Journal of pain and symptom management
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J Pain Symptom Manage · May 2021
Providing End-of-Life Care for Patients With Left Ventricular Assist Devices: Experience of a Hospice Agency.
Patients with left ventricular assist devices (LVADs) need expert palliative care at the end of life. In the U.S., hospice may provide this care, but few patients enroll, and information about hospice experience with LVAD-implanted patients is limited. ⋯ To provide specialist palliative care to LVAD-implanted patients, hospices must be prepared to manage complex and highly varied needs. To do this, hospices must have adequate staff support and access to acute care.
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J Pain Symptom Manage · May 2021
Randomized Controlled TrialIntranasal Fentanyl versus Placebo for Treatment of Episodic Breathlessness in Hospice Patients with Advanced Non-malignant Diseases.
Episodic breathlessness is a distressing and difficult to treat symptom because of its short duration. Fast actioned intranasal fentanyl (INF) is potentially more suitable than oral opioids. ⋯ We found no difference between INF and placebo in relieving episodic breathlessness in nonmalignant conditions. INF was well tolerated, and the study design proved to be feasible in hospice patients with advanced diseases. Future study using higher concentration of fentanyl solution may be warranted.
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J Pain Symptom Manage · May 2021
Associations between Spirituality, Mindfulness, and Psychological Symptoms among Advanced Lung Cancer Patients and Their Spousal Caregivers.
Patients with metastatic lung cancer and their spousal caregivers are at high risk of psychological symptoms. Mindfulness may improve psychological symptoms via spiritual well-being (SW); yet, this mediation model has not been examined in a dyadic context. ⋯ SW is associated with patients' and spouses' psychological symptoms both directly and indirectly through mindfulness. Thus, interventions that target SW, particularly meaning and peace, along with mindfulness may be beneficial to the psychological management of patients facing a terminal disease and their spousal caregivers.