utilization are lower than after stent placement.
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J Pain Symptom Manage · Feb 2014
Aggressiveness of end-of-life care for patients with colorectal cancer in Alberta, Canada: 2006-2009.
North American studies have documented practice variations and deficiencies in end-of-life (EOL) cancer care, such as trends toward treating dying patients aggressively and disparities in access to palliative care or hospice services. ⋯ The percentage of patients who died in an acute care hospital is higher than the 17% U.S. benchmark. Other indicators of receiving aggressive EOL care are consistent with existing care quality benchmarks. The considerable regional variation, however, indicates potential for system improvements.
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J Pain Symptom Manage · Feb 2014
Multicenter Study Observational StudyOne, two, or three? Constructs of the brief pain inventory among patients with non-cancer pain in the outpatient setting.
Either a two-factor representation (pain intensity and interference) or a three-factor representation (pain intensity, activity interference, and affective interference) of the modified Brief Pain Inventory (BPI) is appropriate among cancer patients. ⋯ Consistent with analyses among cancer patients, a two-factor representation of BPI is appropriate for noncancer patients seen in an ambulatory setting. This work lends additional support for the psychometric properties of BPI.
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J Pain Symptom Manage · Feb 2014
Self-reported physical symptoms in intensive care unit (ICU) survivors: pilot exploration over four months post-ICU discharge.
Survivors of critical illness must overcome persistent physical and psychological challenges. Few studies have longitudinally examined self-reported physical symptoms in intensive care unit (ICU) survivors. ⋯ In our sample, sleep disturbance, fatigue, weakness, and pain were the four key symptoms during first four months post-ICU discharge. Future studies focusing on these four symptoms are necessary to promote quality in post-ICU symptom management.