Journal of pain and symptom management
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J Pain Symptom Manage · May 2014
Contending with advanced illness: patient and caregiver perspectives.
Despite improvements in end-of-life care, some unrelieved suffering persists for patients with advanced illness and their family members. Hospice and palliative care services can reduce suffering, but these services remain under-used. ⋯ Findings from this pilot study offer a preliminary theoretical model to enhance the understanding of patient and family caregiver needs during advanced illness. Awareness of their perspective can inform the timing and content of clinicians' communication and interventions.
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J Pain Symptom Manage · May 2014
How and why did a regional palliative care program lead to changes in a region? A qualitative analysis of the Japan OPTIM study.
Improving palliative care is one of the major issues throughout the world. ⋯ This study advances understanding of how the regional palliative care program created a change in the region. The findings are useful for developing a conceptual framework and identifying key interventions to improve regional palliative care for clinicians, researchers, and policy makers.
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J Pain Symptom Manage · May 2014
Identification of symptom clusters in patients with chronic venous leg ulcers.
Patients with venous leg ulcers experience multiple symptoms, including pain, depression, and discomfort from lower leg inflammation and wound exudate. Some of these symptoms impair wound healing and decrease quality of life (QOL). The presence of co-occurring symptoms may have a negative effect on these outcomes. The identification of symptom clusters could potentially lead to improvements in symptom management and QOL. ⋯ Two symptom clusters were identified in this sample of patients with venous leg ulcers. Further research is needed to verify these symptom clusters and to evaluate their effect on patient outcomes.
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J Pain Symptom Manage · May 2014
Creatively caring: effects of arts-based encounters on hospice caregivers in South Africa.
International literature and experience suggest that arts-based encounters can be effective in reducing stress and burnout in health care workers. Are these principles universal? Are they as applicable and effective in resource-constrained situations in Africa as in other parts of the world? We describe the impact of creative and arts-based encounters on a group of hospice caregivers at South Coast Hospice in KwaZulu Natal. An experienced facilitator built a caring and trusting relationship with the participants over a three month period through a variety of means, including a singing and songwriting intervention specifically designed to empower and give voice to the hospice caregivers, most of whom were Zulu women. ⋯ The conceptual themes that emerged from the interviews with the caregivers were interpreted in terms of their inherent cultural assets, a release of agency, a sense of revelation, and transformation. The expressive arts can have a significantly beneficial effect on hospice workers and their patients, and clinical engagement can be enhanced through creative encounters, even in resource-constrained situations. If such creative processes were to be promoted among a wider group of health workers, daily routine work in health care could be not just a repetition of well-rehearsed utilitarian rituals but rather a series of creative and transformative encounters.