Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2018
Association of Advance Directives Completion with the Utilization of Life-Sustaining Treatments during the End-of-Life Care in Older Patients.
Evidence is mixed regarding the impact of advance directives (ADs) on the utilization of end-of-life treatments. ⋯ AD completion was associated with a lower likelihood of receiving life-sustaining treatments during the last month of life in older patients. These findings support the continued use of AD in older population.
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J Pain Symptom Manage · Feb 2018
Czech version of the Patient Dignity Inventory: Translation and Validation in Incurable Patients.
The Patient Dignity Inventory (PDI) is a valid, reliable screening tool to assess a range of issues that have been reported to affect the sense of dignity in patients with life-limiting conditions. ⋯ The results from the study support the reliability of the PDI-CZ and its future use in patients with incurable cancer and noncancer patients.
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J Pain Symptom Manage · Feb 2018
Symptom intensity of hospice patients: A longitudinal analysis of concordance between patients' and nurses' outcomes.
Nearing death, hospice patients are increasingly unable or unwilling to self-report their symptom intensity and rely on nurses' assessments. ⋯ Concordance between patients' and nurses' assessment of symptom prevalence is good, and both patients and nurses reveal identical symptoms as most and least prevalent and intense. However, nurses tend to underestimate symptom intensity. Concordance between patients and nurses symptom intensity scores is poor and does not improve over time.
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J Pain Symptom Manage · Feb 2018
Congruence Between Latent Class and K-modes Analyses in the Identification of Oncology Patients with Distinct Symptom Experiences.
Risk profiling of oncology patients based on their symptom experience assists clinicians to provide more personalized symptom management interventions. Recent findings suggest that oncology patients with distinct symptom profiles can be identified using a variety of analytic methods. ⋯ Both analytic methods can be used to identify subgroups of oncology patients with distinct symptom profiles. Additional research is needed to determine which analytic methods and which dimension of the symptom experience provide the most sensitive and specific risk profiles.
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J Pain Symptom Manage · Feb 2018
Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.
Documenting patients' advance care planning (ACP) wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about ACP documentation practices in the electronic health record. ⋯ Half of chronically ill, older participants had documented ACP, including one-third with documented discussions. However, half of the patients with completed legal forms/orders had no accompanying documented explanatory discussions, and the majority of documented discussions were not easily accessible, even when wishes had changed. Ensuring that patients' preferences are documented and easily accessible is an important patient safety and quality improvement target to ensure patients' wishes are honored.