Journal of pain and symptom management
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Thought leaders in palliative care have long recognized the spiritual implications of illness, including Dame Cicely Saunders' groundbreaking concept of suffering as comprising physical, emotional, social, and spiritual sources of pain. However, despite such recognition, spirituality remains an oft-neglected component of the biopsychosocial spiritual model of caregiving in serious illness. We aim in this article to highlight, through an in-depth account of patients' experiences and attitudes, the concept of illness as a spiritual event.
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J Pain Symptom Manage · Nov 2018
Comparative StudyAssessing Symptoms, Concerns, and Quality of Life in Noncancer Patients at End of Life: How Concordant Are Patients and Family Proxy Members?
It has become commonplace to use family caregivers as proxy responders where patients are unable to provide information about their symptoms and concerns to health care providers. ⋯ Understanding discordance between patients and family member reports of symptoms and concerns is a valuable step toward minimizing patient and family burden at end of life.
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J Pain Symptom Manage · Nov 2018
Translation and Evaluation of a Lung Cancer, Palliative Care Intervention for Community Practice.
A notable gap in the evidence base for palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance on effective, scalable models. ⋯ Our findings suggest that a research-based PC intervention can be successfully adapted to community settings to achieve similar, if not better, QOL outcomes for patients and FCGs compared to UC. Nonetheless, additional modifications to ensure consistent referrals to PC and streamlining routine assessments and patient/FCG education are needed to sustain and disseminate the PC intervention.
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J Pain Symptom Manage · Nov 2018
The Children's International Mucositis Evaluation Scale is Valid and Reliable for the Assessment of Mucositis Among Brazilian Children With Cancer.
The Children's International Mucositis Evaluation Scale (ChIMES) is considered a valid and reliable instrument for the assessment of mucositis in pediatric patients aged 0-18 years. ⋯ The Portuguese self-reported and proxy versions of ChIMES were considered to be culturally adapted, valid, and reliable for Brazilian pediatric patients ranging from an age of one month to 18 years and were named ChIMES-BR.
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J Pain Symptom Manage · Nov 2018
Unintended Harm? Race Differences in the Relationship Between Advance Care Planning and Psychological Distress at the End of Life.
Research has revealed racial disparities in advance care planning and intensity of end-of-life care. Studies of the relationship between advance care planning and sadness and anxiety at the end of life are inconclusive. ⋯ Advance care planning may not work the same way for black and white individuals. End-of-life discussions and naming a health care proxy are potentially harmful to dying black patients' mental health. This finding suggests a need for additional research to understand why caregivers report unmanaged sadness/anxiety for dying black patients who engaged in advance care planning and increased attention to these patients' mental health at the end of life.