Journal of pain and symptom management
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J Pain Symptom Manage · May 2020
Do Longitudinally-Collected Symptom Scores Predict Time to Death in Advanced Breast Cancer: A Joint Modelling Analysis.
Patients with advanced breast cancer have low rates of survival that can be associated with symptom burden. ⋯ Patients with advanced breast cancer experience chronic ongoing low symptom burden, which predicts patient time to death. Future research should examine the mechanisms by which patient characteristics, treatment, and supportive and palliative care can have an impact on patient survival.
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J Pain Symptom Manage · May 2020
Randomized Controlled Trial"Openness" personality trait associated with benefit from a non-pharmacological breathlessness intervention in people with intra-thoracic cancer: an exploratory analysis.
Breathlessness is common in people with lung cancer. Nonpharmacological breathlessness interventions reduce distress because of and increase mastery over breathlessness. ⋯ Worse baseline health, worse breathlessness mastery, but not severity, and openness were associated with a better odds of response. Breathlessness services must be easy to access, and patients should be encouraged and supported to attend.
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J Pain Symptom Manage · May 2020
"Please Keep Mom Alive One More Day" - Clashing Directives of a Dying Patient and Her Surrogate.
All medical care providers are legally and ethically bound to respect their patients' wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment that contradicts the patients' previously stated wishes. Our work discusses the legal and ethical issues surrounding such requests and provides guidance for clinicians to ethically and compassionately respond-without compromising their professional and moral obligations to their patients.
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J Pain Symptom Manage · May 2020
Comfort and Satisfaction with Care of Home-dwelling Dementia Patients at the End-of-Life.
Despite the preference to pass away at home, many dementia patients die in institutions, resulting in a paucity of studies examining end-of-life care outcomes in the home setting. ⋯ Achieving comfort and satisfaction with care for dementia patients dying at home involves an interplay of modifiable factors. Honoring medical intervention preferences, such as those with palliative intent associated with patients' comfort, determined families' satisfaction with care.
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J Pain Symptom Manage · May 2020
Advanced Cancer Patients' Changes in Accurate Prognostic Understanding and Their Psychological Well-Being.
Clinicians often worry that patients' recognition of the terminal nature of their illness may impair psychological well-being. ⋯ Improved PU may be associated with initial decrements in psychological well-being, followed by patients rebounding to baseline levels. Concerns about lasting psychological harm may not need to be a deterrent to having prognostic discussions with patients.