Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2016
Does Increasing Homecare Nursing Reduce Emergency Department Visits at the End of Life? A Population-Based Cohort Study of Cancer Decedents.
Despite being commonplace in health care systems, little research has described home care nursing's effectiveness to reduce acute care use at the end of life. ⋯ Our study showed a temporal association between receiving end-of-life nursing in a given week during the last six months of life, and of more standard nursing in the last month of life, with a reduced ED rate in the subsequent week.
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J Pain Symptom Manage · Feb 2016
Clinical Factors Associated with a Short Survival Time After Percutaneous Nephrostomy for Ureteric Obstruction in Cancer Patients: An Updated Model.
Patients with advanced cancer can develop ureteric obstruction. Percutaneous nephrostomy (PCN) tube insertion can relieve this obstruction and prevent renal failure. PCN is associated with complications and can worsen quality of life. Prognostic models of survival after PCN in cancer patients can help identify the patients who will most likely benefit from this intervention. This work updates a prognostic model to predict overall survival in cancer patients after receiving PCN. ⋯ Survival in patients with malignant ureteric obstruction can range widely from a few days to a few years. The presented prognostic model is an updated model and can be used to identify patients with poor survival after PCN.
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J Pain Symptom Manage · Feb 2016
Using Markov Multistate Models to Examine the Progression of Symptom Severity Among an Ambulatory Population of Cancer Patients: Are Certain Symptoms Better Managed Than Others?
Patient-reported assessments of symptom severity can assist providers in monitoring and managing symptoms for cancer patients, which is important for offering patients optimal cancer care. Understanding which symptoms deteriorate at a faster rate over time can help identify areas for improving symptom management. ⋯ The availability of numerous medications for treating nausea, compared to fatigue and well-being, may be a reasonable explanation for our findings. Alternate management for these symptoms, such as exercise for reducing fatigue, should be investigated to improve patients' quality of life. The use of multistate modeling methods is also unique in the study of symptom progression and provides a more in-depth understanding of the likelihood of symptom deterioration and improvement over time.
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J Pain Symptom Manage · Feb 2016
Review Meta AnalysisGender Differences in Hiccup Patients: Analysis of Published Case Reports and Case-Control Studies.
Although sporadic male predominance in hiccup patients has been reported, the association between gender differences and triggering factors has rarely been evaluated in patients with hiccups. ⋯ We demonstrated male predominance in hiccup patients. This gender difference for hiccups was more pronounced in patients with non-CNS causes, whereas indistinct in patients with CNS causes.
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J Pain Symptom Manage · Feb 2016
Randomized Controlled Trial Comparative StudyBlinded Patient Preference for Morphine Compared to Placebo in the Setting of Chronic Refractory Breathlessness - An Exploratory Study.
Patients' preference for morphine therapy has received little attention in the setting of chronic refractory breathlessness. However, this is one important factor in considering longer term therapy. ⋯ Participants preferred morphine over placebo for the relief of chronic refractory breathlessness. Morphine offers clinically important improvement, but net benefit can be easily outweighed by side effects, reducing net benefits. Side effects require aggressive management to allow more patients to realize benefits.