Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2015
Palliative Care Professionals' Inner Life: Exploring the Relationships Among Awareness, Self-Care, and Compassion Satisfaction and Fatigue, Burnout, and Coping With Death.
Professionals working in the landscape of death and dying frequently are exposed to existential issues, psychological challenges, and emotional distress associated with care at the end of life. Identifying factors that help professionals cope with frequent exposure to issues related to mortality could enhance palliative care providers' and patients' quality of life. ⋯ The awareness-based model of self-care was successfully tested in a multidisciplinary sample of Spanish palliative care professionals. This research applies a quantitative evaluation of the model, providing evidence of a constellation of key variables for health professionals' quality of life, such as specific training, self-care, awareness and coping with death competency.
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J Pain Symptom Manage · Aug 2015
Comparative StudyDifferent Experiences and Goals in Different Advanced Diseases: Comparing Serial Interviews With Patients With Cancer, Organ Failure, or Frailty and Their Family and Professional Carers.
Quality care for people living with life-limiting illnesses is a global priority. A detailed understanding of the varied experiences of people living and dying with different conditions and their family and professional caregivers should help policymakers and clinicians design and deliver more appropriate and person-centered care. ⋯ These contrasting illness narratives affect and shape the experiences, thoughts, and fears of patients and their carers in the last months of life. Palliative care offered by generalists or specialists should be provided more flexibly and equitably, responding to the varied concerns and needs of people with different advanced conditions.
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J Pain Symptom Manage · Aug 2015
Palliative Care Physicians' Attitudes Toward Patient Autonomy and a Good Death in East Asian Countries.
Clarification of the potential differences in end-of-life care among East Asian countries is necessary to provide palliative care that is individualized for each patient. ⋯ There are considerable intercountry differences in physicians' attitudes toward autonomy and physician-perceived good death. East Asia is not culturally the same; thus, palliative care should be provided in a culturally acceptable manner for each country.
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J Pain Symptom Manage · Aug 2015
Correlates and Predictors of Conflict at the End of Life Among Families Enrolled in Hospice.
Despite the palliative care mandate to view family as the unit of care, and the high prevalence and detrimental consequences of conflict at the end of life, little research has been conducted with hospice families to understand what contributes to family conflict. ⋯ Results support the multidimensional theoretical model of family conflict specifying the importance of the family context, key conditions that set the stage for conflict, and essential contributing factors. Implications for routine assessment and screening to identify families at risk and recommendations for future research are highlighted.
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J Pain Symptom Manage · Aug 2015
Validation of the Patient-Reported Outcome Mortality Prediction Tool (PROMPT).
The Patient-Reported Outcome Mortality Prediction Tool (PROMPT) estimates six-month mortality risk in elderly patients with declining health, but its external validity has not been established. ⋯ The PROMPT demonstrated good discrimination but poor calibration in an independent heterogeneous clinical population. Model updating improved calibration and diagnostic performance and decision curve analysis demonstrated potential clinical utility of the PROMPT for initiating advance care planning rather than hospice referrals.