Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2016
Hearing Loss in Hospice and Palliative Care: A National Survey of Providers.
Age-related hearing loss can impair patient-provider communication about symptom management, goals of care, and end-of-life decision-making. ⋯ Hospice and palliative medicine providers believe age-related hearing loss impacts care yet most do not screen. Although they feel they are managing well, few have formal training. Knowledge about management approaches and resources is suboptimal.
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J Pain Symptom Manage · Aug 2016
Hospice Enrollment Following Referral to Community-Based, Specialist-Level Palliative Care: Incidence, Timing and Predictors.
Referral to community-based palliative care may increase the likelihood of hospice enrollment. ⋯ Almost one-quarter of patients were enrolled in hospice while receiving community-based palliative care, and hospice length of stay was relatively long for those who did. Both sociodemographic and clinical characteristics were associated with hospice-related outcomes. Studies are needed to further explore predictors and outcomes of hospice enrollment from palliative care.
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J Pain Symptom Manage · Aug 2016
Observational StudyBispectral Index (BIS) Monitoring in Terminally Ill Patients: A Validation Study.
If regular therapies cannot relieve symptoms sufficiently in the last days of life, continuous palliative sedation may serve to reduce consciousness. Sedation level can be measured with EEG monitoring with the bispectral index (BIS) monitor. ⋯ This is one of the first validation studies in which BIS monitoring in end-of-life patients is described. BIS monitoring is feasible in unconscious terminally ill patients. However, based on our results, the wide range of BIS values in deeply sedated and comfortable patients seems to hamper its use in daily clinical practice.
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J Pain Symptom Manage · Aug 2016
How to Deal With Relatives of Patients Dying in the Hospital? Qualitative Content Analysis of Relatives' Experiences.
Hospital care and communication tend to be focused on the individual patient, and decision making is typically based on the principle of individual autonomy. It can be questioned whether this approach is adequate when a patient is terminally ill. ⋯ Relatives emphasized their relation with the patient and their involvement in care of the patient dying in the hospital. An approach of HCPs to care based on the concept of individual autonomy seems inadequate. The role of relatives might be better addressed by the concept of relational autonomy, which provides HCPs with opportunities to create a relationship with relatives in care that optimally addresses the needs of patients.
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J Pain Symptom Manage · Aug 2016
Observational StudyPrevalence, Impact and Correlates of Severe Fatigue in Patients with Gastrointestinal Stromal Tumors.
The introduction of the tyrosine kinase inhibitor (TKI) imatinib in the treatment of gastrointestinal stromal tumor (GIST) in 2000 was the start of a new era of targeted treatment. Since then, the median survival of patients with GIST has substantially increased. Prolonged survival and chronic TKI use are associated with treatment-induced symptoms, such as fatigue, which can compromise quality of life (QoL). ⋯ Severe fatigue occurs in 30% of GIST patients and in 33% of GIST patients on a TKI. The fatigue is disabling and is not only associated with current TKI use but also with psychological distress and physical functioning. GIST patients should be informed about these associated factors of fatigue that deserve appropriate management.