Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2018
Patterns and Outcomes of Care in Children with Advanced Heart Disease Receiving Palliative Care Consultation.
Although access to subspecialty pediatric palliative care (PPC) is increasing, little is known about the role of PPC for children with advanced heart disease (AHD). ⋯ PPC involvement for children with AHD focuses on goals of care and psychosocial support. Findings suggest that PPC involvement at end of life supports goal-concordant care. Further research is needed to clarify the impact of PPC on patient outcomes.
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J Pain Symptom Manage · Feb 2018
Cytokine Gene Polymorphisms Associated With Various Domains Of Quality Of Life In Women With Breast Cancer.
Little is known about the phenotypic and molecular characteristics associated with various domains of quality of life (QOL) in women after breast cancer surgery. ⋯ Findings suggest that women experience distinctly different physical well-being, social well-being, and total QOL outcomes during and after breast cancer surgery. The genetic associations identified suggest that cytokine dysregulation influences QOL outcomes. However, specific QOL domains may be impacted by different cytokines.
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J Pain Symptom Manage · Feb 2018
Characteristics of Older Adults in Primary Care Who May Benefit from Primary Palliative Care in the United States.
Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. ⋯ In the U.S., approximately 8% primary care visits among older adults was related to advanced illness conditions. Advanced illness visits were most common among those most likely to be socioeconomically vulnerable and highlight the need to focus efforts for high-quality palliative care for these populations.
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Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging. Thus, palliative care providers may be asked to help in these discussions. ⋯ Effective, sensitive engagement requires the palliative care provider to attend to these variegated hopes, fears, and commitments. This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.
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J Pain Symptom Manage · Feb 2018
Development and Field-Test of an Audit Tool and Tracer Methodology for Clinician Assessment of Quality in End-of-Life Care.
Quality improvement in end-of-life care generally acquires data from charts or caregivers. "Tracer" methodology, which assesses real-time information from multiple sources, may provide complementary information. ⋯ The Tracer EoLC v1 can be used with tracer methodology to guide the assessment and rate the quality of end-of-life care.