Journal of Pain and Symptom Management

Asmaa Janah, Anne-Déborah Bouhnik, Rajae Touzani, Marc-Karim Bendiane, Patrick Peretti-Watel
CONTEXT: Chronic pain (CP) is a major concern in cancer survivors. Often underreported by patients, it is both under-assessed and undertreated by care providers. OBJECTIVES: To assess CP prevalence and related treatment in cancer survivors five years after diagnosis; to identify factors associated with prescribing opioids among survivors with CP, focusing on access to palliative care (PC). METHODS: In 2015-2016, we interviewed 4,174 French patients diagnosed with cancer five years previously...
November 8, 2019: Journal of Pain and Symptom Management
Megan M Streur, Elaine A Thompson, Cynthia M Dougherty
CONTEXT: Patients with implantable cardioverter defibrillators (ICD) are at risk for multiple physical and psychological symptoms. Identification of specific symptom profiles associated with poor outcomes may elucidate novel strategies to enhance symptom management. OBJECTIVES: The objectives were to determine common symptoms following initial ICD implant, identify classes of individuals with similar symptom profiles, describe patient characteristics associated with different symptom profiles, and determine if symptom profiles at hospital discharge predicted outcomes 3 and 12 months post-implant...
November 7, 2019: Journal of Pain and Symptom Management
Slavica Kochovska, Chao Huang, Miriam J Johnson, Meera Agar, Marie Fallon, Stein Kaasa, Jamilla A Hussain, Russell K Portenoy, Irene J Higginson, David C Currow
INTRODUCTION: Minimising bias in randomised controlled trials (RCTs) includes intention-to-treat (ITT) analyses. Hospice/palliative care RCTs are constrained by high attrition unpredictable when consenting, including withdrawals between randomisation and first exposure to the intervention. Such withdrawals may systematically bias findings away from the new intervention being evaluated if they are considered non-responders. This study aimed to quantify this impact within ITT principles...
November 7, 2019: Journal of Pain and Symptom Management
Komal Singh, Steven M Paul, Kord M Kober, Yvette P Conley, Fay Wright, Jon D Levine, Paule V Joseph, Christine Miaskowski
BACKGROUND: While chemotherapy-induced vomiting is well-controlled with evidenced-based anti-emetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem. OBJECTIVES: Study purposes, in a sample of outpatients with breast, gastrointestinal (GI), gynecological (GYN), or lung cancer who received two cycles of chemotherapy (CTX, n=1251), were to evaluate for inter-individual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN...
November 2, 2019: Journal of Pain and Symptom Management
Sheri Mila Gerson, Nancy Preston, Amanda Bingley
CONTEXT: Many jurisdictions around the world have passed medical aid in dying laws allowing competent, eligible individuals facing life-limiting illness to self-administer prescribed medication to control timing of death. These laws do not prevent some patients who are receiving hospice services from dying by suicide without assistance. OBJECTIVES: To explore hospice professionals' experiences of patients who die by suicide or intentionally hasten death with or without legal assistance in an area where there is legalized medical aid in dying...
October 31, 2019: Journal of Pain and Symptom Management
Amanda Moale, Melissa L Teply, Tiange Liu, Arun L Singh, Pragyashree Sharma Basyal, Alison E Turnbull
CONTEXT: Conflict is frequently reported by both clinicians and surrogate decision-makers for adult patients in intensive care units (ICUs). Since religious clinicians view religion as an important dimension of end-of-life care, we hypothesized that religious critical care attendings (intensivists) would be more comfortable and perceive less conflict when discussing a patient's critical illness with a religious surrogate (12). OBJECTIVES: To assess if religious intensivists are more or less likely to perceive conflict during a simulated family meeting than secular colleagues...
October 31, 2019: Journal of Pain and Symptom Management
Sophie Pask, Myriam Dell'Olio, Fliss E M Murtagh, Jason W Boland
CONTEXT: Opioids are prescribed to manage moderate to severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment. OBJECTIVE: To identify, appraise and synthesise evidence on i) the impact of opioids on cognition in older adults with cancer/chronic non-cancer pain, and ii) screening tools/neuropsychological assessments used to detect opioid-induced cognitive impairment. METHODS: A systematic literature review following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PROSPERO Registration CRD42018092943)...
