Journal of pain and symptom management
-
J Pain Symptom Manage · Oct 2021
Including the Spiritual Dimension in Multimodal Pain Therapy. Development and Validation of the Spiritual Distress and Resources Questionnaire (SDRQ).
Valid instruments for assessing spiritual resources and distress in pain therapy are scarce. The Spiritual Distress and Resources Questionnaire (SDRQ) was developed to fill this gap. ⋯ The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.
-
J Pain Symptom Manage · Oct 2021
An Exploratory Study of Demographics and Outcomes for Patients Seen by Specialist Palliative Care Social Work in the Inpatient Setting at an Academic Medical Center.
Specialist palliative care social work (PCSW) across a four-team palliative care (PC) service in the inpatient setting at a tertiary academic medical center. ⋯ Involvement of PCSW increased dramatically over the study period. Compared to the rest of the PC team, when PCSW was involved, length of stay was longer, whole-person care components were more likely to be addressed, dyspnea was significantly improved, and pain was significantly worse when compared to those consults not seen by PCSW. Other symptoms such as nausea and anxiety as well as discharge characteristics such as death or hospice discharge were not significantly different with involvement of PCSW.
-
J Pain Symptom Manage · Oct 2021
Training residents in virtual advance care planning: A new twist in telehealth.
Advance care planning (ACP) conversations represent an important physician skill, a need further highlighted by the COVID-19 pandemic. Most resident ACP training occurs in inpatient, settings, often featuring goals of care (GOC) conversations during a crisis. Outpatient clinics are valuable but underutilized settings to provide skills training for residents, yet little research has been done in these spaces. ⋯ This study illustrates the feasibility of a virtual format for ACP curriculum. The virtual community of practice created space for a metacognitive unmasking of prior resident unconscious incompetence. Also, inpatient, crisis-oriented late GOC conversation skills may translate poorly to the outpatient setting requiring early and ongoing GOC skills. Residents need more training to navigate ACP conversations in ambulatory environments.
-
J Pain Symptom Manage · Oct 2021
Changing Institutional Culture Around Hospice Using LEAN Tools to Improve Hospice Utilization in a Veteran Population.
Longer hospice length of stay improves the palliation of symptoms, quality of life, and the dying process for patients and their caregivers. We used a Lean designed Rapid Improvement Event (RIE) to facilitate earlier entry into hospice. ⋯ LEAN tools can be used successfully to improve end of life outcomes in an inpatient VA setting. The 90-day sustainment period following the RIE uncovers barriers to implementation and allows for adjustments to implementation.