Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2018
ReviewComplementary and Alternative Medicine in Hospice and Palliative Care: A Systematic Review.
The aim of palliative care is to improve quality of life for patients with serious illnesses by treating their symptoms and adverse effects. Hospice care also aims for this for patients with a life expectancy of six months or less. When conventional therapies do not provide adequate symptom management or produce their own adverse effects, patients, families, and caregivers may prefer complementary or alternative approaches in their care. ⋯ CAM may provide a limited short-term benefit in patients with symptom burden. Additional studies are needed to clarify the potential value of CAM in the hospice or palliative setting.
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J Pain Symptom Manage · Nov 2018
Multicenter StudyCharacteristics associated with physical function trajectories in older adults with cancer during chemotherapy.
Studies on physical function trajectories in older adults during chemotherapy remain limited. ⋯ While several symptoms were associated with decrements in PCS scores at enrollment in older adults with cancer receiving chemotherapy, morning fatigue was the only symptom associated with decreases in physical function over time. Regular assessments of symptoms and implementation of evidence-based interventions should be considered to maintain physical function in older adults during chemotherapy.
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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
Dyspnea in Amyotrophic Lateral Sclerosis: Rasch-Based Development and Validation of a Patient-Reported Outcome (DALS-15).
Dyspnea is a cardinal but often underestimated symptom in amyotrophic lateral sclerosis (ALS). The lack of a satisfying assessment tool leads to diagnostic uncertainty and bears the risk that established life-prolonging and symptom-relieving therapeutic options will not be adequately applied. ⋯ The DALS-15 satisfies strictest modern measurement criteria and has interval scale properties. It fills an important gap in assessment and could be most helpful to optimize symptom management in patients with ALS.