Journal of pain and symptom management
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Cough is a distressing and disabling symptom in cancer patients. Based on an understanding of the physiology of the cough reflex and the pathophysiology of cough in cancer patients, a systematic approach to the management of this symptom is presented.
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J Pain Symptom Manage · Apr 1991
Clinical TrialInitial clinical experience with the SKY epidural catheter.
The new SKY epidural catheter was evaluated, based upon information collected about implant and use of 53 catheters by 51 patients. Catheters were used to treat chronic pain of a malignant (n = 25) and nonmalignant (n = 28) origin. Of 3450 treatment days, 89% occurred at home. ⋯ No subarachnoid or epidural infections occurred. The SKY catheter proved to be safe and reliable. Therapy was cost-effective, since patients achieved substantial pain relief while treated at home.
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Undertreatment of cancer pain is widely recognized. This study sought to determine if inadequate communication about pain intensity between health care providers and their patients could represent a significant factor interfering with the control of cancer pain. One hundred and three consecutive patients with solid tumors and normal mental status examinations were screened within 48 hr during two study periods. ⋯ Improved correspondence was noted with lower patient VAS scores. This study demonstrates that health care provider impressions of patient pain are often quite different than those of the patient and that these discrepancies are most pronounced in patients with significant pain. The routine use of pain assessment tools, such as the VAS, could enhance patient-caregiver communication and improve care for patients with cancer pain.
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The present study examined the psychometric properties of the Daily Sleep Diary (DSD), an instrument developed for monitoring sleep among chronic pain patients. As part of a comprehensive evaluation, 46 chronic pain patients completed the DSD each morning. Items assessed the number of hours slept, length of sleep onset, frequency of awakenings during the night that resulted in trouble falling back to sleep, early morning awakening, quality of sleep, lack of restfulness, and the previous night's sleep compared to usual sleep. ⋯ Pain severity was related to fewer hours slept and delayed sleep onset. The DSD items correlated with measures of both depression and anxiety. The results emphasize the importance of including sleep in both assessment and treatment of chronic pain patients.