Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2023
ReviewImpact of an Institution-wide Goals of Care Program on the Timing of Referrals to Outpatient Palliative Care.
Palliative care has received increased interest since the COVID-19 pandemic due to its role in guiding goals of care (GOC) discussions. ⋯ There were no significant differences in OS among patients seen in the SCC before and after myGOC, likely related to a ceiling effect. More oncologists had ACP discussions with patients, and patients had lower symptom scores on ESAS after myGOC, likely indicating that more patients were referred for GOC discussions and ACP rather than for symptom distress.
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J Pain Symptom Manage · Dec 2023
ReviewTreatment Effect Estimates from Pilot Trials Are Unreliable.
The CONSORT guideline defines a pilot trial as a small-scale version of a desired future efficacy trial that is intended to answer the key questions of whether and how a larger study should be done. For example, a pilot trial might evaluate different approaches to data collection or outcome measurement. However, pilot trials are unreliable for assessing treatment efficacy due to the statistical phenomenon called sampling variability. ⋯ Treatment effect estimates from pilot trials should not be used to make future development decisions regarding a novel therapy because of the high risk of misleading conclusions.
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J Pain Symptom Manage · Dec 2023
ReviewA Meta-Ethnographic Review of Paid Staff and Volunteers Working together in Palliative Care.
Volunteers in palliative care settings are an essential part of care provision for patients and those important to them. Effective collaboration between volunteers and paid staff has been regarded as an important element of successful working, however, at times failures in coordination, information sharing and tensions within teams have been highlighted. ⋯ For effective working relationships between paid staff and volunteers, proactive engagement, recognition of each other's role and contribution, mutual sharing of information, and intentional interaction between both groups is needed.
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J Pain Symptom Manage · Dec 2023
Strategies to Improve Perioperative Palliative Care Integration for Seriously Ill Veterans.
Seriously ill patients are at higher risk for adverse surgical outcomes. Palliative care (PC) interventions for seriously ill surgical patients are associated with improved quality of patient care and patient-centered outcomes, yet, they are underutilized perioperatively. ⋯ The study demonstrates that individual, programmatic, and organizational efforts could facilitate interservice collaboration between PC clinicians and surgeons.