Journals Journal of Pain and Symptom Ma...

Journal of Pain and Symptom Management
Rebecca Liddicoat Yamarik, Cachet Wenziger, Elani Streja, Angela Ngoc-Thao, Kevin S Wei, Bishen Bedi, Steven Asch
BACKGROUND: Longer hospice length of stay improves the palliation of symptoms, quality of life, and the dying process for patients and their caregivers. We used a Lean designed Rapid Improvement Event (RIE) to facilitate earlier entry into hospice. MEASURES: Our primary outcome was hospice length of stay. Secondary outcomes were avoiding unwanted inpatient utilization and hospice location. INTERVENTIONS: We conducted a 5-day RIE utilizing Lean tools targeting the inpatient medicine wards...
April 5, 2021: Journal of Pain and Symptom Management
Meera R Basu, Lindsay Partin, Anna Revette, Joanne Wolfe, Danielle D DeCourcey
CONTEXT: Parents desire more opportunities for advance care planning (ACP), however, large-scale adoption of ACP for seriously ill children remains unrealized. Little is known about current approaches to ACP and strategies to circumvent existing barriers to ACP provision. OBJECTIVE: To explore multidisciplinary clinician perceptions about perceived barriers and strategies to improve ACP provision. DESIGN: Qualitative study including focus groups conducted with multidisciplinary clinicians at two centers from December 2018-April 2019...
April 3, 2021: Journal of Pain and Symptom Management
Sarah Mills, Anne Cioletti, Gareth Gingell, Subha Ramani
CONTEXT: Advance care planning (ACP) conversations represent an important physician skill, a need further highlighted by the COVID-19 pandemic. Most resident ACP training occurs in inpatient, settings, often featuring goals of care (GOC) conversations during a crisis. Outpatient clinics are valuable but underutilized settings to provide skills training for residents, yet little research has been done in these spaces. OBJECTIVE: We sought to (1) create an ACP curriculum harnessing the principles of a community of practice in a virtual format, and (2) obtain residents' perspectives regarding their skills and confidence in having early GOC conversations in the outpatient setting...
April 2, 2021: Journal of Pain and Symptom Management
Sandrine Bretonniere, Veronique Fournier
CONTEXT: The French parliament passed a groundbreaking law in 2016, opening a right for patients to access continuous and deep sedation until death (CDS) at the end of life, under conditions. Parliamentarians' goal was to consolidate patients' rights whilst avoiding legislating on medical aid in dying. OBJECTIVES: To conduct a first national retrospective survey on CDS to evaluate the number of CDS requested, proposed and performed in 2017 and to elicit qualitative data from physicians on the terms used by patients to refer to CDS and on the practice...
April 2, 2021: Journal of Pain and Symptom Management
Crislaine de Lima, Martins Fidelesdos Santos Neto, Ricardo Filipe Alves Costa, Julia Onishi Franco, Giovanna Simões Calfi, Bianca Sakamoto Ribeiro Paiva, Carlos Eduardo Paiva
BACKGROUND: Research on Palliative Care (PC) can be used as a direct measure to assess the level of PC development in a country or region. AIM: To investigate the scientific production in the field of palliative care in South American countries over the last two decades. METHODS: The search was performed using the terms "palliative care", "hospice care", "hospices" and "terminal care" combined with the names of South American countries in several databases...
April 2, 2021: Journal of Pain and Symptom Management
Pauli J Lamppu, Marja-Liisa Laakkonen, Harriet Finne-Soveri, Hannu Kautiainen, Jouko V Laurila, Kaisu H Pitkälä
CONTEXT: Long-term care facility (LTCF) residents have unmet needs in end-of-life and symptom care. OBJECTIVES: This study examines the effects of an end-of-life care staff training intervention on LTCF residents' pain, symptoms, and psychological well-being and their proxies' satisfaction with care. METHODS: We report findings from a single-blind, cluster randomized controlled trial (RCT) featuring 324 residents with end-of-life care needs in 20 LTCF wards in Helsinki...
