Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2016
Shock Index and Decreased Level of Consciousness as Terminal Cancer Patients' Survival Time Predictors: A Retrospective Cohort Study.
Predicting prognosis using noninvasive and objective tools may facilitate end-of-life decisions for terminal cancer patients, their families, and other health care professionals. ⋯ An SI ≥ 1.0 along with DLOC is a highly reliable tool for predicting short-term survival time in terminal cancer patients.
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J Pain Symptom Manage · Feb 2016
POST Forms More Than Advance Directives Associated with Out-of-Hospital Death: Insights from a State Registry.
Patients' end-of-life care outcomes often do not reflect their preferences. Ninety-two percent of West Virginians prefer to die outside the hospital, yet only 58.8% do. ⋯ A prospective study is needed to validate that a statewide POST program and registry provide a more effective way than ADs to express, document, and honor patients' preferences for an OHD.
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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
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
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.