October 31, 2019: Journal of Pain and Symptom Management
Milagros D Silva, Stephanie Tsai, Rosanna M Sobota, Brittany T Abel, M Carrington Reid, Ronald D Adelman
CONTEXT: Research has shown that utilizing medical interpreters in language discordant patient-provider encounters improves outcomes. There is limited research evaluating the views of medical interpreters on best interpreter practices when they are utilized to break bad news or participate in end of life conversations. OBJECTIVES: To (1) develop insights from medical interpreters about their role when interpreting discussions regarding end of life issues, (2) identify practices interpreters perceive as helping to improve or hinder patient-provider communication, and (3) obtain suggestions on how to improve communication during end of life conversations with Spanish and Chinese speaking patients...
October 25, 2019: Journal of Pain and Symptom Management
Yichen Xu, Xin Shelley Wang, Yanzhi Chen, Qiuling Shi, Tsun Hsuan Chen, Pingping Li
BACKGROUND: Based on the traditional Chinese medicine (TCM) theory, Renshen Yangrong Tang (RSYRT), which mixed with 12 herbs, commonly used as a pharmacological option in China for fatigue management by correcting Qi deficiency. This randomized controlled phase II trial investigated the efficacy of RSYRT for reducing cancer-related fatigue. METHODS: Cancer survivors with moderate or severe fatigue (rated ≥4 on a 0-10 scale) over 2 months were randomized to take herbal extract granules of RSYRT or a low dose of a single herb (huangqi) twice a day for 6 weeks...
October 24, 2019: Journal of Pain and Symptom Management
Bertrand Pourroy, Christophe Curti, Edouard Lamy, Jauhel N'Gbesso, Innocent Krasse, Patrice Vanelle
No abstract text is available yet for this article.
October 24, 2019: Journal of Pain and Symptom Management
Nneka N Ufere, Jennifer L Halford, Joshua Caldwell, Min Young Jang, Sunil Bhatt, John Donlan, Janet Ho, Vicki Jackson, Raymond T Chung, Areej El-Jawahri
CONTEXT: Patients with decompensated cirrhosis have high rates of healthcare utilization at end-of-life (EOL). However, the impact of transplant candidacy on intensity of EOL care is currently unknown. OBJECTIVES: To assess the relationship between transplant candidacy and intensity of EOL care in the last year of life in an ambulatory cohort of patients with decompensated cirrhosis. METHODS: We performed a retrospective analysis of 230 patients with decompensated cirrhosis who were evaluated for liver transplantation in a large healthcare system between 1/1/2010 and 12/31/2017 and died by 6/20/2018...
October 23, 2019: Journal of Pain and Symptom Management
Alan R Roth, Angelo Canedo, Raisa Balabanova, Vandana Chauhan
BACKGROUND: A multi-level quality improvement program was implemented at an urban community hospital, serving a racially and ethnically pluralistic patient population, in order to increase participation in advance care planning (ACP). MEASURES: Number of eligible patients who completed an advance care planning form. INTERVENTION: Projects were implemented over the course of two years that targeted patients, health care providers, the organization, and the community...
October 23, 2019: Journal of Pain and Symptom Management
Jesús Díez-Manglano, Soledad Isasi de Isasmendi Pérez, Rosa García Fenoll, Luis Ángel Sánchez, Françesc Formiga, Vicente Giner Galvañ, Carlos Dueñas, Bernardino Roca Villanueva, Cristina Estrada Díaz, Emilio Casariego Vales
CONTEXT: Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE: To describe the use of palliative sedation in patients who die in internal medicine departments. METHODS: An observational, cross-sectional, retrospective and multicenter, clinical audit study was conducted in 145 hospitals in Spain and Argentina. Each hospital included the first 10 patients who died in the internal medicine department, starting on December 1, 2015...
