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Journal of Pain and Symptom Management

Jacqueline K Yuen, Amy S Kelley, Laura P Gelfman, Elizabeth E Lindenberger, Cardinale B Smith, Robert M Arnold, Brook Calton, Jane Schell, Stephen H Berns
CONTEXT: High quality advance care planning (ACP) discussions are important to ensure patient receipt of goal-concordant care, however there is no existing tool for assessing ACP communication quality. OBJECTIVES: To develop and validate a novel instrument that can be used to assess ACP communication skills of clinicians and trainees. METHODS: We developed a 20-item ACP Communication Assessment Tool (ACP-CAT) plus two summative items. Randomized rater pairs assessed residents' performances in video-recorded standardized patient encounters before and after an ACP training program using the ACP-CAT...
September 11, 2019: Journal of Pain and Symptom Management
Monika Hagemann, Sofia Zambrano, Lukas Bütikofer, Antje Bergmann, Karen Voigt, Steffen Eychmüller
CONTEXT: Although the number of studies on the economic impact of palliative care (PC) is growing, the great majority report costs from North America. OBJECTIVES: We aimed to provide a comprehensive overview of PC hospital cost components from the perspective of a European mixed funded health care system by identifying cost drivers of PC and quantifying their effect on hospital costs compared to usual care (UC). METHODS: We performed a retrospective, observational analysis examining cost data from the last hospitalization of patients who died at a large academic hospital in Switzerland comparing patients receiving PC versus UC...
September 10, 2019: Journal of Pain and Symptom Management
Jegy M Tennison, Santhosshi Narayanan, Robin Cummings, Eduardo Bruera
No abstract text is available yet for this article.
September 5, 2019: Journal of Pain and Symptom Management
Joanna Veazey Brooks, Claire Poague, Taynara Formagini, Christian Sinclair, Heather V Nelson-Brantley
CONTEXT: Patients with cancer experience many symptoms that disrupt quality of life, and symptom communication and management can be challenging. The Edmonton Symptom Assessment System (ESAS) was developed to standardize assessment and documentation of symptoms, yet research is needed to understand patients' and caregivers' experiences using the tool and its ability to impact patient-provider aligned care. OBJECTIVES: To understand how the ESAS shapes communication between patients and providers by exploring patients' and caregivers' experiences using the ESAS and assessing the level of agreement in symptom assessment between patients and palliative care physicians...
September 5, 2019: Journal of Pain and Symptom Management
Sabine Valenta, Elisabeth Spichiger, Steven M Paul, Michael W Rabow, Vicki L Plano Clark, Karen L Schumacher, Christine Miaskowski
CONTEXT: While constipation is a common symptom in oncology patients, it often goes unrecognized and untreated. In addition, little is known about characteristics associated with inter-individual differences in constipation severity. OBJECTIVES: Describe prevalence, characteristics, and management of constipation; evaluate for inter-individual differences in constipation severity over ten weeks; and identify demographic, clinical, and symptom characteristics associated with higher constipation severity scores...
September 5, 2019: Journal of Pain and Symptom Management
(no author information available yet)
No abstract text is available yet for this article.
September 4, 2019: Journal of Pain and Symptom Management
Karleen Giannitrapani, Soraya Fereydooni, Azin Azarfar, Maria J Silveira, Peter A Glassman, Amanda Midboe, Amy Bohnert, Maria Zenoni, Robert D Kerns, Robert A Pearlman, Steven M Asch, William Becker, Karl A Lorenz
CONTEXT: Signature informed consent (SIC) is a part of a Veterans Health Administration (VHA) ethics initiative for patient education and shared decision-making with long-term opioid therapy (LTOT). Historically, patients with cancer-related pain receiving LTOT are exempt from this process. OBJECTIVES: Our objective is to understand patients' and providers' perspectives on using signature informed consent for LTOT in patients with cancer-related pain. METHODS: Semi-structured interviews with 20 opioid prescribers and 20 patients who were prescribed opioids at two large academically-affiliated VHA Medical Centers...
