Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2018
Development and psychometric properties of a survey to assess barriers to implementing advance care planning in primary care.
Valid and reliable measurement of barriers to advance care planning (ACP) in health care settings can inform the design of robust interventions. ⋯ This questionnaire to assess barriers to ACP discussion from the perspective of family physicians demonstrates preliminary evidence of reliability and validity.
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J Pain Symptom Manage · Jan 2018
Reliability and validity of the Korean Memorial Symptom Assessment Scale-Short Form in gynecological cancer patients.
Symptoms of patients with cancer need to be evaluated with a standard instrument. The Memorial Symptom Assessment Scale-Short Form (MSAS-SF) is a symptom assessment tool that has been validated in many languages. ⋯ The Korean-version MSAS-SF is a valid tool for the reliable assessment of patients with gynecologic cancer in Korea.
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J Pain Symptom Manage · Jan 2018
Observational StudyThe impact of combined use of opioids, antipsychotics and anxiolytics on survival in the hospice setting.
Opioids and sedatives are the cornerstone of symptom management in the end-of-life patients, but undertreatment is a common problem. Although several studies explored the individual effect of opioids, anxiolytics, and antipsychotics on survival, not much is known regarding their combined use. As these drugs share similar and potentially fatal side effects, primarily respiratory depression which occurs more often during night-hours, it is crucial to explore whether their interaction poses a danger for fragile hospice patients. ⋯ This research supports the safety of opioids, anxiolytics, and antipsychotics in the hospice setting when used both individually as well as in combination.
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J Pain Symptom Manage · Jan 2018
Case ReportsIs There Ever a Role for the Unilateral Do Not Attempt Resuscitation Order in Pediatric Care?
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. ⋯ The authors posit that such a unilateral do not attempt resuscitation order is only appropriate in very limited circumstances in pediatric care. Instead, focus should be placed on open discussion between parents and members of the clinical team, shared decision making, and maintenance of the clinician-parent relationship while simultaneously supporting members of the clinical team who express discomfort with parental decisions. The authors propose an alternative framework for approaching such a conflict based on clinician-parent collaboration and open communication.
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J Pain Symptom Manage · Jan 2018
The Views of Clergy Regarding Ethical Controversies in Care at the End of Life.
Although religion often informs ethical judgments, little is known about the views of American clergy regarding controversial end-of-life ethical issues including allowing to die and physician aid in dying or physician-assisted suicide (PAD/PAS). ⋯ Most U.S. clergy approve of "allowing to die" but reject the morality or legalization of PAD/PAS. Respectful discussion in public discourse should consider rather than ignore underlying religious reasons informing end-of-life controversies.