Journal of pain and symptom management
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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.
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J Pain Symptom Manage · Nov 2018
Third-Year Medical Students' Reactions to Surgical Patients in Pain: Doubt, Distress, and Depersonalization.
Medical students have limited instruction about how to manage the interpersonal relationships required to care for patients in pain. ⋯ These observations about patient-doctor relationships suggest that there is a larger problem among clinicians relating to patient distress and personal processing of the emotional nature of patient care. Efforts to address this problem will require explicit instruction in skills to develop a personal strategy for managing the emotionally challenging aspects of clinical work.
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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.
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J Pain Symptom Manage · Nov 2018
ReviewDevelopment of a Standard for Hospital-Based Palliative Care Consultation Teams in Japan Using a Modified Delphi Method.
Hospital-based palliative care consultation teams (PCCTs) are rapidly being disseminated throughout Japan. The roles of PCCTs have changed during the past decade, particularly with the introduction of a modified national cancer care act to promote early palliative care and integrated oncology and palliative care. ⋯ We developed a standard for PCCTs in Japanese cancer hospitals. This standard provides a useful guide for clinical activities and a tool to evaluate quality of palliative care.
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J Pain Symptom Manage · Nov 2018
Depression and Health Care Utilization at End of Life Among Older Adults With Advanced Non-Small-Cell Lung Cancer.
Limited data exist regarding how depression diagnosed at different times relative to a cancer diagnosis may affect healthcare utilization at end of life (EOL). ⋯ EOL healthcare utilization varied by timing of depression diagnosis. Those with pre-cancer depression had lower odds of high-intensity healthcare, were more likely to utilize hospice, and have longer hospice stays. Regular depression screening and treatment may help patients optimize decision-making for EOL care. Additionally, hospice providers may need additional resources to attend to mental health needs in this population.