Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2015
When Physicians Report Having Used Medical Drugs to Deliberately End a Patient's Life: Findings of the "End-of-Life in France" Survey.
The debate on the decriminalization of active assistance in dying is still a topical issue in many countries where it is regarded as homicide. Despite the prohibition, some physicians say they have used drugs to intentionally end a patient's life. ⋯ These findings underscore the pressing need for a clarification of the concepts involved among health professionals, patients, and society at large, and better training and support for physicians.
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J Pain Symptom Manage · Aug 2015
Comparative StudyCost Savings Associated With an Inpatient Palliative Care Unit: Results From the First Two Years.
Palliative care consultation services (PCCS) decrease costs for patients by matching treatments received to patients' and families' goals of care. However, few studies have examined the costs of a specialized palliative care unit (PCU). ⋯ Among patients who died in the hospital, transfer to a PCU is associated with significant cost savings as compared with patients on hospital wards who are seen by a PCCS.
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J Pain Symptom Manage · Aug 2015
Comparative StudyPredictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue.
Fatigue is the most common symptom in oncology patients during chemotherapy. Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. ⋯ The modifiable risk factors that were associated with only morning fatigue were body mass index, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.
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J Pain Symptom Manage · Aug 2015
Improvements in Physicians' Knowledge, Difficulties, and Self-Reported Practice After a Regional Palliative Care Program.
Although several studies have explored the effects of regional palliative care programs, no studies have investigated the changes in physician-related outcomes. ⋯ After the regional palliative care program, there were marked improvements in physicians' knowledge and difficulties. These improvements were associated with the level of physicians' participation in the program.
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J Pain Symptom Manage · Aug 2015
Case ReportsStercoral Perforation of the Colon: A Potentially Fatal Complication of Opioid-Induced Constipation.
Stercoral perforation of the colon is a rare complication of constipation, and there have only been a few reported cases of stercoral perforation of the colon secondary to opioid-induced constipation. This article describes such a case in a cancer survivor with chronic cancer-related pain and reviews the medical/surgical literature on stercoral perforation of the colon.