Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2022
Randomized Controlled Trial Multicenter StudySeriously ill patients' prioritized goals and their clinicians' perceptions of those goals.
Seriously ill patients whose prioritized healthcare goals are understood by their clinicians are likely better positioned to receive goal-concordant care. ⋯ A majority of seriously ill outpatients are cared for by clinicians who accurately perceive their patients' prioritized healthcare goals. However, a substantial portion are not and may be at higher risk for goal-discordant care. Interventions that facilitate goals-of-care discussions may help align care with goals, as recent discussions were associated with accurate perceptions of patients' prioritized goals.
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J Pain Symptom Manage · Sep 2022
Randomized Controlled Trial Multicenter StudyHeterogeneity of treatment effect in a randomized trial of a communication intervention.
Interventions to promote serious illness conversations have shown promise in promoting high-quality care. However, in randomized trials, some participants may benefit more from the intervention than others. ⋯ Identifying heterogeneity of treatment effect can be a valuable exercise following completion of a randomized trial. Interactions between the intervention and patient income and self-assessed health suggest these factors could be used to design more effective interventions to enhance communication about goals of care.
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J Pain Symptom Manage · Sep 2022
Randomized Controlled TrialTranscranial Direct Current Stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial.
Chronic pain in end-stage renal disease (ESRD) is an increasingly neglected clinical problem affecting more than 60% of patients. Long-term chronic pain could be associated with brain imbalance in circuits of pain matrix and is associated with poor quality of life (QoL) and mood disturbance. ⋯ Anodal tDCS over the motor cortex emerges as a potential therapeutic approach for improving pain, QoL, and mood in patients with ESRD.
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J Pain Symptom Manage · Apr 2022
Randomized Controlled TrialExploring the Feasibility of a Mindfulness-Music Therapy Intervention to Improve Anxiety and Stress in Adolescents and Young Adults with Cancer.
Adolescent and young adults (AYAs) with cancer experience significant psychological distress due to cancer treatment that can persist long after treatment. However, little is known regarding optimal interventions to support the psychosocial needs of AYAs with cancer. ⋯ The delivery of a four-session mindfulness-based music therapy intervention to AYAs receiving chemotherapy was feasible and significantly improved perceived stress. These preliminary findings should be confirmed in a randomized controlled trial.
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J Pain Symptom Manage · Apr 2022
Randomized Controlled TrialClinical decision support for symptom management in lung cancer patients: A group RCT.
Clinical guidelines are available to enhance symptom management during cancer treatment but often are not used in the practice setting. Clinical decision support can facilitate the implementation and adherence to clinical guidelines. and improve the quality of cancer care. ⋯ SAMI improved clinical management for all target symptoms but did not improve patient outcomes. A larger study is warranted to evaluate effectiveness.