Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2019
Randomized Controlled TrialExtent and Determinants of Terminally Ill Cancer Patients' Concordance Between Preferred and Received Life-Sustaining Treatment States: An Advance Care Planning Randomized Trial in Taiwan.
Promoting patient value-concordant end-of-life care is a priority in health care systems but has rarely been examined in randomized clinical trials. ⋯ Our advance care planning intervention did not facilitate concordance between terminally ill cancer patients' preferred and received LST states, but patient value-concordant end-of-life care may be facilitated by interventions to cultivate accurate prognostic awareness, improve quality of life, support depressive patients, and clarify anxious patients' overexpectations of LST efficacy.
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J Pain Symptom Manage · Jul 2019
Introduction to a new Special Series for the Journal of Pain and Symptom Management - Science in Action: Evidence and opportunities for palliative care across diverse populations and care settings.
Practices to optimize palliative care delivery and new opportunities in which to integrate palliative care vary across populations and care settings. Systematic reviews are an efficient and methodologically rigorous approach to summarize existing research to identify both evidence-based best practices and new areas for future research and clinical practice. This is the introduction to a special series of articles in which members of the American Academy of Hospice and Palliative Medicine Research Committee report the results of circumscribed systematic reviews, which in a specific population or care setting seek to 1) summarize existing evidence for optimal palliative care practices or 2) identify opportunities where better palliative care delivery could improve patient and/or family outcomes.
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J Pain Symptom Manage · Jul 2019
Identifying Optimal Factor Scores on the Bereaved Family Survey: Implications for Practice and Policy.
The Bereaved Family Survey (BFS) is used to evaluate the quality of end-of-life (EOL) care in Veterans Affairs inpatient settings. The BFS consists of a global Performance Measure (BFS-PM) and three factors that relate to specific aspects of EOL care. ⋯ The identification of data-driven targets makes BFS factor scores more useful to clinicians and administrators focused on improving quality of EOL care in their facilities. Our results lend support for prioritizing quality improvement efforts related to respectful care and communication.
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J Pain Symptom Manage · Jul 2019
ReviewSymptom Clusters in People Living With HIV: A Systematic Review.
An increasing number of studies regarding symptom management have begun to shift their focus from managing a single symptom to multiple symptom clusters. However, there is a lack of consistency of compositions among different studies and even in two different analyses reported in a single study within the same population. ⋯ This systematic review summarized the compositions, measures, and analytical techniques of symptom clusters for PLWH. Although this review found unstable results on the compositions of symptom clusters and it was difficult to reach a definitive conclusion, the results still implicate the necessity of developing a threshold to decide what symptoms should be included in the clusters and the use of multiple data analysis techniques to obtain stable results.
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J Pain Symptom Manage · Jul 2019
ReviewSymptom experience of children with cancer younger than 8 years of age: an integrative review.
Children with cancer endure multiple symptoms during treatment. However, there remains a lack of systematic approaches to capture the whole picture of the symptom experience of children with cancer younger than eight years of age. ⋯ Children with cancer younger than eight years of age experience multiple symptoms. There is a need to investigate the full symptom profiles of these young children in consideration of their developmental nuances; to examine the concordance among different symptom reporters; and to conduct more qualitative studies to explore their symptom experience.