Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2015
Dying in the hospital: what happens and what matters, according to bereaved relatives.
Most deaths in Western countries occur in hospital, but little is known about factors determining the quality of dying (QOD). ⋯ Relatives rated QOD as sufficient. A majority of patients and relatives were not sufficiently prepared for imminent death, and relatives experienced many problems. QOD appears to be a multidimensional construct, strongly affected by medical care and staff attentiveness.
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J Pain Symptom Manage · Feb 2015
Multicenter Study Observational StudyA prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.
Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). ⋯ HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.
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J Pain Symptom Manage · Feb 2015
Randomized Controlled Trial Comparative StudyMorphine or oxycodone for cancer-related pain? A randomized, open-label, controlled trial.
There is wide interindividual variation in response to morphine for cancer-related pain; 30% of patients do not have a good therapeutic outcome. Alternative opioids such as oxycodone are increasingly being used, and opioid switching has become common clinical practice. ⋯ In this population, there was no difference between analgesic response or adverse reactions to oral morphine and oxycodone when used as a first- or second-line opioid. These data provide evidence to support opioid switching to improve outcomes.
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J Pain Symptom Manage · Feb 2015
Comparative StudyGrief after patient death: direct care staff in nursing homes and homecare.
Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. ⋯ Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare.
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J Pain Symptom Manage · Feb 2015
Comparative StudyComparison of ECOG/WHO performance status and ASA score as a measure of functional status.
The Eastern Cooperative Oncology Group/World Health Organization Performance Status (ECOG/WHO PS) is a prognostic factor. It should be used in analyzing health outcomes such as risk-adjusted hospital performance models in cancer populations. Performance status is rarely recorded in surgery, often the place where cancer is first diagnosed. Could a universally collected preoperative measure be substituted for ECOG/WHO PS? ⋯ The ASA score can be used as a proxy for ECOG/WHO PS in risk adjustment models predicting cancer surgery. Further studies should assess its broader application for other outcomes and in other settings.