Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2020
Symptom Clusters in Women with Breast Cancer During the First 18 Months of Adjuvant Therapy.
Women with breast cancer treated with aromatase inhibitor (AI) therapy experience multiple concurrent symptoms or symptom clusters. Understanding of the symptom experience and identifying symptom clusters before and during AI therapy are important for the development of interventions to improve clinical outcomes. ⋯ This study helps us to better understand the most common symptom clusters over the first 18 months of adjuvant therapy among postmenopausal women with early-stage breast cancer. It is critical for health care providers to know the symptom clusters commonly experienced by women receiving AI therapy with or without chemotherapy and manage them properly over time.
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J Pain Symptom Manage · Feb 2020
Natural Language Processing Accurately Measures Adherence to Best Practice Guidelines for Palliative Care in Trauma.
The Trauma Quality Improvement Program Best Practice Guidelines recommend palliative care (PC) concurrent with restorative treatment for patients with life-threatening injuries. Measuring PC delivery is challenging: administrative data are nonspecific, and manual review is time intensive. ⋯ NLP performs with similar accuracy with manual review but with improved efficiency. NLP has the potential to accurately identify PC delivery and benchmark performance of best practice guidelines.
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J Pain Symptom Manage · Feb 2020
Breathlessness, anxiety, depression and function - the BAD-F study: a cross-sectional, population prevalence study in adults.
Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. ⋯ Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
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J Pain Symptom Manage · Feb 2020
Development and Validation of the Palliative Care Attitudes Scale (PCAS-9): A Measure of Patient Attitudes toward Palliative Care.
Palliative Care is underutilized, and research has neglected patient-level factors including attitudes that could contribute to avoidance or acceptance of Palliative Care referrals. This may be due in part to a lack of existing measures for this purpose. ⋯ Findings support the overall reliability, validity, and generalizability of the PCAS-9 in serious illness samples and have implications for increasing Palliative Care utilization via clinical care and future research efforts.
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J Pain Symptom Manage · Feb 2020
Challenges in Implementing Hospice Clinical Trials: Preserving Scientific Integrity While Facing Changing Environments.
Numerous changes can occur between the original design plans for clinical trials, the submission of funding proposals, and the implementation of the clinical trial. In the hospice setting, environmental changes can present significant obstacles, which require changes to the original plan designs, recruitment, and staffing. The purpose of the study was to share lessons and problem-solving strategies that can assist in future hospice trials. ⋯ Researchers would do well to review their protocol and statistics early in a clinical trial. They should be prepared for adjustments to accommodate market and environmental changes outside their control. Ongoing data monitoring, specifically related to recruitment, is advised.