March 29, 2021: Journal of Pain and Symptom Management
Michael J McNeil, Erica C Kaye, Yuvanesh Vedaraju, Justin N Baker, Meenakshi DevidasPhD, Julia Downing, Dylan Graetz, Radhikesh Ranadive, Abby R Rosenberg, Lori Wiener, Meaghann S Weaver
CONTEXT: The coronavirus pandemic (COVID-19) has profoundly impacted the provision of pediatric palliative care (PPC) interventions including goals of care discussions, symptom management, and end-of-life care. OBJECTIVE: Gaining understanding of the professional and personal experiences of PPC providers on a global scale during COVID-19 is essential to improve clinical practices in an ongoing pandemic. METHODS: The Palliative Assessment of Needed DEvelopments & Modifications In the Era of Coronavirus Survey-Global survey was designed and distributed to assess changes in PPC practices resulting from COVID-19...
March 29, 2021: Journal of Pain and Symptom Management
Ragnhild Habberstad, Trude Camilla S Frøseth, Nina Aass, Ellen Bjerkeset, Tatiana Abramova, Elena Garcia-Alonso, Mariangela Caputo, Romina Rossi, Jason W Boland, Cinzia Brunelli, Jo Åsmund Lund, Stein Kaasa, Pål Klepstad
BACKGROUND: Radiotherapy (RT) reduces pain in about 60% of patients with painful bone metastases, leaving many patients without clinical benefit. This study assesses predictors for RT effectiveness in patients with painful bone metastases. MATERIALS AND METHODS: We included adult patients receiving RT for painful bone metastases in a multicenter, multinational longitudinal observational study. Pain response within 8 weeks was defined as ≥2-point decrease on a 0-10 pain score scale, without increase in analgesics; or a decrease in analgesics of ≥25% without increase in pain score...
March 29, 2021: Journal of Pain and Symptom Management
Fur-Hsing Wen, Wen-Chi Chou, Ming-Mo Hou, Po-Jung Su, Wen-Chi Shen, Jen-Shi Chen, Wen-Cheng Chang, Professor Siew Tzuh Tang
BACKGROUND: Family caregivers' distinct depressive-symptom trajectories are understudied and have been examined independently during end-of-life (EOL) caregiving or bereavement, making it difficult to validate two competing hypotheses (wear-and-tear vs. relief) of caregiving effects on bereavement. Existing studies may also miss short-term heterogeneity in depressive symptoms during the immediate postloss period due to lengthy delays in the first postloss assessment. PURPOSE: This secondary-analysis study examined distinct depressive-symptom trajectories for caregivers of advanced cancer patients from EOL caregiving through the first 2 bereavement years with closely spaced assessments...
March 29, 2021: Journal of Pain and Symptom Management
F Teike Lüthi, M Bernard, K Vanderlinden, P Ballabeni, C Gamondi, A S Ramelet, G D Borasio
CONTEXT: To improve access to palliative care, identification of patients in need of general or specialized palliative care is necessary. To our knowledge, no available identification instrument makes this distinction. ID-PALL is a screening instrument developed to differentiate between these patient groups. OBJECTIVE: To assess the structural and criterion validity and the inter-rater agreement of ID-PALL. METHODS: In this multicenter, prospective, cross-sectional study, nurses and physicians assessed medical patients hospitalized for 2 to 5 days in two tertiary hospitals in Switzerland using ID-PALL...
March 26, 2021: Journal of Pain and Symptom Management
Jori Bogetz, Amy Trowbridge, Jenny Kingsley, Mallory Taylor, Lori Wiener, Abby R Rosenberg, Krysta S Barton
CONTEXT: With advances in treatments that have resulted in children living longer with serious illness, it is essential to understand how parents adapt to changes during the final stages of their child's life or after their child's death. OBJECTIVE: To examine the process by which parents adapt to their child's serious illness and death among a group of non-bereaved and bereaved parents of adolescents and young adults (AYAs) with advanced cancer. METHODS: Qualitative study exploring the experiences of parents of AYAs who were being treated for recurrent or refractory advanced cancer (non-bereaved parents) or had died from their disease (bereaved parents) at one large academic center...
