Journal of pain and symptom management
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J Pain Symptom Manage · May 2016
A Decade of Changes in Family Caregivers' Preferences for Life-Sustaining Treatments for Terminally Ill Cancer Patients at End of Life in the Context of a Family-Oriented Society.
Temporal changes in different family caregiver cohorts' preferences for life-sustaining treatments (LSTs) at end of life (EOL) have not been examined nor have the concept of whether caregivers' LST preferences represent a homogeneous or heterogeneous construct. Furthermore, LST preferences are frequently assessed from multiple treatments, making clinical applications difficult/infeasible. ⋯ Family caregivers' LST preferences for terminally ill cancer patients are a heterogeneous construct and shifted from uniformly rejecting all LSTs toward greater uncertainty. Surrogate EOL-care decision making may be facilitated by earlier and thorough assessments of caregivers' LST preferences and tailoring interventions to the unique needs of caregivers in each class identified in this study.
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J Pain Symptom Manage · May 2016
Chemotherapy Use in the Months Before Death and Estimated Costs of Care in the Last Week of Life.
Considerable attention has been paid to the disproportionately high costs of care for patients nearing death, yet little is known about the costs associated with chemotherapy use among end-stage cancer patients. ⋯ Chemotherapy for end-stage cancer patients is associated with higher estimated EOL care costs. Given evidence of limited benefit and potential harm of chemotherapy for end-stage cancer patients, the cost-effectiveness of such care is questioned and further study warranted.
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J Pain Symptom Manage · May 2016
Validation of the Amharic Version of the M. D. Anderson Symptom Inventory and Assessment of Symptoms in Ethiopian Cancer Patients.
Cancer patients often face a variety of symptoms that impact their quality of life. The management of these symptoms is highly dependent on the accurate appraisal of their severity through the use of a standardized symptom assessment tool. The M. D. Anderson Symptom Inventory (MDASI), developed in English, is one of such tools that contain 13 core cancer related symptoms that can easily be rated on a scale of 0-10. ⋯ The MDASI-Am is a valid and reliable tool for measuring symptom severity and symptom interference with daily living in Ethiopian cancer patients.
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J Pain Symptom Manage · May 2016
Clusters of Multiple Complex Chronic Conditions: A Latent Class Analysis of Children at End of Life.
Children at end of life often experience multiple complex chronic conditions with more than 50% of children reportedly having two or more conditions. These complex chronic conditions are unlikely to occur in an entirely uniform manner in children at end of life. Previous work has not fully accounted for patterns of multiple conditions when evaluating care among these children. ⋯ This analysis presented a novel way of understanding patterns of multiple complex chronic conditions among children that may inform tailored and targeted end-of-life care for different clusters.
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J Pain Symptom Manage · May 2016
Differences in Symptom Burden Among Patients with Moderate, Severe, or Very Severe Chronic Obstructive Pulmonary Disease.
The symptom experience of patients with chronic obstructive pulmonary disease (COPD) is extremely complex. It is characterized by multiple co-occurring symptoms. However, very few studies have described this experience in COPD patients. ⋯ Regardless of stage of disease, the high symptom burden identified in this study underscores the need for COPD patients to be screened for multiple co-occurring symptoms.