Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2017
Multicenter StudyImpact of Radiation Therapy on Aggressive Care and Quality of Life near Death.
Radiation therapy (RT) is used with palliative intent in patients with advanced stage cancer. Prior studies, primarily in patients with poor performance status (PS), suggest that RT is associated with aggressive medical care, which may impact patients' quality of life near death (QoD) adversely. ⋯ Targeted use of RT in end-of-life cancer care may benefit patients with good PS, but its use may adversely affect patients with poorer PS. Decisions about RT use in this setting should consider likely end-of-life outcomes based on patients' current PS.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialImpact of different exercise programs on severe fatigue in patients undergoing anticancer treatment - a randomized controlled trial.
Physical exercise can alleviate cancer-related fatigue. Randomized controlled trials in patients with advanced cancer are scarce. ⋯ Our results imply that tumor-patients' severe general fatigue can be reduced when patients conduct appropriate physical exercise. This study amends previous knowledge, as it describes the impact of outpatient physical exercise on fatigue in a heterogeneous patient cohort with various advanced cancer entities. Furthermore, this trial differentiates between patients with only a self-directed exercise program versus those receiving additional partially professional supervision.
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J Pain Symptom Manage · Jan 2017
Remaining lifetime after recognition of terminal illness depends on diagnosis: a nationwide population-based cohort study.
Timely recognition of the terminal phase of life will benefit patients and caregivers as it may facilitate advance care planning and support. ⋯ This study found a median remaining lifetime of 55 days after recognition of terminal illness. Remaining lifetime differed between cancer and noncancer patients and according to age and gender. Increased attention should be directed toward timely recognition of the transition into the terminal phase, especially for patients with noncancer disease.
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J Pain Symptom Manage · Jan 2017
Perception of Helpfulness of a Question Prompt Sheet among Cancer Patients Attending Outpatient Palliative Care.
Data on the use of question prompt sheets (QPSs) in palliative care are limited. Our team previously developed a single-page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients. ⋯ The QPS was perceived as helpful in patient-physician communication among advanced cancer outpatients and it did not increase patient anxiety. Physicians similarly reported that the QPS was helpful and it did not prolong clinic visits. Further research is needed for its widespread adoption and integration into routine clinical practice.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialMindfulness-Based Stress Reduction in Post-Treatment Breast Cancer Patients: Immediate and Sustained Effects across Multiple Symptom Clusters.
Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters. ⋯ Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.