Articles: caregivers.
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J Pain Symptom Manage · Mar 2025
Clinician Perspectives Highlight the Need for Early Dyadic Coping Skills for People Living with Amyotrophic Lateral Sclerosis.
A diagnosis of ALS can be challenging, and many people find ways to adapt. At the same time, emotional distress can arise early after an ALS diagnosis even when high quality multidisciplinary care is provided. When emotional distress occurs, it can become chronic over time, and can affect both the person living with ALS and their care-partner (together called a dyad). ⋯ RT-ALS program content and structure is acceptable to clinicians. It is imperative to next seek further input from dyads about whether this type of program would be of interest and if yes, to pilot and refine the program for feasibility testing and then efficacy.
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Cochrane Db Syst Rev · Feb 2025
Review Meta AnalysisHome-based educational interventions for children with asthma.
Asthma is a chronic airway condition with a global prevalence of 262.4 million people. Asthma education is an essential component of management and includes provision of information on the disease process and self-management skills development such as trigger avoidance. Education may be provided in various settings. The home setting allows educators to reach populations (e.g. financially poor) that may experience barriers to care (e.g. transport limitations) within a familiar environment, and allows for avoidance of attendance at healthcare settings. However, it is unknown if education delivered in the home is superior to usual care or the same education delivered elsewhere. There are large variations in asthma education programmes (e.g. patient-specific content versus broad asthma education, number/frequency/duration of education sessions). This is an update of the 2011 review with 14 new studies added. ⋯ We found uncertain evidence for home-based asthma educational interventions compared to usual care, education delivered outside the home or a less-intensive educational intervention. Home-based education may improve quality of life compared to control and reduce the odds of hospitalisation compared to less-intensive educational intervention. Although asthma education is recommended in guidelines, the considerable diversity in the studies makes the evidence difficult to interpret about whether home-based education is superior to none, or education delivered in another setting. This review contributes limited information on the fundamental optimum content and setting for educational interventions in children. Further studies should use standard outcomes from this review and design trials to determine what components of an education programme are most important.
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J Pain Symptom Manage · Feb 2025
Patient-rated acceptability of automatic palliative care referral: a prospective cohort study.
Timely palliative care can alleviate distress after diagnosis of an incurable cancer. However, late referrals to palliative care continue, reflecting various provider and patient barriers. ⋯ These unsolicited phone calls offering SPC consultation were highly acceptable to patients/caregivers, and most agreed to the consultation. Implementing routine calls offering SPC consultation may be a timely alternative to awaiting conventional oncologist referral.
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J Pain Symptom Manage · Feb 2025
Barriers to Serious Illness Conversations Among Patients with Advanced Cancer: A Qualitative Study.
Serious illness conversations (SICs) are discussions between clinicians and cancer patients about illness understanding, information preferences, and goals of care. Interventions to prompt SICs increase SIC rates and improve care delivery near the end of life. This embedded substudy examined SIC barriers and facilitators among "refractory" patients without an SIC despite enrollment in an SIC clinical trial. ⋯ Patient readiness remains an important barrier even after targeted SIC interventions. Future SIC interventions should consider approaches tailored to patient communication preferences and interventions involving personal interactions.