August 30, 2019: Journal of Pain and Symptom Management
Kavita V Dharmarajan, Chasity B Walters, Tomer T Levin, Carol Ann Milazzo, Christopher Monether, Robin Rawlins-Duell, Roma Tickoo, Daniel E Spratt, Shona Lovie, Gina Giannantoni-Ibelli, Beryl McCormick
CONTEXT: Advanced cancer patients have unrecognized gaps in their understanding about palliative radiation therapy (PRT). OBJECTIVES: To build a video decision aid for hospitalized patients with advanced cancer referred for PRT and prospectively test its efficacy in reducing decisional uncertainty, improving knowledge, increasing treatment readiness and readiness for palliative care consultation, and its acceptability among patients. METHODS: Forty patients with advanced cancer hospitalized at Memorial Sloan Kettering Cancer Center watched a video decision aid about PRT and palliative care...
August 28, 2019: Journal of Pain and Symptom Management
David Shih Wu, David E Kern, Sydney Morss Dy, Scott M Wright
CONTEXT: Innovative patient-centered approaches to goals of care (GOC) communication training are needed. Teaching a narrative approach, centered on the patient's unique story, is conceptually sound but has not been evaluated with respect to objective skills attainment. We developed a curriculum based on a novel, easily-remembered narrative approach to GOC, the 3-Act Model, and piloted it with a cohort of Internal Medicine (IM) interns. OBJECTIVES: To describe the development of the 3-Act Model curriculum and to assess its impact on the GOC communication skills of IM interns...
August 28, 2019: Journal of Pain and Symptom Management
Kozue Suzuki, Ryo Matsunuma, Yoshinobu Matsuda, Masanori Mori, Hiroaki Watanabe, Takashi Yamaguchi
No abstract text is available yet for this article.
August 28, 2019: Journal of Pain and Symptom Management
Mervyn Koh Yh, Allyn Hum Ym, Khoo Hwee Sing, Andy Ho Hy, Chong Poh Heng, Ong Wah Ying, Joseph Ong, Patricia Neo Sh, Yong Woon Chai
CONTENT: Burnout is common amongst palliative care clinicians. Resilience helps to reduce burnout, compassion fatigue and is associated with longevity in palliative care. OBJECTIVES: We aimed to study palliative care clinicians who have remained in the field for longer than 10 years to deepen our understanding on their views on burnout and resilience. PATIENTS AND METHODS: We conducted a qualitative study using semi-structured interviews and purposive sampling on 18 palliative care clinicians - 5 doctors, 10 nurses and 3 social workers who worked in various palliative care settings (hospital palliative care team, home hospice and inpatient hospice)...
August 26, 2019: Journal of Pain and Symptom Management
Talita Caroline de Oliveira Valentino, Carlos Eduardo Paiva, David Hui, Marco Antonio de Oliveira, Bianca Sakamoto Ribeiro Paiva
CONTEXT: Many patients with advanced cancer experience aggressive care during the end-of-life. Several studies have evaluated the benefits of palliative care (PC) on the reduction of aggressive measures; however, limited data are available about their benefit in Brazilian patients. OBJECTIVES: To evaluate the impact of palliative care on the reduction of aggressive measures at the end-of-life. METHODS: Longitudinal study that analyzed retrospectively medical records of patients who died of advanced cancer from 2010 to 2014...
August 23, 2019: Journal of Pain and Symptom Management
Dulce M Cruz-Oliver, Tuo-Yen Tseng, Mary M Mitchell, Zachary Catanzarite, Chakra Budhathoki, Thomas J Smith, Cynda Rushton, Amy Knowlton
CONTEXT: Little attention has been given to social environmental factors associated with advance care planning (ACP) among African Americans or persons living with advanced Human Immunodeficiency Virus (PLHIVs). OBJECTIVES: The present study aimed to identify support network factors that affect the likelihood of naming a decision-maker and of talking to family/friends and doctors about ACP among vulnerable PLHIVs. METHODS: PLHIV were recruited from a large urban HIV clinic...
August 22, 2019: Journal of Pain and Symptom Management
Mellar P Davis
PC-FACS(FastArticleCriticalSummaries for Clinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at Comments from readers are welcomed at
August 21, 2019: Journal of Pain and Symptom Management
Ciarán Kenny, Julie Regan, Lucy Balding, Stephen Higgins, Norma O'Leary, Fergal Kelleher, Ray McDermott, John Armstrong, Alina Mihai, Eoin Tiernan, Jennifer Westrup, Pierre Thirion, Declan Walsh
CONTEXT: Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract, but also occurs in those with tumours outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in those with malignancies outside anatomic swallow regions. OBJECTIVE: To establish the prevalence and predictors of dysphagia in adults with solid malignancies outside the head, neck, and upper gastrointestinal tract...
