Journal of pain and symptom management
-
J Pain Symptom Manage · Jan 2019
Multicenter StudyHeart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?
Heart rate variability is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to homeostasis. ⋯ Our results suggest a less complex autonomic response to noxious stimuli in VS/UWS patients. Such method may help to better understand sympathovagal response to potentially painful stimulation in brain-injured patients.
-
J Pain Symptom Manage · Jan 2019
Pre-Ventricular Assist Device Palliative Care Consultation: A Qualitative Analysis.
In 2013, the Centers for Medicare and Medicaid Services issued a mandate requiring that all patients undergoing destination therapy ventricular assist device (DT VAD) implantation have access to a palliative care team before surgery. Subsequently, many VAD programs implemented a mandatory preimplantation palliative care consultation for patients considering DT VAD. However, little is known about the quality of these consults. ⋯ One-time preimplantation palliative care consultations at our institution do not lead to completion of preparedness planning or even general palliative care assessment. Further work is needed to determine the most effective way to integrate palliative care into preimplantation care.
-
PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pc-facs@aahpm.org.
-
J Pain Symptom Manage · Jan 2019
Personalized goal for dyspnea and clinical response in advanced cancer patients.
The clinical response after comprehensive symptom management is difficult to determine in terms of a clinically important difference. Moreover, therapies should try to reach the threshold perceived by the individual patient for the determination of a favorable response to a treatment. ⋯ Patient Dyspnea Goal Response and Patient Global Impression seem to be relevant for evaluating the effects of a comprehensive management of symptoms, including dyspnea, assisting decision making process. Some factors may be implicated in determining the individual target and clinical response. A personalized symptom goal may translate in terms of therapeutic intervention, according to the achievement of the patients' expectations. High values of dyspnea intensity, a lower Karnofsky level, as well as high level of Dyspnea Intensity Goal (that is less patients' expectations) favor the achievement of the target.
-
J Pain Symptom Manage · Jan 2019
Letter Randomized Controlled Trial Multicenter Study Comparative StudyComparability of the Australian national Cancer Symptom Trials (CST) group's study populations to national referrals to non-CST specialist palliative care services participating in the Palliative Care Outcomes Collaboration (PCOC).