Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2020
Attitudes of professional caregivers and family members regarding the use of monitoring devices to improve assessments of pain and discomfort during continuous sedation until death.
Assessing consciousness and pain during continuous sedation until death (CSD) by behavior-based observational scales alone has recently been put into question. Instead, the use of monitoring technology has been suggested to make more objective and reliable assessments. Insights into which factors influence attitudes toward using these monitoring devices in a context of CSD is a first step in formulating recommendations to inform future practice. ⋯ Most participants had no objections, and all participants found the use of monitoring devices during CSD feasible and acceptable. We identified a number of facilitators and barriers and suggested that being aware that care can be improved, good communication, shared decision making, and continuing professional education can overcome the identified barriers. We suggest future research would focus on developing implementation strategies and guidelines for introducing objective monitoring devices in diverse palliative care settings.
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J Pain Symptom Manage · Aug 2020
COVID-19 - Impact on DNR Orders in the Largest Cancer Center in Jordan.
The COVID-19 pandemic requires health care teams to rethink how they can continue to provide high-quality care for all patients, whether they are suffering from a COVID-19 infection or other diseases with clinical uncertainty. Although the number of COVID-19 cases in Jordan remains relatively low compared to many other countries, our team introduced significant changes to team operations early, with the aim of protecting patients, families, and health care staff from COVID-19 infections, while preparing to respond to the needs of patients suffering from severe COVID-19 infections. This paper describes the changes made to our "do not resuscitate" policy for the duration of the pandemic.
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J Pain Symptom Manage · Aug 2020
Low Socioeconomic Status Associated with Lower Utilization of Hospice Care Services during End-of-life Treatment in Cancer Patients: A Population-based Cohort Study.
Socioeconomic status (SES) is an important determinant of disparities in health services and may affect the utilization of hospice care services during end-of-life (EOL) treatment in patients with cancer. However, previous studies evaluating the association between SES and utilization of hospice care services among patients with cancer revealed inconsistent findings. ⋯ Low SES was associated with lower utilization of hospice care services during EOL care in patients with cancer. Our data support the need to target low SES patients with cancer in efforts to optimally increase hospice care services during EOL care.
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J Pain Symptom Manage · Aug 2020
COVID-19 Lessons: The Alignment of Palliative Medicine and Trauma-Informed Care.
As the COVID-19 pandemic wears on, its psychological, emotional, and existential toll continues to grow and indeed may now rival the physical suffering caused by the illness. Patients, caregivers, and health-care workers are particularly at risk for trauma responses and would be well served by trauma-informed care practices to minimize both immediate and long-term psychological distress. Given the significant overlap between the core tenets of trauma-informed care and accepted guidelines for the provision of quality palliative care (PC), PC teams are particularly well poised to both incorporate such practices into routine care and to argue for their integration across health systems. We outline this intersection to highlight the uniquely powerful role PC teams can play to reduce the long-term psychological impact of the COVID-19 pandemic.
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J Pain Symptom Manage · Aug 2020
Comparing symptom ratings by staff and family carers in residents dying in long-term care facilities in three European countries, results from a PACE-survey.
Symptom management is essential in the end-of-life care of long-term care facility residents. ⋯ There is a need for improved communication between staff and family and discussion about symptom burden in the dying phase in long-term care facilities.