Journal of palliative medicine
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Comparative Study
A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer.
Constipation is a common and distressing condition in patients with cancer, especially those taking opioid analgesics. Many institutions prevent and treat constipation with titrated laxatives, which is known as a bowel protocol. An effective and well-tolerated bowel protocol is a very important component of cancer care, and there is little evidence on which to base selection of the most appropriate agents. This study compares a protocol of the stimulant laxative sennosides alone with a protocol of sennosides plus the stool softener docusate, in hospitalized patients at an oncology center. The docusate-containing protocol had an initial docusate-only step for patients not taking opioids, and four to six 100-mg capsules of docusate sodium in addition to the sennosides for the rest of the protocol. ⋯ The addition of the initial docusate-only step and adding docusate 400-600 mg/d to the sennosides did not reduce bowel cramps, and was less effective in inducing laxation than the sennosides-only protocol. Further research into the appropriate use of docusate and into the details of bowel protocol design are required.
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Amyotrophic lateral sclerosis (ALS) is well recognized as a terminal illness with an established need for palliative care. Parkinson's disease is a substantially more common cause of death, yet little has been written about the palliative needs of these patients at the end of life. To highlight the palliative care needs and experiences of patients with Parkinson's disease and related disorders (PDRD), we compared them to patients with ALS. ⋯ In the views of caregivers, suffering associated with ALS is no more severe than suffering associated with PDRD, and both groups appear to have unmet palliative care needs in the last months of life. Studies to define hospice readiness and special needs in hospice might improve end-of-life care for PDRD patients.
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Randomized Controlled Trial Clinical Trial
The effect of music therapy on anxiety in patients who are terminally ill.
The literature supporting the use of music therapy in palliative care is growing. However, the number of quantitative research studies investigating the use of music therapy in palliative care, and specifically anxiety, is limited. ⋯ The study supports the use of music therapy to manage anxiety in terminally ill patients. Further studies are required to examine the effect of music therapy over a longer time period, as well as addressing other symptom issues.
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McGill Quality of Life Questionnaire (MQOL) is an instrument specifically designed to evaluate quality of life (QOL) in patients with advanced diseases. The primary objective of this study was to translate this questionnaire into Persian and assess its reliability and validity in Iranian patients suffering from an advanced cancer. The report also includes the correlations between patients' characteristics and their QOL scores. ⋯ The Persian version of MQOL is, for the most part, a valid, reliable instrument in this setting. Because of cultural differences, the existential subscale may require adaptation. Further studies are needed to explore other aspects of QOL in Iranian patients with cancer.