Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2020
Rehabilitation for cancer patients in inpatient hospices / palliative care units and achievement of a good death: analyses of combined data from nationwide surveys among bereaved family members.
In end-of-life care, rehabilitation for patients with cancer is considered to be an important means for improving patients' quality of death and dying. ⋯ Rehabilitation in palliative care units may contribute to several domains of quality of death and dying, particularly maintaining hope and pleasure. Further research is needed to investigate whether palliative rehabilitation contributes to the achievement of a good death.
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J Pain Symptom Manage · Dec 2020
Observational StudyQuality assessments of end-of-life care by medical record review for patients dying in intensive care units in Taiwan.
Essential indicators of high-quality end-of-life care in intensive care units (ICUs) have been established but examined inconsistently and predominantly with small samples, mostly from Western countries. Our study goal was to comprehensively measure end-of-life-care quality delivered in ICUs using chart-derived process-based quality measures for a large cohort of critically ill Taiwanese patients. ⋯ Taiwanese patients dying in ICUs heavily used LSTs until death despite high prevalences of documented prognostic communication, providing specialty palliative-care consultations, having a do-not-resuscitate order in place, and death without cardiopulmonary resuscitation. Family meetings should be actively promoted to facilitate appropriate end-of-life-care decisions to avoid unnecessary suffering from potentially inappropriate LSTs during the last days of life.
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J Pain Symptom Manage · Dec 2020
Unravelling fatigue in hemodialysis patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method.
Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias because of their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called memory-experience gap). Experience sampling methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data. ⋯ Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences, which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.
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J Pain Symptom Manage · Dec 2020
ReviewPreferences and experiences of Muslim patients and their families in Muslim-majority countries for end-of-life care: a systematic review and thematic analysis.
Care for people with progressive illness should be person centered and account for their cultural values and spiritual beliefs. There are an estimated 1.7 billion Muslims worldwide, largely living in low-income and middle-income countries. ⋯ Despite the scarce evidence of relatively low quality, the analysis revealed core themes. To achieve palliative care for all in line with the total pain model, beliefs must be identified and understood in relation to decision-making processes and practices.
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J Pain Symptom Manage · Dec 2020
Randomized Controlled TrialSurrogate Decision Maker Stress in Advance Care Planning Conversations: A Mixed-Methods Analysis from a Randomized Controlled Trial.
Spokespersons serving as surrogate decision makers for their loved ones report high levels of stress. Despite known benefits, advance care planning (ACP) conversations often do not occur. More information is needed to understand spokesperson stress during ACP. ⋯ Identifying what factors impact spokesperson stress in ACP conversations can be used to help design ACP interventions to more appropriately address the needs and concerns of spokespersons.