Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2018
Development and Assessment of a Measure of Parent and Child Needs in Pediatric Palliative Care.
Pediatric palliative care has no evidence-based needs assessment measure. The Parent and Child Needs Survey (PCNeeds) is a new instrument designed to assess the needs of children in palliative care, including children receiving end-of-life care, and their families. ⋯ Initial psychometric analysis of the PCNeeds is encouraging, but further study of reliability and validity with more diverse respondents is needed.
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J Pain Symptom Manage · Apr 2018
Meta AnalysisEffects of Exercise Training on Restless Legs Syndrome, Depression, Sleep Quality, and Fatigue Among Hemodialysis Patients: A Systematic Review and Meta-analysis.
Hemodialysis (HD) patients experience a heavy symptom burden that leads to a decreased quality of life. Pharmacological treatment is effective but costly and has adverse effects. Exercise is a promising approach for symptom management, but the effect of exercise on restless legs syndrome (RLS), depression, sleep quality, and fatigue in HD patients is still uncertain. ⋯ Exercise training may help HD patients to reduce the severity of RLS, depression, and fatigue. More high-quality RCTs with larger samples and comparative RCTs focused on different exercise regimens are needed.
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J Pain Symptom Manage · Apr 2018
Outpatient Pain Medication Use: An Electronic Daily Diary Study in Metastatic Breast Cancer.
Understanding cancer patients' everyday pain experiences and their concomitant use of pain medication may help identify ways to improve pain management among outpatients. ⋯ Our findings provide some evidence that patients with advanced cancer tend to use their pain medications appropriately. Patients with lower pain appear to be taking medications in response to increases in pain, whereas patients whose pain is typically more intense may be relying on other cues to prompt them to take analgesic medication. Clinicians may need to be sensitive to individual differences in the factors associated with pain medication use in daily life.
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J Pain Symptom Manage · Apr 2018
"I'd Recommend …" How to Incorporate Your Recommendation Into Shared Decision Making for Patients With Serious Illness.
Patients and families facing serious illness often want and need their clinicians to help guide medical decision making by offering a recommendation. Yet clinicians worry that recommendations are not compatible with shared decision making and feel reluctant to offer them. We describe an expert approach to formulating a recommendation using a shared decision-making framework. We offer three steps to formulating a recommendation: 1) evaluate the prognosis and treatment options; 2) understand the range of priorities that are important to your patient given the prognosis; and 3) base your recommendation on the patient's priorities most compatible with the likely prognosis and available treatment options.