Journal of palliative medicine
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Instructional advance directives (ADs) are traditionally written to apply in terminal illness. As such, they do not readily capture patient preferences for care in acute and chronic illness. ⋯ Traditional instructional ADs fail to capture important patient preferences. Future research should further validate these preferences and explore whether including these specific options in ADs can improve their efficacy.
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Comparative Study
Symptom clusters in patients with cancer with metastatic bone pain.
The primary objective was to explore how patients' worst pain clustered together with functional interference items. Secondary objectives were to determine whether symptom clusters change with palliative radiotherapy (RT) and to compare the difference between responders and nonresponders to radiation. ⋯ Symptom clustering has proved to be therapeutically important because treatment of one symptom may affect others within the same cluster. The significant correlations between worst pain and the functional interference items reaffirm the importance of pain reduction as a treatment goal for palliative radiotherapy. By treating a patient's symptom of worst pain, it would subsequently ease their response burden on their daily functional activities by decreasing symptom severity, increasing function, and improving overall quality of life.
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Review Meta Analysis Comparative Study
Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine: a meta-analysis and systematic review of the literature.
To assess the adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison with slow release oral morphine. ⋯ Although no difference in the overall adverse effect profile exists between transdermal opiates and slow release oral morphine, the difference in some adverse effects (mainly constipation) seems to favor transdermal opiates in the preference of patients with moderate-severe cancer pain.
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To determine what questions family caregivers want to discuss with health care providers (HCPs) in order to prepare for the death of a loved one. ⋯ Family caregivers of patients with terminal illness need more than prognostic information in order to prepare for the death. HCPs should be aware that caregivers may not ask important questions and that unanswered questions may contribute to caregiver distress. Awareness of caregivers' questions can help HCPs improve the care provided to caregivers by better preparing them for the death of their loved one.