Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2020
Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people.
Chronic breathlessness is associated with poorer quality of life (QoL). This population study aimed to define dimensions of QoL and duration and dominant causes of breathlessness that most diminished QoL. ⋯ This is the first study to report on chronic breathlessness and impairment across dimensions of QoL and differences by its duration. Mobility, usual activity, and pain drive these reductions.
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J Pain Symptom Manage · Oct 2020
Terminally ill cancer patients' emotional preparedness for death is distinct from their accurate prognostic awareness.
Emotional preparedness for death (hereafter called death preparedness) and prognostic awareness (PA), a distinct but related concept, each contributes to patients' practical, psychological, and interpersonal preparations for death. However, the distinction between these two concepts has never been investigated. ⋯ The distinction between death preparedness and accurate PA was supported by their poor agreement, lack of reciprocal associations, and two different sets of predictors. Health care professionals should not only cultivate cancer patients' accurate PA but also facilitate emotional preparation for death to achieve a good death and improve end-of-life care quality.
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J Pain Symptom Manage · Oct 2020
Healing the hearts of bereaved parents: Impact of legacy artwork on grief in pediatric oncology.
Approximately 12% of children with cancer will not survive, representing a devastating loss for parents. Strategies to improve parental coping and grief have been understudied. Although legacy-making is frequently offered as standard care to children with terminal illness and their families, these interventions have received little empirical attention. ⋯ Participating in legacy artwork may result in self-reported positive outcomes for bereaved parents before and after their child's death, including family bonding, enhanced communication, meaning-making, and improvements in grief. As a result of these benefits, children's hospitals may consider offering legacy artwork for children with cancer and their families.
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J Pain Symptom Manage · Oct 2020
Engaging Hospices in Quality Measurement and Improvement: Early Experiences of a Large Integrated Healthcare System.
The quality of hospice care remains highly variable in the U. S. Patients, providers, and health care systems lack a comprehensive method of measuring the quality of care provided by an individual hospice. ⋯ For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14). The hospice RFI process is one health care system's attempt to evaluate hospice quality. Further research will determine whether the scoring system proves to be a sensitive, specific, and reproducible measure of hospice quality, and whether the collaborative can foster quality improvement over time.
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The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. ⋯ Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.