Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2020
Spiritual care, pain reduction and preferred place of death among advanced cancer patients in Soweto, South Africa.
When religious and spiritual (R/S) care needs of patients with advanced disease are met, their quality of life (QoL) improves. We studied the association between R/S support and QoL of patients with cancer at the end of life in Soweto, South Africa. ⋯ Patients with cancer have R/S needs. R/S care among our patients appeared to improve their end-of-life experience. More research is needed to determine the mechanisms by which R/S care may have improved the observed patient outcomes.
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J Pain Symptom Manage · Jul 2020
Spiritual Distress Manifested in a Teenager Following a Stem Cell Transplant.
A mother and nurse 20 years after her son's tragic death, after a high-risk stem cell transplant, learns that his major behavioral changes while in strict isolation came under the term of spiritual distress. Through her personal experience, the writer describes how her son's thoughts and feelings were expressed in behaviors, atypical for his usual demeanor. This article highlights the importance and value of healthcare providers listening to a parent's perceptions of their child's state of mind. Atypical behavior could be a manifestation of spiritual distress and requires further assessment from the health care team.
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J Pain Symptom Manage · Jul 2020
Rapid De-Escalation and Triaging Patients in Community-Based Palliative Care.
The coronavirus disease 2019 (COVID-19) pandemic created a rapid and unprecedented shift in our medical system. Medical providers, teams, and organizations have needed to shift their visits away from face-to-face visits and toward telehealth (both by phone and through video). Palliative care teams who practice in the community setting are faced with a difficult task: How do we actively triage the most urgent visits while keeping our vulnerable patients safe from the pandemic? ⋯ We recommend active triaging, communication, and frequent screening for COVID-19 symptoms for palliative care patients been evaluated in the community setting. An understanding of infection risk, mutual consent between designated providers, patients, and their families are crucial to maintaining safety while delivering community-based palliative care during the COVID-19 pandemic.
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J Pain Symptom Manage · Jul 2020
Comparing an artificial neural network to logistic regression for predicting ED visit risk among patients with cancer: a population-based cohort study.
Prior work using symptom burden to predict emergency department (ED) visits among patients with cancer has used traditional statistical methods such as logistic regression (LR). Machine learning approaches for prediction, such as artificial neural networks (ANNs), are gaining attention but are yet to be commonly applied in practice. ⋯ Although both models were similar in predictive performance using our data, ANNs have an important role in prediction because of their flexible structure and data-driven distribution-free benefits and should thus be considered as a potential modeling approach when developing a prediction tool.
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J Pain Symptom Manage · Jul 2020
Randomized Controlled TrialAn individualized, interactive, advance-care planning intervention promotes transitions in prognostic-awareness states among terminally ill cancer patients in their last 6 months-A secondary analysis of a randomized controlled trial.
To examine whether an advance care planning intervention randomized controlled trial facilitates terminally ill cancer patients' transitions to accurate prognostic awareness (PA) and the time spent in the accurate PA state in patients' last six months. ⋯ Our intervention meaningfully facilitated participants' transition toward accurate PA and more time spent in the accurate PA state (State 4). Our intervention can help health care professionals foster cancer patients' accurate PA earlier in the terminal illness trajectory to make informed end-of-life care decisions tailored to their readiness for prognostic information.