Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2016
Randomized Controlled TrialTrajectories of Terminally Ill Patients' Cardiovascular Response to Receptive Music Therapy in Palliative Care.
Relaxation interventions are frequently used to promote symptom relief in palliative care settings, but little is known about the underlying mechanisms. ⋯ Higher levels of VM-HRV in the music therapy group highlight the importance of a therapeutic relationship for the effectiveness of relaxation interventions in end-of-life care settings. Music therapy caused significantly stronger reductions of vascular sympathetic tone and, therefore, may be indicated in the treatment of pain and stress-related symptoms in palliative care. Initial self-ratings of pain moderated patients' physiological response and need to be taken into account in clinical practice and future theory building.
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J Pain Symptom Manage · Jun 2016
Randomized Controlled Trial Multicenter StudySaw Palmetto for Symptom Management During Radiation Therapy for Prostate Cancer.
Lower urinary tract symptoms (LUTSs) affect 75%-80% of men undergoing radiation therapy (RT) for prostate cancer. ⋯ SP at 960 mg may be a safe herbal supplement, but its efficacy in managing LUTS during RT needs further investigation.
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J Pain Symptom Manage · May 2016
Randomized Controlled TrialEffects of a Short-Term Dance Movement Therapy Program on Symptoms and Stress in Patients with Breast Cancer Undergoing Radiotherapy: A Randomized, Controlled, Single-Blind Trial.
Integrated interventions with combined elements of body movement and psychotherapy on treatment-related symptoms in cancer patients are relatively scarce. ⋯ The short-term DMT program can counter the anticipated worsening of stress and pain in women with breast cancer during radiotherapy.
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J Pain Symptom Manage · May 2016
Randomized Controlled TrialMeasuring Depression-Severity in Critically-ill Patients' Families with the Patient Health Questionnaire (PHQ): Tests for Unidimensionality and Longitudinal Measurement Invariance, with Implications for CONSORT.
Families of intensive care unit patients are at risk for depression and are important targets for depression-reducing interventions. Multi-item scores for evaluating such interventions should meet criteria for unidimensionality and longitudinal measurement invariance. The Patient Health Questionnaire (PHQ), widely used for measuring depression severity, provides standard nine-, eight-, and two-item scores. However, published studies often report no (or weak) evidence of these scores' unidimensionality/invariance, and no tests have evaluated them as measures of depression severity in intensive care unit patients' families. ⋯ The longer eight- and nine-item PHQ scores appear inappropriate for assessing depression severity in this population, with constructs based on smaller subsets of items being more promising targets for future trials. The Consolidated Standards of Reporting Trials requirement for prespecified trial outcomes is problematic because unidimensionality/invariance testing must occur after trial completion. Consolidated Standards of Reporting Trials could be strengthened by endorsing rigorous assessment of composite scores and encouraging use of the most appropriate substitute, should trial-based evidence challenge the legitimacy of prespecified multi-item scores.
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J Pain Symptom Manage · Apr 2016
Randomized Controlled Trial Multicenter StudyHow Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?
Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. ⋯ The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment.