Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
Impact of continuing medical education for physicians on the quality of cancer pain treatment in China.
The management of cancer pain has gained attention in China since the proposal of the three-step analgesic ladder in 1986 and has been further improved after the Chinese Ministry of Health launched the campaign for "Good Pain Management Ward" in 2011. The Beijing Pain Management Center for Quality Control and Improvement was formed with the intent to improve the quality of pain management by various means such as providing continuing medical education (CME) and conducting evaluation in Beijing, the capital of China. ⋯ CME significantly improved the quality of cancer pain treatment in the participating hospitals. Thus, standard CME courses may be adopted to improve the quality of cancer pain treatment by other regions in China and other countries.
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J Pain Symptom Manage · Aug 2021
Nutrition impact symptom clusters in patients with head and neck cancer receiving concurrent chemoradiotherapy.
The objective of this study was to identify the nutrition impact symptom (NIS) clusters in patients with head and neck cancer (HNC) receiving concurrent chemoradiotherapy (CCRT) and explore their relationships with the weight loss rate (WLR). ⋯ The NIS had close internal connections with each other, so the strategies applied by healthcare professionals should focus on multiple related symptoms, especially to manage the RT-specific symptom cluster.
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J Pain Symptom Manage · Aug 2021
Identifying Prevalence of and Risk Factors for Abnormal Urine Drug Tests in Cancer Pain Patients.
Opioids have become a mainstay treatment for severe cancer pain. Although opioid prescribing has decreased, opioid mortality continues to rise. Utilizing urine drug tests (UDT) can help monitor medication adherence and identify use of unprescribed or illicit substances. ⋯ This study demonstrates that oncologic pain patients are not a risk-free population for abnormal UDT, thus recommends a UDT with initial opioid prescriptions and annually thereafter, with more frequent tests for patients suspected to be at higher risk for misuse.
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J Pain Symptom Manage · Aug 2021
Observational StudyAssessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.
Palliative care triggers have been used in the intensive care unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. ⋯ A trigger-based model, geared to the needs of the specific ICU, may be one way of improving integration of palliative care into the ICU, especially in sub-Saharan Africa.
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J Pain Symptom Manage · Aug 2021
Observational StudyPrevalence and risk factors of breathlessness across Canada: A national retrospective cohort study in home care and nursing home populations.
Breathlessness is a symptom associated with poor clinical outcomes and prognosis. Little is known about its long-term trends and associations with social factors including decline in social activities and caregiver distress. ⋯ The prevalence of clinician-reported breathlessness is higher in home care than in nursing home populations, the former having risen by 10% over the decade. Prevalence of breathlessness is associated with decline in social activities and caregiver distress. Enhanced supports may be required to meet increasing patient need in the community.