Journal of palliative medicine
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A year ago, we began a project designed to align public messages from 10 organizations involved in advance care planning (ACP), palliative care (PC), and hospice to increase public engagement. By public messaging, we are referring to a well-established evidence-driven method of disseminating information at scale that enables the public to take action to protect their health. Our project plan was upended by the coronavirus disease 2019 (COVID-19) pandemic-but we used the opportunity to conduct focus groups during the pandemic that, compared with focus groups conducted before the pandemic, provide an important portrait of public perceptions of serious illness care that can be used to design for greater public engagement. ⋯ Despite these findings, our focus group participants strongly endorsed five messaging principles (1) talk up the benefits, (2) present choices for every step, (3) use stories that are positive and aspirational, (4) invite dialogue-more than once, and (5) invoke a new team-of people who matter, clinicians, medical institutions, and community organizations who are ready to help. After listening to 100-word stories describing real patient experiences with ACP, PC, and hospice, our focus group participants expressed interest and appreciation. But to improve public engagement broadly, we need to explain our work to the general public in a way that makes them want to know more.
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Context: Treatment-induced mucositis commonly affects cancer patients, and ketamine oral rinse solution has shown efficacy for refractory pain. Although intranasal ketamine as systemic therapy has previously been studied, there are no reports on intranasal ketamine spray for topical pain treatment. Objective: To present the novel use of atomized intravenous ketamine solution for topical treatment of sinonasal mucositis pain. ⋯ Conclusion: Atomized ketamine solution delivered intranasally may be a safe and effective topical treatment for mucositis pain of the sinuses. Interpretation of safety of the initial dosing used was affected by several confounding factors. However, a reduced dose appeared efficacious and was well tolerated.
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Randomized Controlled Trial
A Palliative Care Intervention for Patients on Phase 1 Studies.
Background: Phase 1 clinical trials remain vital for oncology care. Patients on these trials require supportive care for quality-of-life (QOL) concerns. Objective: To test a Palliative Care Intervention (PCI) for patients with solid tumors enrolled in Phase I therapeutic trials with a priori hypothesis that psychological distress, QOL, satisfaction, symptoms, and resource utilization would be improved in the PCI group. ⋯ Conclusions: A nurse-delivered PCI can improve some QOL outcomes and distress for patients participating in Phase 1 trials. Greater integration of PC is needed to provide quality care to these patients and to support transitions from treatment to supportive care, especially at the end of life. ClinicalTrials.gov Identifier: NCT01612598.
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Meta Analysis
Effect of Exercise on Fatigue in Patients with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Trials.
Background: Fatigue is a frequent debilitating symptom among patients with lung cancer. The effect of exercise on fatigue remains to be quantified. Objective: This review aimed to examine the effect of exercise on fatigue by synthesizing findings from randomized controlled trials (RCTs). ⋯ Exercise also improved depressive symptoms, anxiety, and quality of life; however, its impact on functional capacity was not significant. More clinical trials are warranted to explore the mechanisms underlying the impact of exercise on fatigue. Strategies improving adherence to exercise prescription should be developed to help these patients overcome potential challenges.