October 23, 2019: Journal of Pain and Symptom Management
Diana H Ferreira, Sandra Louw, Philip McCloud, Belinda Fazekas, Christine F McDonald, Meera Agar, Katherine Clark, Nikki McCaffrey, Magnus Ekström, David C Currow
CONTEXT: Chronic breathlessness is a clinical syndrome that results in significant distress and disability. Morphine can reduce chronic breathlessness when the contributing aetiologies are optimally treated. OBJECTIVE: Does oxycodone reduce chronic breathlessness compared with placebo? METHODS: A multi-site, randomised, placebo-controlled, double-blind, parallel-arm, fixed-dose trial of oral controlled-release oxycodone 15mg (5 mg 8 hourly) or placebo (ACTRN12609000806268 at www...
October 23, 2019: Journal of Pain and Symptom Management
Marie T Williams, Hayley Lewthwaite, Dina Brooks, Dennis Jensen, Sara J Abdallah, Kylie N Johnston
CONTEXT: Explanations provided by health professionals may underpin helpful or harmful symptom beliefs and expectations of people living with chronic breathlessness. OBJECTIVES: This study sought perspectives from health professionals with clinical/research expertise in chronic breathlessness on priority issues in chronic breathlessness explanations and research. METHODS: Authors (n=74) of publications specific to chronic breathlessness were invited to a three-round Delphi survey...
October 23, 2019: Journal of Pain and Symptom Management
Helene L Elliott-Button, Miriam J Johnson, Ugochinyere Nwulu, Joseph Clark
CONTEXT: Breathlessness is common in chronic conditions but often goes unidentified by clinicians. It is important to understand how identification and assessment of breathlessness occurs across healthcare settings, to promote routine outcome assessment and access to treatment OBJECTIVE: To summarise how breathlessness is identified and assessed in adults with chronic conditions across different healthcare settings. METHODS: This is a systematic review and descriptive narrative synthesis (PROSPERO registration: CRD42018089782)...
October 23, 2019: Journal of Pain and Symptom Management
David C Currow, Sungwon Chang, Helen K Reddel, Slavica Kochovska, Diana Ferreira, Irina Kinchin, Miriam Johnson, Magnus Ekström
INTRODUCTION: Breathlessness is associated with depression, but its relationship to anxiety or impaired function are less clear. OBJECTIVES: This study evaluated associations between chronic breathlessness and: anxiety; depression; functional status in the general population. METHODS: This cross sectional study of consenting adults (≥18 years) used an online survey. Quota sampling (n=3,000) was employed reflecting the 2016 national census for sex, age and place of residence...
October 22, 2019: Journal of Pain and Symptom Management
Mika Miyashita, Naoko Tsukamoto, Michiyo Hashimoto, Kohei Kajiwara, Jun Kako, Hitoshi Okamura
CONTEXT: Cancer therapy-induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests. OBJECTIVES: This study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer. METHODS: The FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy...
October 22, 2019: Journal of Pain and Symptom Management
Mohammed Al Maqbali, Ciara Hughes, Jackie Gracey, Jane Rankin, Eileen Hacker, Lynn Dunwoody
BACKGROUND: The Functional Assessment of Chronic Illness Therapy (FACIT) is a measurement system that was developed to assess the health-related quality of life among patients with cancer and other chronic illnesses. The Functional Assessment of Chronic Illness Therapy- Fatigue (FACIT-F) is a 40-item questionnaire, and it is the one of most frequently used instrument to assess fatigue in cancer populations. The aim of the study is to evaluate the psychometric properties of the Arabic FACIT-F among patients diagnosed with cancer...
October 21, 2019: Journal of Pain and Symptom Management
Laure Dombrecht, Veerle Piette, Luc Deliens, Filip Cools, Kenneth Chambaere, Linde Goossens, Gunnar Naulaers, Luc Cornette, Kim Beernaert, Joachim Cohen
CONTEXT: Making end-of-life decisions in neonates involves ethically difficult and distressing dilemmas for healthcare providers. Insight into which factors complicate or facilitate this decision-making process could be a necessary first step in formulating recommendations to aid future practice. OBJECTIVES: This study aimed to identify barriers to and facilitators of the end-of-life decision-making process as perceived by neonatologists and nurses. METHODS: We conducted semi-structured face-to-face interviews with 15 neonatologists and 15 neonatal nurses, recruited through four neonatal intensive care units in Flanders, Belgium...
October 19, 2019: Journal of Pain and Symptom Management
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