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
Development of a brief cognitive and behavioural intervention for the management of episodic breathlessness - a Delphi survey with international experts.
Episodic breathlessness is characterized by a severe worsening of breathlessness intensity that goes beyond usual fluctuations. Episodes are usually short; therefore, nonpharmacological strategies (cognitive and behavioral) seem most promising to be beneficial. Which strategies-delivered separately or in combination-might be most effective and feasible remains unclear. ⋯ Using the consented nonpharmacological strategies, a brief cognitive and behavioral intervention was developed that balances between individualization and standardization of the intervention.
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J Pain Symptom Manage · May 2021
Development and validation of the QUALI-PALLI-FAM questionnaire for assessing relatives' perception of quality of inpatient palliative care: A prospective cross-sectional survey.
Relatives of patients receiving palliative care are at risk for psychological and physical distress, and their perception of quality of care can influence patients' quality of life. ⋯ The QUALI-PALLI-FAM appears to be a valid, reliable, and well-accepted tool to explore relatives' perception of quality of inpatient palliative care and complements the QUALI-PALLI-PAT questionnaire. Further testing is required in various settings and countries.
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J Pain Symptom Manage · May 2021
Observational StudySelection Bias in Observational Studies of Palliative Care: Lessons Learned.
Palliative care (PC) programs are typically evaluated using observational data, raising concerns about selection bias. ⋯ This case study demonstrates that selection of comparison groups impacts the magnitude of measured and unmeasured confounding, which may change effect estimates. The substantial impact of confounding on effect estimates in this study raises concerns about the evaluation of novel serious illness care models in the absence of randomization. We present key lessons learned for improving future evaluations of PC using observational study designs.