Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2017
Multicenter StudyImpact of Palliative Care Screening and Consultation in the ICU: A Multi-hospital Quality Improvement Project.
There are few multicenter studies that examine the impact of systematic screening for palliative care and specialty consultation in the intensive care unit (ICU). ⋯ Receiving a PCC in the ICUs was significantly associated with more frequent DNR code status and hospice referrals, but not 30-day readmissions or hospital utilization. Early PCC was associated with significant LOS and direct cost reductions. Providing PCC early in the ICU should be considered.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialImpact of Adding a Pictorial Display to Enhance Recall of Cancer Patient Histories: A Randomized Trial.
Current health care delivery models have increased the need for safe and concise patient handover. Handover interventions in the literature have focused on the use of structured tools but have not evaluated their ability to facilitate retention of patient information. ⋯ Most studies examining the institution of handover protocols in the health care setting have failed to harness the power of pictures and other representative images. This study demonstrates the ability of pictorial displays to improve both immediate and delayed recall of patient histories without increasing review time. These types of displays may be amenable to generation by software programs and have the potential to enhance information transfer in various settings.
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J Pain Symptom Manage · Jan 2017
Randomized Controlled TrialCoping in Patients with Incurable Lung and Gastrointestinal Cancers: A Validation Study of the Brief COPE.
Patients with incurable cancer engage in several coping styles to manage the impact of cancer and its treatment. The Brief COPE is a widely used measure intended to capture multiple and distinct types of coping. The Brief COPE has not been validated among patients with incurable cancer. ⋯ The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers.
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J Pain Symptom Manage · Jan 2017
Variations in care quality outcomes of dying people: Latent class analysis of an adult national register population.
Symptom relief is a key goal of palliative care. There is a need to consider complexities in symptom relief patterns for groups of people to understand and evaluate symptom relief as an indicator of quality of care at end of life. ⋯ Interindividual variability and complexity in symptom relief patterns may inform quality of care and its evaluation for dying people across care settings.
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J Pain Symptom Manage · Jan 2017
Timing of Advance Directive Completion and Relationship to Care Preferences.
Given recent Medicare rules reimbursing clinicians for engaging in advance care planning, there is heightened need to understand factors associated with the timing of advance directive (AD) completion before death and how the timing impacts care decisions. ⋯ Early documentation of care wishes may not be associated with an increased likelihood of electing aggressive care; however, ADs completed in the last months of life have higher rates of election of aggressive care.