Journal of pain and symptom management
-
J Pain Symptom Manage · Aug 2016
Building Resilience for Palliative Care Clinicians: An Approach to Burnout Prevention Based on Individual Skills and Workplace Factors.
For palliative care (PC) clinicians, the work of caring for patients with serious illness can put their own well-being at risk. What they often do not learn in training, because of the relative paucity of evidence-based programs, are practical ways to mitigate this risk. Because a new study indicates that burnout in PC clinicians is increasing, we sought to design an acceptable, scalable, and testable intervention tailored to the needs of PC clinicians. ⋯ The intervention will focus on individual skill building and will be evaluated with measures of resilience, coping, and affect. For PC clinicians, resilience skills are likely as important as communication skills and symptom management as foundations of expertise. Future work to strengthen clinician resilience will likely need to address system issues more directly.
-
J Pain Symptom Manage · Aug 2016
Association of Descriptors of Breathlessness with Diagnosis and Self-Reported Severity of Breathlessness in Patients with Advanced Chronic Obstructive Pulmonary Disease or Cancer.
Verbal descriptors are important in understanding patients' experience of breathlessness. ⋯ The relationship between clusters and diagnosis is not robust enough to use the descriptors to identify the primary cause of breathlessness. Further work exploring how use of breathlessness descriptors reflects the severity of breathlessness and distress due to breathlessness could enable the descriptors to evaluate patient status and target interventions.
-
J Pain Symptom Manage · Aug 2016
Reliability and Validity of the Brief Fatigue Inventory and Dyspnea Inventory in People with Chronic Obstructive Pulmonary Disease.
Dyspnea, fatigue, and pain are common in individuals with chronic obstructive pulmonary disease (COPD). However, questionnaires with a similar format are not available to assess their relative severity and interference. ⋯ The BFI and DI are valid and reliable measures to evaluate fatigue and dyspnea in COPD patients and could be used concurrently with the Brief Pain Inventory to inform the relative severity and interference of these common symptoms in COPD.
-
J Pain Symptom Manage · Aug 2016
A High-Touch Model of Community-based Specialist Palliative Care: Latent Class Analysis Identifies Distinct Patient Subgroups.
Community-based palliative care may support seriously ill homebound patients. Programs vary widely, and few studies have described the heterogeneity of the populations served or service delivery models. ⋯ The population served by a community-based specialist palliative care program manages patients with different levels of illness burden, which are associated with patient characteristics and service utilization.
-
When ventilatory support is withdrawn in an intensive care unit (ICU), the place of death for most patients is the hospital. However, the majority of terminally ill patients prefer to die at home. Few articles have addressed taking adult mechanically ventilated patients home from the ICU for withdrawal of ventilatory support (WVS). ⋯ Successful WVS and a natural death at home is possible with logistic support from the hospice organization and the expertise of the hospice team, guided by a comprehensive protocol/checklist.