Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2023
Project EPIC (Early Palliative Care In COPD): A Multiphase Evaluation of the EPIC Telehealth Intervention.
Early, concurrent palliative care interventions in chronic obstructive pulmonary disease (COPD) are limited. Project EPIC (Early Palliative Care In COPD) is a multiphase mixed methods study working to fill this gap. ⋯ EPIC was acceptable and feasible in patients with COPD and their family caregivers. Larger feasibility and effectiveness trials are warranted.
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J Pain Symptom Manage · Apr 2023
Randomized Controlled TrialEffects of a Patient Question Prompt List on Question Asking and Self-Efficacy During Outpatient Palliative Care Appointments.
Question prompt lists (QPLs) promote participation during medical appointments, including in the context of serious illness care. However, no studies have used parameters of a theoretical framework to examine the effects of QPL use in outpatient palliative care. ⋯ Despite their promise in previous studies, results of the current study suggest that QPLs may lack potency to shift patient and care partner question asking in palliative care appointments, and that other mechanisms outlined in Self-Efficacy Theory may characterize the relation between question asking and self-efficacy.
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J Pain Symptom Manage · Apr 2023
The impact of stressful life events after bereavement: a nationwide cross-sectional survey.
Bereaved family members sometimes experience distress due to stressful life events. However, the effects of this distress on depression and grief remain unclear. ⋯ Most family members experienced distress due to stressful life events, which were risk factors for MDD and CG. Assessing risk factors for maladaptation to post-bereavement life changes and enhancing readiness to adapt to them is important.
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J Pain Symptom Manage · Apr 2023
Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit.
To describe a physician (MD) and registered nurse (RN) led palliative care consultation team embedded in the medical intensive care unit (MICU). To compare patterns of palliative care consultation, and rates of goals of care documentation and in-ICU mortality before and after the implementation of the embedded team. ⋯ After embedding a palliative care MD/RN team into the MICU, patients received earlier palliative care consultation, were more likely to have medical decision-maker and goals of care documented, and less likely to die in the hospital. Future work will examine how to adapt this model to other ICUs to improve palliative care access for critically ill patients broadly.
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J Pain Symptom Manage · Apr 2023
Inflammation and performance status: the cornerstones of prognosis in advanced cancer.
In advanced cancer, although performance status (PS), systemic inflammatory response and nutritional status are known to have prognostic value, geographical variations and sociodemographic indexes may also impact survival. ⋯ The established prognostic factors that were compared had similar prognostic capacity in both cohorts. A high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer survival of patients with advanced cancer in the prospective European and Brazilian cohorts.