Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2023
Quality Indicators for Adolescents and Young Adults with Advanced Cancer: A Modified Delphi Process with Patients, Family Members, and Clinicians.
Quality measures have been devised for end-of-life care of older adults with cancer, but are lacking for adolescents and young adults (AYAs). ⋯ A patient- and family-centered process for quality indicator development led to strong endorsement of multiple potential indicators by Delphi participants. Further validation and refinement will be performed using a survey of bereaved family members.
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J Pain Symptom Manage · Jul 2023
Specialist palliative care referral practices among oncologists, cardiologists, respirologists: a comparison of national survey studies.
Although patients with nonmalignant diseases have palliative care needs similar to those of cancer patients, they are less likely to receive specialist palliative care (SPC). Referral practices of oncologists, cardiologists, and respirologists could provide insight into reasons for this difference. ⋯ For cardiologists and respirologists in 2018, perceived availability of SPC services was poorer, timing of referral later, and frequency of referral lower than among oncologists in 2010. Further research is needed to identify reasons for differences in referral practices and to develop interventions to overcome them.
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J Pain Symptom Manage · Jul 2023
Preoperative Code Status Discussion Workflows: Targets for Improvement in Multidisciplinary Pathways.
Discussion of perioperative code status is an important element of preoperative care and a component of the American College of Surgeons' Geriatric Surgery Verification (GSV) program. Evidence suggests code status discussions (CSDs) are not routinely performed and are inconsistently documented. ⋯ Process mapping highlighted challenges associated with the implementation of multidisciplinary care pathways and indicated a need for centralization and consolidation of perioperative code status documentation.
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J Pain Symptom Manage · Jul 2023
Randomized Controlled TrialTechnology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A randomized controlled trial.
Caregivers managing symptoms of family members with cancer during home hospice care, often feel ill-prepared and need patient care coaching. ⋯ Automated mHealth symptom reporting by caregivers, paired with tailored caregiver coaching on symptom management and nurse notifications, reduces cancer patients' physical and psychosocial symptoms during home hospice, providing a novel and efficient approach to improving end-of-life care.
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J Pain Symptom Manage · Jul 2023
Randomized Controlled TrialEffect of an Artificial Intelligence Decision Support Tool on Palliative Care Referral in Hospitalized Patients: A Randomized Clinical Trial.
Palliative care services are commonly provided to hospitalized patients, but accurately predicting who needs them remains a challenge. ⋯ A decision support tool integrated into palliative care practice and leveraging AI/ML demonstrated an increased palliative care consultation rate among hospitalized patients and reductions in hospitalizations.