Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2014
Outpatient pain predicts subsequent one-year acute health care utilization among adults with sickle cell disease.
Patient demographic and clinical factors have known associations with acute health care utilization (AHCU) among patients with sickle cell disease (SCD), but it is unknown if pain measured predominantly in an outpatient setting is a predictor of future AHCU in patients with SCD. ⋯ Findings support use of outpatient CPI scores or pain intensity and age to identify at-risk young adults with SCD who are likely to benefit from improved outpatient pain management plans.
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J Pain Symptom Manage · Jul 2014
The impact of body mass index dynamics on survival of patients with advanced pancreatic cancer receiving chemotherapy.
High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. ⋯ In patients with APC undergoing palliative chemotherapy, decreases in BMI at APC diagnosis and during chemotherapy are more hazardous for OS than precancer BMI or baseline BMI (at diagnosis) as absolute values. Further studies are needed to validate this finding and investigate strategies to maintain BMI during chemotherapy in this setting.
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J Pain Symptom Manage · Jul 2014
Patients' sense of security during palliative care-what are the influencing factors?
Having a sense of security is vitally important to patients who have a limited life expectancy. ⋯ These findings stress the importance of palliative care services in supporting dying patients' sense of security through symptom management with a wide scope and through supporting the patients' sense of mastery, identity, and perception of a secure care interaction and also through attention to the family members' situation.
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J Pain Symptom Manage · Jul 2014
A quality improvement initiative for improving appropriateness of referrals from a cancer center to subacute rehabilitation.
Subacute rehabilitation may not be appropriate for many patients with advanced cancer. We evaluated outcomes of cancer center inpatients transferred to subacute rehabilitation, implemented a multidisciplinary intervention to improve appropriateness of referrals, and evaluated its potential impact. ⋯ Intervention may have improved outcomes short-term but was complicated and difficult to maintain. Addressing appropriateness of subacute rehabilitation referrals can occur within a multidisciplinary approach to improving communication about goals of care for patients with advanced disease.
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J Pain Symptom Manage · Jul 2014
Primary thromboprophylaxis in hospices: the association between risk of venous thromboembolism and development of symptoms.
Venous thromboembolism (VTE) risk assessment for adults admitted to hospital is commonplace, but the utility of assessment tools in patients admitted to hospices or palliative care units and prediction of symptomatic VTE is unknown. ⋯ Hospice inpatients are at risk for VTE. TER alone is simpler to use and may be more useful in this population than the THRIFT but still has limitations regarding ability to predict symptoms.