Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2018
Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.
Medical assistance in dying (MAiD) allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physicians' attitudes toward MAiD or describe patient characteristics, there are few studies that explore the professional challenges faced by physicians who provide MAiD. ⋯ Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service.
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J Pain Symptom Manage · Aug 2018
From Fear to Confidence: Changing Providers' Attitudes About Pediatric Palliative and Hospice Care.
Children have limited access to hospice care: few existing hospice programs have dedicated pediatric teams, and adult hospice providers feel inadequately trained to care for children. ⋯ A two-day, high-intensity low-cost community-based education program can improve adult providers' knowledge of and skill level with pediatric care, leading to a change in attitude from fear to confidence. This model has the potential to increase access to pediatric hospice care as it uses existing adult hospice infrastructure.
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J Pain Symptom Manage · Aug 2018
Randomized Controlled TrialThemes Addressed by Couples With Advanced Cancer During a Communication Skills Training Intervention.
Couple-based communication interventions have beneficial effects for patients with cancer and their partners. However, few studies have targeted patients with advanced stages of disease, and little is known about how best to assist couples in discussing issues related to life-limiting illness. ⋯ Findings suggest that couples likely would be receptive to an intervention that combines training in communication skills with guidance in focusing on issues related to life completion to assist with transitions at end of life. Such interventions might enhance both individuals' abilities to cope with illness-related symptoms and demands, enjoy the time they have together, and derive meaning from the experience.
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J Pain Symptom Manage · Aug 2018
Randomized Controlled TrialA Randomized Trial of Acceptability and Effects of Values-Based Advance Care Planning in Outpatient Oncology: Person-Centered Oncologic Care and Choices.
No standard advance care planning (ACP) process exists in oncology. We previously developed and validated the values questions for Person-Centered Oncologic Care and Choices (P-COCC), a novel ACP intervention combining a patient values interview with an informational care goals video. ⋯ Our values-based ACP paradigm is acceptable but may increase distress in cancer outpatients. Further studies are investigating the underpinnings of these effects and ways to best support cancer patients in ACP.
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J Pain Symptom Manage · Aug 2018
Multicenter StudyPain in Maintenance Hemodialysis Patients: A Multicenter Study.
Pain is a common complaint in maintenance hemodialysis (MHD) patients yet is often inadequately assessed and undertreated. ⋯ Pain is common in MHD patients and is significantly associated with female gender, comorbidity, time on dialysis, and depression. Results of this study may serve as a starting point for palliative interventions for MHD patients.