Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2019
Review Meta AnalysisThe effectiveness of music therapy for terminally ill patients：A meta-analysis and systematic review.
The quality of death has increasingly raised concern because of the physical and psychological suffering of patients with advanced disease. Music therapy has been widely used in palliative care; however, its physical and mental effectiveness remains unclear. ⋯ This meta-analysis study demonstrated that music therapy served as an effective intervention to alleviate pain and psychological symptoms of terminally ill patients. However, considering the limitation of the quantity of the studies included, these results would need to be further confirmed.
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J Pain Symptom Manage · Feb 2019
Validity, Reliability and Diagnostic accuracy of the Respiratory Distress Observation Scale for assessment of dyspnea in adult palliative care patients.
The prevalence and severity of dyspnea increase at the end of life. Many of these patients have difficulty in reporting their symptoms. Accurate surrogate measures are needed for appropriate assessment and treatment. The Respiratory Distress Observation Scale (RDOS) is proposed as a possible scale although more external validation is needed. We set out to validate the RDOS in the context of palliative care patients near the end of life. ⋯ The RDOS shows promise and clinical utility as an observational dyspnea assessment tool. Further studies in uncommunicative patients are needed to determine clinical usefulness and generalizability of results.
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J Pain Symptom Manage · Feb 2019
Randomized Controlled Trial Multicenter StudyDid a goals-of-care discussion happen? Differences in the occurrence of goals-of-care discussions as reported by patients, clinicians, and in the electronic health record.
Goals-of-care discussions are associated with improved end-of-life care for patients and therefore may be used as a process measure in quality improvement, research, and reimbursement programs. ⋯ Different approaches to assess goals-of-care discussions give differing results, yet each may have advantages. Patient report is most likely to correlate with patient-reported receipt of goal-concordant care.
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J Pain Symptom Manage · Feb 2019
Multicenter StudyModerating effects of forgiveness on relationship between empathy and health-related quality of life in hemodialysis patients: a structural equation modeling approach.
Health-related quality of life (QOL) is a recommended clinical tool to assess hemodialysis patients and a primary end point to observe the effectiveness of overall disease management. Empathy is associated with positive outcomes such as pain relief and reduced anxiety and distress. Numerous studies have tested the relationships among empathy, forgiveness, and QOL; however, a mechanism of forgiveness has not been fully explored in hemodialysis patients. ⋯ The results imply that empathy significantly directly and indirectly influences health-related QOL. Empathy among hemodialysis patients should be monitored and effectively managed to improve positive effects on their health-related QOL. Nurses should consider implementing empathy interventions with an emphasis on building forgiveness strategies to help hemodialysis patients improve their health-related QOL.
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J Pain Symptom Manage · Feb 2019
Multicenter Study Observational StudyPalliative Care Clinician Overestimation of Survival in Advanced Cancer: Disparities and Association with End-of-Life Care.
Clinicians frequently overestimate survival time in serious illness. ⋯ Overestimation is common in PC, associated with lower hospice use and a potentially mutable source of racial/ethnic disparity in EOL care.