August 21, 2019: Journal of Pain and Symptom Management
Chris Feudtner, Abby R Rosenberg, Renee D Boss, Lori Wiener, Maureen E Lyon, Pamela S Hinds, Myra Bluebond-Langner, Joanne Wolfe
CONTEXT: In order to dramatically advance the evidence base for pediatric palliative care (PPC) interventions, practices, and programs in the United States and similar practice settings, the field needs to better understand the challenges and opportunities for rigorous scholarship. OBJECTIVES: The Pediatric Palliative Care Research Network conducted a workshop to clarify challenges and identify key priorities. METHODS: The workshop focused on PPC research topics and methods, including: outcomes measurement, qualitative inquiry, analyses of "big data," prospective collection of research data, case series and cohort studies, and intervention trials, with synthesizing summary and follow-up discussions...
August 21, 2019: Journal of Pain and Symptom Management
Young Ho Yun, EunKyo Kang, Sohee Park, Su-Jin Koh, Ho-Suk Oh, Bhumsuk Keam, Young Rok Do, Won Jin Chang, Hyun Sik Jeong, Eun Mi Nam, Kyung Hae Jung, Hak Ro Kim, Jiyeon Choo, Jihye Lee, Jin-Ah Sim
CONTEXT: Few randomized controlled trials of advance care planning with a decision aid (DA) show an effect on patient preferences for end-of-life (EOL) care over time, especially in racial/ethnic settings outside the United States. OBJECTIVES: The objective of this study was to examine the effect of a decision aid consisting of a video and an advance care planning (ACP) booklet for end-of-life (EOL) care preferences among patients with advanced cancer. METHODS: Using a computer-generated sequence, we randomly assigned (1:1) advanced cancer patients to a group that received a video and workbook that both discussed either ACP (intervention group) or cancer pain control (control group)...
August 20, 2019: Journal of Pain and Symptom Management
Kathleen M Akgün, David A Gruenewald, Dawn Smith, Debra Wertheimer, Carol Luhrs
BACKGROUND: We sought to increase intensive care unit-family meeting (ICU-FM) documentation in the electronic health record in Veterans Affairs (VA) hospitals. MEASURES: Primary outcomes were proportion of VA decedents with ICU-FM and Bereaved Family Survey-Performance Measure (BFS-PM) scores of "excellent". INTERVENTION: Quality Improvement (QI) project, clinical champion and ICU-FM templates, were implemented in nine participating VA facilities...
August 20, 2019: Journal of Pain and Symptom Management
Meghan Marmor, Andrea Jonas, Alicia Mirza, Elika Rad, H Wong, Rebecca A Aslakson
CONTEXT: Individuals with Cystic Fibrosis (CF) frequently survive into adulthood and many have multi-faceted symptoms that impair quality of life. OBJECTIVE: We conducted a systematic review to investigate opportunities to improve utilization of palliative care among adults with CF. METHODS: We searched PubMed, Embase, Scopus, Web of Science and CINAHL databases from inception until September 27, 2018, and reviewed references manually. Eligible articles were published in English, involved adults age 18 years and older with CF and contained original data regarding patient outcomes related to presence of advanced care planning (ACP), symptom experience, and preferred and/or received end-of-life care...
August 19, 2019: Journal of Pain and Symptom Management
Lev D Bubis, Laura E Davis, Hera Canaj, Vaibhav Gupta, Yunni Jeong, Lisa Barbera, Qing Li, Lesley Moody, Paul J Karanicolas, Rinku Sutradhar, Natalie G Coburn, Alyson L Mahar
CONTEXT: Understanding the magnitude and risk-factors for symptom burden of cancer patients at the end-of-life is critical to guiding effective patient- and system-level interventions. OBJECTIVES: We aimed to estimate the prevalence of severe patient-reported symptoms among cancer outpatients during the six months before death and to identify patient groups at a higher risk for reporting severe symptoms. METHODS: This was a retrospective cohort study of cancer decedents at regional cancer centers from 2010-2016...
August 17, 2019: Journal of Pain and Symptom Management
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