European journal of oncology nursing : the official journal of European Oncology Nursing Society
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Hospice cancer patients experience poorly-controlled pain in spite of widely-disseminated evidence-based guidelines for use by hospice care practitioners. Pain management occurs in the context of the interdisciplinary team, centered on a caring triad in the home: the person with pain, their caregiver, and their nurse. This review: 1) Summarizes what is known about differing ways that members of the hospice caring triad (patients, caregivers, and nurses) interpret and respond to cancer pain, in order to develop a cancer pain social processes theoretical framework, 2) Identifies gaps in understanding of hospice cancer pain social processes, and 3) Identifies framework concepts for research-based clinical practice with potential to improve pain outcomes. ⋯ To our knowledge, no single study has generated a framework for hospice cancer pain social processes addressing and incorporating the roles of all three caring triad members. Therefore, comprehensive hospice cancer pain clinical evaluation and interventions plans may be missing key elements of pain management, especially for persons with ongoing poorly controlled pain.
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To analyse the psychometric properties and performance of existing instruments that aim to measure benefit finding in adult cancer populations. ⋯ One instrument reported validation statistics for all the identified criteria. While existing instruments provide a range of operationalisations of the benefit finding concept and have been more or less used in previous research, a majority are in the early stages of development and require further validation work in adult cancer populations. Given the increasing interest in the role benefit finding in clinical practice, researchers are urged to use these instruments further and to report relevant validation statistics when using them.
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The overall aim of the project was to update and inform nurses of current best practice based on previously published literature to enable nurses to assess and manage breakthrough cancer pain (BTCP) and thereby to provide optimal management of BTCP. ⋯ By implementing the EONS guidelines nurses will utilise the latest available knowledge in clinical practice and the understanding and management of BTCP will improve assessment and overall management of breakthrough pain in cancer patients.
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This narrative literature review uses systematic principles to define evidence regarding dignity conserving care at end-of-life from published research on dignity or distress in end-of-life care. ⋯ Evidence for supporting palliative care services has previously been found to be weak in determining solutions to meet individual's important needs. Drawing together primary research, as in this study, is therefore of importance. The suggested care actions will be used to develop a dignity care pathway for end-of-life care, which is currently being evaluated by the authors. The intention is to provide more valid evidence for the effectiveness of the care actions suggested.
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Breathlessness in patients with advanced cancer is common. It remains a difficult symptom to improve despite recent advances in cancer treatment and the increasing evidence available. Patients and carers experience a high level of distress from this frightening symptom. There is a greater volume of evidence to guide the management of breathlessness accompanying advanced non-malignant disease, as opposed to malignant disease, as most research has been conducted in this group. This article reviews the management of breathlessness in patients with cancer. ⋯ The cause of breathlessness in advanced cancer patients is usually multifactorial. A combination of pharmacological with non-pharmacological approaches is essential to manage breathlessness. Breathlessness services (e.g. Breathlessness Intervention Service) can be considered to be innovative and effective models of care when provided as part of a network of services aimed at helping patients with advanced cardiorespiratory disease, including patients with advanced cancer.