Journal of palliative medicine
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Reports in the end-of-life literature reveal that patients and health care professionals, including social workers, nurses, and physicians, avoid discussions about preparation for such care. End-of-life care discussion barriers include, but are not limited to, professionals feeling unprepared to have the discussions and patients' lack of readiness to discuss planning for this care. ⋯ In a controlled trial of an Advanced Illness Coordinated Care Program, social workers initiated end-of-life planning discussions using the Stages of Change model (SOC). This article describes how the social workers introduced end-of-life planning discussions using the SOC conceptual structure to illustrate the application of a conceptual framework for professionals working with advanced illness populations.
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Approximately one half to two thirds of patients with cancer-related pain experience breakthrough pain (BTP) in their daily activities. ⋯ Patients with head and neck cancer do suffer a lot because of the high incidence of BTP (48%). The majority of patients suffering from BTP are not satisfied at all with the measures taken for their BTP. The majority of patients in India have head and neck cancer; we must approach this matter as a challenge and new technique and therapy should be introduced for the benefit of these patients.
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Randomized Controlled Trial
Effect of topical morphine (mouthwash) on oral pain due to chemotherapy- and/or radiotherapy-induced mucositis: a randomized double-blinded study.
The objective of the study was to determine if mouthwashes with a morphine-containing solution decrease oral pain associated with radiotherapy- and/or chemotherapy-induced oral mucositis (OM). ⋯ Our results suggest a possible analgesic effect of topical morphine in line with previous studies. However, more efforts must be made for the adjustment of systemic analgesics and the development of new alternatives to treat locally OM-associated pain.
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A comprehensive whole-person approach might improve processes and outcomes of care for patients with cancer. ⋯ The NEST13+ tool facilitated identification of a wider range of important needs than traditional evaluation, while care outcomes were not improved. Traditional evaluation may need improvement. Future trials of the NEST13+ should focus on more intensive clinician-directed interventions.
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Case Reports
The malignant psoas syndrome revisited: case report, mechanisms, and current therapeutic options.
The malignant psoas syndrome (MPS) is a rare and challenging cancer pain state that is often refractory to rational polymodal analgesic therapy. We describe the first case of cervix cancer-related MPS due to extrinsic psoas muscle infiltration and review the therapeutic trajectory and outcome. The anatomic determinants, pain mechanisms, and current and proposed novel treatment strategies for MPS are discussed.