Journal of pain and symptom management
-
J Pain Symptom Manage · Sep 2014
Dyspnea and panic among patients with newly diagnosed non-small cell lung cancer.
Among patients with lung cancer, dyspnea is associated with psychological distress, fatigue, and poor coping. Respiratory symptoms are also a common trigger for panic attacks in the general population. Minimal research has addressed the prevalence of panic disorder or the association of dyspnea with the risk of panic disorder in lung cancer. ⋯ Almost half of the patients with newly diagnosed non-small cell lung cancer reported dyspnea, and patients with dyspnea were more than twice as likely to endorse panic disorder symptoms relative to patients without dyspnea. Results highlight the need to differentiate panic disorder symptoms among patients who report dyspnea, particularly those who are younger or experiencing major depression symptoms.
-
J Pain Symptom Manage · Sep 2014
Implantable cardioverter defibrillator deactivation: a hospice quality improvement initiative.
Dying patients whose implantable cardioverter defibrillators (ICDs) continue to deliver shocks may experience significant pain, and the National Quality Forum has endorsed routine deactivation of ICDs when patients near the end of life. The overarching goal of this quality improvement project was to increase rates of ICD deactivation among hospice patients. ⋯ A multifaceted intervention can increase rates of ICD deactivation among patients near the end of life.
-
J Pain Symptom Manage · Sep 2014
Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation.
Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. ⋯ The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.
-
J Pain Symptom Manage · Sep 2014
Progressive development and enhancement of palliative care services in Japan: nationwide surveys of designated cancer care hospitals for three consecutive years.
Policymaking plays an important role in national palliative care services. The Japanese Cancer Control Act was implemented in 2006. ⋯ The Cancer Control Act promoted the development and enhancement of palliative care services in DCCHs. Regional medical cooperation and education are the future challenges of palliative care in Japan.
-
Maintaining professional boundaries enables clinicians to keep their patients' best interests in mind. Palliative care clinicians may be at risk for professional boundary crossings because of the intimate nature of caring for people with life-threatening illnesses. ⋯ We discuss the approach that the physician and nurse took in deciding about whether the boundary crossing was ethically permissible. We also offer sample questions for palliative care clinicians to consider when thinking about their actions.