Articles: palliative-care.
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Randomized Controlled Trial
Symptom Assessment in Patients with Advanced Cancer: Are the Most Severe Symptoms the Most Bothersome?
Objective: We investigated correspondence between symptom severity and symptom bothersomeness in patients with advanced cancer. Background: Symptom severity is commonly assessed in clinical cancer settings, but bothersomeness of these symptoms is less often measured. Methods: Participants with advanced cancer enrolled in a cluster-randomized trial of early palliative care completed the Edmonton Symptom Assessment System (ESAS) and the quality of life at the end of life (QUAL-E) measure as part of their baseline assessment. For each symptom, we examined the correspondence between the symptom being indicated as most severe on the ESAS and rated as most bothersome on the QUAL-E. Results: For the 386 patients who completed relevant sections of the ESAS and QUAL-E, tiredness (32.8%), sleep (23.8%), and appetite (20.2%) were most frequently rated as most severe, whereas pain (28.9%) and tiredness (24.3%) were most frequently indicated as most bothersome. ⋯ The probability that patients rating a symptom as most severe would also rate it as most bothersome was highest for pain (66%), nausea (58%), and tiredness (40%). Discussion: ESAS symptom severity does not necessarily indicate patients' most bothersome symptom; regardless of severity, pain and tiredness are most frequently perceived as most bothersome. Further research should investigate the clinical benefits of patients also indicating their three most bothersome ESAS symptoms.
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Critical care nurse · Oct 2019
Randomized Controlled TrialPalliation of Thirst in Intensive Care Unit Patients: Translating Research Into Practice.
Thirst is prevalent among patients in intensive care units. A research-based "thirst bundle" was shown to significantly decrease thirst in these patients. ⋯ The palliative "thirst bundle" significantly alleviated patients' thirst and resulted in little caregiver burden. Further efforts are warranted to incorporate this intervention into intensive care unit practice.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled Trial Multicenter StudyToward Understanding the Relationship between Prioritized Values and Preferences for Cardiopulmonary Resuscitation Among Seriously Ill Adults.
Prioritizing among potentially conflicting end-of-life values may help patients discriminate among treatments and allow clinicians to align treatments with values. ⋯ Clinicians face challenges as they clarify patient values and align treatments with values. Patients' values predicted CPR preferences, but a substantial proportion of patients expressed CPR preferences that appeared potentially inconsistent with their primary value. Clinicians should question assumptions about relationships between values and CPR preferences. Further research is needed to identify ways to use values to guide treatment decisions.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialCOMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients with End Stage Liver Disease.
Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. ⋯ Logistical obstacles hindered completion of the trial as originally designed. Nevertheless, a preemptive palliative care intervention resulted in increased time to first readmission and more days alive outside the hospital in the first six months after study entry.
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Support Care Cancer · Sep 2019
Randomized Controlled TrialA new model of early, integrated palliative care: palliative rehabilitation for newly diagnosed patients with non-resectable cancer.
The aim of this paper is to describe a model of palliative rehabilitation for newly diagnosed advanced cancer patients and present data on how it was utilised during a randomised controlled trial (RCT). ⋯ The new model of palliative rehabilitation presented here had a flexibility to meet the needs of the participants and led to a very high degree of patient satisfaction. It could serve as an inspiration to other cancer centres wanting to integrate palliative care into standard oncology services.