Journal of palliative medicine
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Randomized Controlled Trial Multicenter Study
An Advanced Practice Nurse Coordinated Multidisciplinary Intervention for Patients with Late-Stage Cancer: A Cluster Randomized Trial.
Early palliative care provided through a palliative care consultative service is effective in enhancing patient outcomes. However, it is unknown whether the integration of palliative care as part of routine comprehensive cancer care improves patients' self-reported clinical outcomes. ⋯ In this translational study, we demonstrated that if patients newly diagnosed with late-stage cancer were managed by disease-specific multidisciplinary teams who palliated their symptoms, providing whole-patient care, patient outcomes remained stable or improved.
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Randomized Controlled Trial Multicenter Study
Fixed-Dose Subcutaneous Methylnaltrexone in Patients with Advanced Illness and Opioid-Induced Constipation: Results of a Randomized, Placebo-Controlled Study and Open-Label Extension.
Subcutaneous methylnaltrexone (MNTX), dosed based on body weight, is efficacious and well tolerated in inducing bowel movements in patients with advanced illness and opioid-induced constipation (OIC); however, fixed-dose administration of MNTX may improve ease of administration. ⋯ Fixed-dose MNTX administered QOD in the RCT and PRN in the OLE study demonstrated robust efficacy and was well tolerated in treating OIC in patients with advanced illness.
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Randomized Controlled Trial
Communication intervention in the neonatal intensive care unit: can it backfire?
For parents of a critically ill infant, good communication may help alleviate stress and anxiety. To improve communication, physicians must be responsive to families' needs and values surrounding the care of their hospitalized infant. ⋯ In this pilot study, we found that families in the intervention group were less satisfied with communication. Families who are primed to expect better communication, such as those participating in a communication intervention, may be less satisfied with standard care.
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Randomized Controlled Trial Comparative Study
Inpatient palliative care for patients with acute heart failure: outcomes from a randomized trial.
Heart failure (HF) is associated with a high symptom burden and reduced quality of life (QOL). Models integrating palliative care (PC) into HF care have been proposed, but limited research is available on the outcomes of such models. ⋯ An inpatient PC model for patients with acute HF is associated with short-term improvement in symptom burden, QOL, and depressive symptoms.
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Randomized Controlled Trial
Nurse education program on meaninglessness in terminally ill cancer patients: a randomized controlled study of a novel two-day workshop.
Fostering patients' sense of meaning is an essential task for palliative care clinicians. Few studies have reported the effects on nurses of a short-term training program aimed at improving skills to relieve feelings of meaninglessness in terminally ill cancer patients. ⋯ This short-term educational intervention had a significant beneficial effect on nurses' confidence and modest effects on attitudes.