Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2020
Frequency of Burn-Out among Palliative Care Physicians Participating in a Continuing Medical Education Course.
Palliative care (PC) physicians are vulnerable for burnout given the nature of practice. The burnout frequency may be variable and reported between 24% and 38% across different countries. ⋯ Burnout among PC physicians who attended a board review course was 38%. Being single/separated showed trend toward association with burnout. Physicians who choose to attend continuing medical education may have unique motivating characteristics allowing them to better cope with stress and avoid burnout.
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J Pain Symptom Manage · Jul 2020
Distinct Symptom Experience Among Subgroups of Patients with ESRD Receiving Maintenance Dialysis.
Patients with end-stage renal disease receiving dialysis experience multiple concurrent symptoms. A person-centered understanding of patients' symptom experiences may offer insights into individualized management. ⋯ Consistent with findings in other chronic conditions, subgroups of patients on dialysis have unique symptom experiences. Therefore, an individualized approach to symptom management is warranted. Our findings offer a phenotypic characterization for research on the underlying mechanisms for these symptom experiences.
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J Pain Symptom Manage · Jul 2020
Palliative Care Pandemic Pack: a Specialist Palliative Care Service response to planning the COVID-19 pandemic.
Specialist palliative care services (SPCS) have a vital role to play in the global coronavirus disease 2019 pandemic. Core expertise in complex symptom management, decision making in uncertainty, advocacy and education, and ensuring a compassionate response are essential, and SPCS are well positioned to take a proactive approach in crisis management planning. ⋯ Our local SPCS have developed a Palliative Care Pandemic Pack to disseminate succinct and specific information, guidance, and resources designed to enable the rapid upskilling of nonspecialist clinicians needing to provide palliative care. It may be a useful tool for our SPCS colleagues to adapt as we face this global challenge collaboratively.
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J Pain Symptom Manage · Jul 2020
Scaling implementation of the Serious Illness Care Program through Coaching.
We designed group coaching calls to reinforce communication skill acquisition and Serious Illness Care Program uptake in adult primary care. ⋯ Group coaching of PCPs resulted in more than a twofold increase in documented serious illness conversations.
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J Pain Symptom Manage · Jul 2020
Suicide Attempt Following Determination of Ineligibility for Assisted Death: A Case Series.
Medical assistance in dying (MAID) and similar right-to-die laws are becoming increasingly common in jurisdictions across North America and elsewhere. To be eligible for MAID in Canada, requesters must have a serious illness, intolerable suffering, and a reasonably foreseeable natural death. They must also undergo two assessments to confirm eligibility. ⋯ All three cases had previous diagnoses of depressive disorders and mild cognitive impairment, and two cases had histories of suicide attempts. In at-risk patients, we speculate that the period surrounding a finding of MAID ineligibility may represent a period of particular vulnerability. Clinicians must be vigilant and prepared for the possibility of heightened risk, including risk of self-harm, after a finding of ineligibility for assisted death.