Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2021
Continuous deep sedation until death: first national survey in France after the 2016 law promulgating it.
The French parliament passed a groundbreaking law in 2016, opening a right for patients to access continuous and deep sedation until death (CDS) at the end of life, under conditions. Parliamentarians' goal was to consolidate patients' rights whilst avoiding legislating on medical aid in dying. ⋯ After the law was passed in France, CDS were requested, proposed and performed in all medical settings, in nursing homes, at home. The qualitative data presented here show the relevance of exploring physicians' reflexive stances on this practice in different settings and within the context of a patient-physician relationship marked by a new patient's right. The study highlights the wide range of elements of language used by patients at the end of life, as understood by respondent physicians to mean a request for CDS and underscores the polymorphous meaning of CDS.
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J Pain Symptom Manage · Oct 2021
Randomized Controlled TrialUnderstanding the Role of Knowledge in Advance Care Planning Engagement.
Advance care planning remains underutilized. A better understanding of the role of education in promoting engagement is needed. ⋯ Knowledge deficits regarding advance care planning are common and associated with the same sociodemographic factors linked to other healthcare disparities. While improving knowledge is an important component of intervention, it is unlikely sufficient in and of itself to increase engagement.
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J Pain Symptom Manage · Oct 2021
Meta AnalysisAssociation of Palliative Care Intervention with Health Care Use, Symptom Burden and Advance Care Planning in Adults with Heart Failure and Other Noncancer Chronic Illness.
Palliative care (PC) improves outcomes in noncancer illness. We hypothesized the benefit is driven by studies of heart failure (HF) patients exclusively versus studies of other noncancer illnesses. ⋯ PC is particularly effective at reducing potentially unwanted hospital admissions for patients with HF compared to other noncancer illnesses. Our findings should further encourage efforts to increase PC access to HF patients.
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J Pain Symptom Manage · Oct 2021
Care Associated with Satisfaction of Bereaved Family Members of Terminally Ill Cancer Patients with Dyspnea: A Cross-sectional Nationwide Survey.
Terminal dyspnea in dying cancer patients is frequent and distressing, and the impact extends to their families. Families are often involved in providing care for terminal dyspnea. ⋯ Dedicated and compassionate care may be the essential part of the care for terminal dyspnea. Dedicated and compassionate care for patients and care for family members have a potential of improving the care satisfaction among family caregivers.
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J Pain Symptom Manage · Oct 2021
Genetic Factors associated with Pain Severity, Daily Opioid Dose Requirement, and Pain Response among Advanced Cancer Patients receiving Supportive Care.
Current understanding of genetic factors associated with pain severity, and improvement of pain with opioids in advanced cancer patients (AC) is inadequate for delivery of personalized pain therapy (PPT). Therefore, the aim of this study was to determine the genetic factors associated with pain severity, daily opioid dose, and pain response in AC patients receiving supportive care. ⋯ This study identified that SNPs of OPRM1, COMT, NFKBIA, CXCL8, IL-6, STAT6, and ARRB2 genes were associated with pain severity, opioid daily dose, and pain response in AC receiving supportive care. Additional studies are needed to validate our findings for PPT.