Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2017
Evaluation of a pain assessment procedure in long-term care residents with pain and dementia.
The management of pain in long-term care (LTC) residents with dementia is complex. A prospective exploratory study was conducted to describe the course of pain and pain management strategies following a guideline-based pain assessment procedure in LTC residents with pain and dementia. ⋯ There is room for improvement regarding pain management in LTC residents with pain and dementia, and performance feedback seems a promising strategy to explore further.
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J Pain Symptom Manage · Nov 2017
Community Game Day: Using an end-of-life conversation game to encourage advance care planning.
Advance care planning (ACP) is an important process that involves discussing and documenting one's values and preferences for medical care, particularly end-of-life treatments. ⋯ These findings suggest that using a conversation game during community outreach is a useful approach for engaging patients and caregivers in ACP. The convergence of quantitative and qualitative data strongly supports the continued investigation of the game in randomized controlled trials.
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J Pain Symptom Manage · Nov 2017
Review Meta Analysis Comparative StudyOpioid-Induced Constipation Relief of Fixed-Ratio Combination Prolonged-Release Oxycodone/Naloxone Compared with Oxycodone and Morphine for Chronic Non-malignant Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Opioid-induced constipation (OIC) is one of the most frequent and severe adverse events (AEs) after treatment with opioids. Recent studies have indicated that fixed-ratio combination prolonged-release oxycodone/naloxone (OXN PR) could decrease OIC with similar pain relief compared with other opioids. ⋯ For people with chronic pain, treatment with OXN PR decreases the incidence of OIC and provides intermediate-term bowel function improvement with clinical importance; in addition, pain relief is not weakened. The OIC after treatment with OXN PR for cancer-related pain and over the long term remains unknown.
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J Pain Symptom Manage · Nov 2017
Preferences for life-sustaining treatments examined by hidden Markov modeling are mostly stable in terminally ill cancer patients' last 6 months of life.
Stability of life-sustaining treatment (LST) preferences at end of life (EOL) has not been well established for terminally ill cancer patients nor have transition probabilities been explored between different types of preferences. ⋯ Our patients' LST preferences remained stable without prominent shifts toward preferring less aggressive LSTs even when death approached. Clarifying patients' understanding and expectations about LST efficacy and tailoring interventions to the unique needs of patients in each state may provide personalized EOL care.
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J Pain Symptom Manage · Nov 2017
What Impact Do Chaplains Have? A Pilot Study of Spiritual AIM for Advanced Cancer Patients in Outpatient Palliative Care.
Spiritual care is integral to quality palliative care. Although chaplains are uniquely trained to provide spiritual care, studies evaluating chaplains' work in palliative care are scarce. ⋯ Spiritual AIM, a brief chaplain-led intervention, holds potential to address spiritual needs and religious and general coping in patients with serious illnesses.