Journal of pain and symptom management
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J Pain Symptom Manage · May 2018
Meta AnalysisNonpharmacologic Interventions for Improving Sleep Disturbances in Patients With Lung Cancer: A Systematic Review and Meta-analysis.
Lung cancer patients experience higher levels of sleep disturbances compared to other cancer patients, and this leads to greater distress, poorer function, and lower quality of life. Nonpharmacologic interventions have demonstrated improvements in the context of breast cancer, but their efficacy in the lung cancer population is unclear. ⋯ Limitations include the high heterogeneity of interventions and outcome measures, in addition to small sample sizes and high risk of bias within studies. Because they do not allow for a clear interpretation of the results, it is recommended that every patient should be assessed individually to guide a possible referral.
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J Pain Symptom Manage · May 2018
Case ReportsImplementing Routine Palliative Care Consultation Before LVAD Implantation: A Single Center Experience.
Left ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires preimplantation palliative care assessment; however, many palliative care teams have little experience providing this service. ⋯ Although palliative care consultants provided initial evaluation and management of multiple symptoms, there was not a large ongoing need. Integration of palliative services into the care of patients receiving LVADs can be incorporated into the workflow of the cardiothoracic and palliative care teams, resulting in improved ACP for all patients receiving LVADs and better care coordination for patients at the end of life.
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J Pain Symptom Manage · May 2018
ReviewCurrent Best Practices for Sexual and Gender Minorities in Hospice and Palliative Care Settings.
Although several publications document the health care disparities experienced by sexual and gender minorities (SGMs), including lesbian, gay, bisexual, and transgender (LGBT) individuals,1e4 less is known about the experiences and outcomes for SGM families and individuals in hospice and palliative care (HPC) settings. This article provides a brief overview of issues pertaining to SGMs in HPC settings, highlighting gaps in knowledge and research. Current and best practices for SGM individuals and their families in HPC settings are described, as are recommendations for improving the quality of such care.
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J Pain Symptom Manage · May 2018
Family Meetings in Inpatient Specialist Palliative Care: A Mechanism to Convey Empathy.
Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in inpatient settings. ⋯ Family meetings improve reported empathy. It would be beneficial to have more specific preparation and planning by the clinical team for meetings with people who have a history of familial conflict, and those where the staff's agenda is around discharge planning. Published guidelines could be adapted to better support staff to run meetings where there are complex family dynamics. Adoption of family meetings in outpatient settings has the potential to improve perceptions of empathy with a larger patient group.