March 25, 2021: Journal of Pain and Symptom Management
Elizabeth Elliott, Tracie Watson, Daulath Singh, Connie Wong, Shelly S Lo
CONTEXT: The outcomes of specialty palliative care (PC) interventions for patients with hematologic malignancies (HMs) is under-investigated. OBJECTIVES: We performed a systematic review to evaluate the effect of PC interventions on patient- and caregiver- reported outcomes and healthcare utilization among adults with HMs (leukemia, myeloma, and lymphoma). METHODS: From database inception through September 10, 2020, we systematically searched PubMed, CINAHL, Embase, Scopus, Web of Science, and Cochrane Reviews using terms representing HMs and PC...
March 24, 2021: Journal of Pain and Symptom Management
Meaghann S Weaver, Cynthia M A Geppert, David J Alfandre
No abstract text is available yet for this article.
March 21, 2021: Journal of Pain and Symptom Management
Kate Fiona Jones, Piret Paal, Xavier Symons, Megan C Best
CONTEXT: Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need. OBJECTIVE: The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators...
March 20, 2021: Journal of Pain and Symptom Management
Jacqueline Gillespie, Antoine Przybylak-Brouillard, Christine L Watt
CONTEXT: Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease, associated with impaired quality of life for patients and caregivers. As treatment is largely supportive, early involvement of palliative care (PC) is recommended as standard of care. Despite this, literature surrounding PC information needs is limited. OBJECTIVES: To explore the PC information needs of patients with ALS and their caregivers and identify gaps in the literature. METHODS: A scoping review using MEDLINE, EMBASE, CINAHL and PsycINFO databases (2000-2019) was conducted...
March 20, 2021: Journal of Pain and Symptom Management
Yoshiyuki Kizawa, Takashi Yamaguchi, Akihiro Sakashita, Maho Aoyama, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
CONTEXT: Cardiopulmonary resuscitation (CPR) is one of the most important end-of-life care decisions. However, the experience of bereaved families during code status discussions is not well documented. OBJECTIVE: The aims of this study were to describe the degree of emotional distress of bereaved families when discussing code status, identify their perceived areas for improvement and determine associated factors. METHODS: This study is part of a nationwide post-bereavement survey, the Japan HOspice and Palliative care Evaluation 3 (J-HOPE3) study...
March 20, 2021: Journal of Pain and Symptom Management
Danielle Leber
No abstract text is available yet for this article.
March 15, 2021: Journal of Pain and Symptom Management
Jessica Ma, Jessica Beliveau, Wendy Snider, Weston Jordan, David Casarett
CONTEXT: Although health systems need to track utilization and mortality, it can be difficult to obtain reliable information on patients who die outside of the health system. This leads to missing data and introduces the potential for bias. OBJECTIVES: To evaluate the linkage of patient death data sources with a tertiary health system electronic health record (EHR) to increase the accuracy of health system end-of-life health care utilization data in the last month and six months of life METHODS: : The federal Death Master File (DMF) and North Carolina Department of Health and Human Services (NC DHHS) decedent files from 2017 and 2018 were linked to a health system EHR...
March 12, 2021: Journal of Pain and Symptom Management
Ofir Morag, Natalie Shalit
No abstract text is available yet for this article.
March 12, 2021: Journal of Pain and Symptom Management
Stephanie S Tu, John R O'Leary, Terri R Fried
CONTEXT: While medical end-of-life planning has been well characterized, less is known about non-medical planning to prepare for the end of life. OBJECTIVES: To determine the prevalence of engagement in non-medical end-of-life (EOL) planning and its relationship to medical EOL planning. METHODS: 304 persons age 65 and older recruited from physician offices and a senior center were administered an in-person interview asking about participation in the following non-medical EOL planning behaviors: moving to a location with more help, teaching someone to do things around the house, purchasing long-term care insurance, telling someone the location of important documents, preparing a financial will, conveying wishes for funeral arrangements, purchasing a cemetery plot, and prepaying for a funeral...
March 11, 2021: Journal of Pain and Symptom Management
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