Journal of palliative medicine
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Radiation Oncology Program Directors' Attitudes Toward Twenty-Seven Discrete Palliative Care Skills.
Background: We evaluated radiation oncology residency program directors' attitudes toward discrete palliative care skills in effort to determine which skills should be prioritized in radiation oncology resident training. Design: We identified 93 U. S. radiation oncology residency program directors and sent them a survey through e-mail. ⋯ Results: Twenty-nine program directors (response rate 31%) completed the survey. Of the 27 skills, 100% were rated as highly important to high-quality cancer care, 70% were rated as highly relevant to radiation oncology practice, and 81% were rated as highly important to resident education (median score ≥7). Using the composite score, 70% of skills were categorized as "Include." The domains of Caregiver Support (100%), End-of-Life Care (66%), and Spiritual/Cultural Assessment and Management (33%) had the highest proportions of skills rated as "Uncertain." Conclusions: The surveyed radiation oncology residency program directors generally value palliative care skills within radiation oncology.
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Buprenorphine (BUP) can be a safe and effective alternative to traditional opioids for many patients with chronic pain. For patients on higher doses of opioids, rotation to BUP is complicated by the requirement of an opioid-free interval or withdrawal during the transition. Microdosing inductions, in which BUP is gradually titrated, while full agonist opioids are continued, are a viable alternative to traditional inductions. ⋯ Beyond the products used, the speed of the microinduction, setting, final BUP dosing, and management of concomitant full agonists vary widely in the literature. Microdosing regimens should be individualized based on local guidelines and patient-specific factors. Further studies comparing the safety and efficacy of different protocols are warranted.
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Randomized Controlled Trial
Meaning-Centered Pain Coping Skills Training: A Pilot Feasibility Trial of a Psychosocial Pain Management Intervention for Patients with Advanced Cancer.
Background: Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. Objective: To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Training (MCPC). Design: This trial used a single-arm feasibility design. ⋯ Conclusions: MCPC demonstrated strong feasibility and acceptability. Findings warrant further evaluation of MCPC in a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03207360.