Journal of pain and symptom management
-
J Pain Symptom Manage · Jan 2015
Multicenter StudyLong-term psychosocial outcomes among bereaved siblings of children with cancer.
The death of a child from cancer affects the entire family. Little is known about the long-term psychosocial outcomes of bereaved siblings. ⋯ How siblings experience the death of a child with cancer may impact their long-term psychosocial well-being. Sibling-directed communication and concurrent supportive care during the cancer experience and the year after the sibling death may mitigate poor long-term outcomes.
-
J Pain Symptom Manage · Jan 2015
Patterns of community-based opioid prescriptions in people dying of cancer.
Studies of opioid use in cancer patients have been cross-sectional or have focused on mean consumption over a specific time interval. ⋯ Patients dying of cancer require increasing doses of opioids over time; although we cannot distinguish the relative contributions of disease progression and opioid tolerance, age and certain cancers seem related to this phenomenon. Given the potentially prohibitive cost of prospective epidemiological studies, more elaborate clinical administrative databases that include regular pain assessment are necessary to determine optimal opioid use and factors associated with dose increases over time at a population level.
-
J Pain Symptom Manage · Jan 2015
Opioid availability and palliative care in Nepal: influence of an international pain policy fellowship.
Globally, cancer incidence and mortality are increasing, and most of the burden is shifting to low- and middle-income countries (LMICs), where patients often present with late-stage disease and severe pain. Unfortunately, LMICs also face a disproportionate lack of access to pain-relieving medicines such as morphine, despite the medical and scientific literature that shows morphine to be effective to treat moderate and severe cancer pain. ⋯ Following the World Health Organization public health model for development of pain relief and palliative care, the Fellow, working with colleagues and mentors, has achieved initial successes: three forms of oral morphine (syrup, immediate-release tablets, and sustained-release tablets) are now manufactured in the country; health-care practitioners are receiving training in the use of opioids for pain relief; and a new national palliative care association has developed a palliative care training curriculum. However, long-term implementation efforts, funding, and technical assistance by governments, philanthropic organizations, and international partners are necessary to ensure that pain relief and palliative care become accessible by all in need in Nepal and other LMICs.
-
J Pain Symptom Manage · Jan 2015
Multicenter Study Observational StudySymptom burden of cancer patients: validation of the German M. D. Anderson Symptom Inventory: a cross-sectional multicenter study.
Cancer patients frequently suffer from various symptoms often impairing functional status and quality of life. To enable timely supportive care, these symptoms must be assessed adequately with reliable tools. ⋯ The MDASI-German version is a valid tool for measuring patient-reported symptom severity and symptom interference in German cancer patients. It is easily applicable and can be used by German clinicians and researchers for screening and monitoring purposes and the comparison of international data.
-
J Pain Symptom Manage · Jan 2015
Multicenter StudyFeasibility of using algorithm-based clinical decision support for symptom assessment and management in lung cancer.
Distressing symptoms interfere with the quality of life in patients with lung cancer. Algorithm-based clinical decision support (CDS) to improve evidence-based management of isolated symptoms seems promising, but no reports yet address multiple symptoms. ⋯ The CDS systems, such as SAMI-L, have the potential to fill a gap in promoting evidence-based care.