Journal of pain and symptom management
-
J Pain Symptom Manage · May 2018
Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study.
Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. ⋯ Our results indicate that use of a validated pain assessment scale, assessment of oral health, and prescribed pro re nata injections for pain, nausea, and anxiety might offer a way to improve symptom relief. These clinical tools and medications should be implemented in the care of the dying in RCHs, and controlled trials should be undertaken to prove the effect.
-
J Pain Symptom Manage · May 2018
Comparative Study Observational StudyCharacteristics of Unscheduled and Scheduled Outpatient Palliative Care Clinic Patients at a Comprehensive Cancer Center.
There is limited literature regarding outpatient palliative care and factors associated with unscheduled clinic visits. ⋯ Unscheduled new FU patients have higher levels of physical and psychosocial distress and higher opioid intake. Outpatient palliative care centers should consider providing opportunities for walk-in visits for timely management and close monitoring of such patients.
-
J Pain Symptom Manage · May 2018
Defining the Scope of Prognosis: Primary Care Clinicians' Perspectives on Predicting the Future Health of Older Adults.
Studies examining the attitudes of clinicians toward prognostication for older adults have focused on life expectancy prediction. Little is known about whether clinicians approach prognostication in other ways. ⋯ The perspectives of primary care clinicians in this study confirm that prognostic considerations can go beyond precise estimates of mortality risk and life expectancy to include a number of outcomes and approaches to predicting those outcomes.
-
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.
-
J Pain Symptom Manage · May 2018
Factors Affecting Palliative Care Development in Africa: In-Country Experts' Perceptions in Seven Countries.
Factors contributing to and impeding palliative care (PC) development in Africa can provide insights into current strategies for advancing PC. ⋯ The key factors underpinning PC development in the seven countries contributed to the beginnings of PC in Africa, fueled by advocates who built on existing strengths to maximize opportunities. However, the current approach is at high risk in terms of its sustainability, and strategies for maximizing existing resources and growing infrastructure support are needed moving forward.