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
"It's Not Us Versus Them": Building Cross-Disciplinary Relationships in the Perioperative Period.
Palliative care (PC) interventions improve quality outcomes for surgical patients, yet they are underutilized in the perioperative period. Developing cross-disciplinary provider relationships increases PC consults. However, the attributes of collaborative relationships and how they evolve are unclear. ⋯ The study informs future interventions to improve the quality of care for seriously ill patients by better-involving PC in the perioperative period. Future work will extend this approach to incorporate the perspectives of patients on their providers' collaboration and how it impacts patient-related outcomes at the intersection of PC and surgery.
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J Pain Symptom Manage · Apr 2023
High Flow Nasal Cannula in patients with cancer at the end of life.
High flow nasal cannula (HFNC) is frequently used to manage dyspnea in patients with cancer near the end of life. Because HFNC is restricted to the in-patient setting, patients on HFNC need to be liberated from it to be discharged from the hospital. ⋯ Only a minority of patients with cancer at the end of life can be liberated from HFNC, and only a minority are discharged alive. This information is important when discussing goals of care with patients and their families before initiating HFNC.
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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
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.