Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2016
Observational StudyPatient-Controlled Therapy (PCT) of Breathlessness in Palliative Care: A New Therapeutic Concept for Opioid Application?
Breathlessness is one of the most distressing symptoms experienced by patients with advanced cancer and noncancer diagnoses alike. Often, severity of breathlessness increases quickly, calling for rapid symptom control. Oral, buccal, and parenteral routes of provider-controlled drug administration have been described. It is unclear whether patient-controlled therapy (PCT) systems would be an additional treatment option. ⋯ Opioid PCT is a feasible and acceptable therapeutic method to reduce refractory breathlessness in palliative care patients.
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J Pain Symptom Manage · Mar 2016
Dimensionality, Stability and Validity of the Beck Hopelessness Scale in Cancer Patients Receiving Curative and Palliative Treatment.
Hopelessness is a clinically important construct in patients with advanced illness. ⋯ Our study demonstrates psychometric limitations of the BHS in patients receiving both curative and palliative treatment, suggesting reduced utility in cancer populations. Given the clinical importance of the construct, a cancer-specific approach to capture the unique meaning of hopelessness in patients with severe medical illness is recommended.
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J Pain Symptom Manage · Mar 2016
Multicenter StudyAdherence to Measuring What Matters Measures Using Point-of-Care Data Collection Across Diverse Clinical Settings.
Measuring What Matters (MWM) for palliative care has prioritized data collection efforts for evaluating quality in clinical practice. How these measures can be implemented across diverse clinical settings using point-of-care data collection on quality is unknown. ⋯ Variations in clinician documentation of adherence to MWM quality measures are seen across clinical settings. Additional studies are needed to better understand benchmarks and acceptable ranges for adherence tailored to various clinical settings.
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J Pain Symptom Manage · Mar 2016
ReviewInterpreting at the End of Life: A Systematic Review of the Impact of Interpreters on the Delivery of Palliative Care Services to Cancer Patients with Limited English Proficiency.
Language barriers can influence the health quality and outcomes of limited English proficiency (LEP) patients at end of life, including symptom assessment and utilization of hospice services. ⋯ LEP patients had worse quality of end-of-life care and goals of care discussions when professional interpreters were not used. More intervention studies are needed to improve the quality of care provided to LEP patients and families receiving palliative services.
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J Pain Symptom Manage · Mar 2016
Improving Emergency Providers' Attitudes Towards Sickle Cell Patients in Pain.
Provider biases and negative attitudes are recognized barriers to optimal pain management in sickle cell disease, particularly in the emergency department (ED). ⋯ Brief video-based educational interventions can improve emergency providers' attitudes toward patients with sickle pain crises, potentially curtailing pain crises early, improving health outcomes and patient satisfaction scores.