Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2021
Psychological Distress in Bereaved Caregivers of Patients with Advanced Cancer.
Individuals caring for patients with advanced cancer (caregivers) experience psychological distress during the patient's illness course. However, data on the prevalence of bereaved caregivers' psychological distress and its relationship with the quality of patient's end of life (EOL) care are limited. ⋯ Many bereaved caregivers of patients with advanced cancer experience symptoms of depression and anxiety, which are associated with their perceptions of distress in their loved ones at the EOL.
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J Pain Symptom Manage · Mar 2021
Launching the Next Steps to Improve Hospice and Palliative Medicine Fellow Performance Assessment: A Look Back To the Initial Toolkit of Assessment Methods.
Education leaders in hospice and palliative medicine (HPM) have long acknowledged the challenge of fellow performance assessment and the need for HPM-specific fellow assessment tools. In 2010, and in alignment with the Accreditation Council for Graduate Medical Education's (ACGME's) directive toward competency-based medical education, the national HPM Competencies Workgroup curated a set of assessment tools, the HPM Toolkit of Assessment Methods. The Toolkit has been a resource for HPM fellowship directors in evolving practical, multifaceted fellow assessment strategies. ⋯ This article describes the development of the Toolkit, including recommended tools and methods for assessment within each ACGME competency domain, and links the lessons learned to recommendations for the 2020 workgroup to consider in creating the next HPM assessment strategy and toolkit. Effective implementation will be crucial in supporting fellows to reach independent practice, which will further strengthen the field and workforce to provide the highest quality patient and family-centered care in serious illness. This will require an inspired, committed effort from the HPM community, which we enthusiastically anticipate.
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J Pain Symptom Manage · Mar 2021
CHARTING THE TERRITORY: END-OF-LIFE TRAJECTORIES FOR CHILDREN WITH COMPLEX NEUROLOGICAL, METABOLIC AND CHROMOSOMAL CONDITIONS.
For parents, family, or clinicians of children with rare life-threatening conditions, there is little information regarding likely symptoms, illness trajectory, and end-of-life care. ⋯ Although much emphasis on pediatric palliative care has been on supportive treatment and symptom management, when faced with a lack of sound understanding of a rare illness, the mode of care can often be reactive and based on critical needs. By developing greater knowledge of symptoms and illness trajectory, both management and care can be more responsive and anticipatory, thereby helping ease illness burden and suffering.
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J Pain Symptom Manage · Mar 2021
Multicenter StudyHow we can improve the quality of care for patients requesting medical assistance in dying: a qualitative study of health care providers.
Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. ⋯ Canadian health care providers described unique challenges in caring for patients who request MAID, along with practices to improve the quality of care.
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J Pain Symptom Manage · Mar 2021
Randomized Controlled TrialStable symptom clusters and evolving symptom networks in relation to chemotherapy cycles.
The existence of stable symptom clusters with variations or changes in cluster membership and the merging of symptom clusters over time urge us to investigate how symptom relationships change over time. ⋯ Stable symptom clusters and evolving networks were identified. The most central symptom was fatigue; however, the paucity of studies that investigated symptom networks and central symptoms calls for further investigations on these phenomena. Identification of central symptoms and underlying mechanisms will guide efficient symptom management. Future studies will need to focus on developing comprehensive interventions for managing symptom clusters or targeting central symptoms.