Showing papers in "Journal of Pain and Symptom Management in 2017"

TL;DR: A multidisciplinary Delphi panel developed a consensus definition for ACP for adults that can be used to inform implementation and measurement of ACP clinical, research, and policy initiatives.

TL;DR: ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research and future efforts are needed to standardize this tool and explore its full potential to support symptom management.

TL;DR: Estimation of need for CPC is a critical step in meeting the needs of children with life-threatening conditions and provides a sound platform to advocate for closure of the unacceptably wide gaps in coverage.

TL;DR: The field would benefit from hypothesis-driven outcomes research based on a priori specification of the spiritual dimensions under investigation and their longitudinal relationship with key palliative outcomes, the use of validated measures of predictors and outcomes, and rigorous assessment of potential confounding variables.

TL;DR: Various prognostic tools have been validated but vary in their complexity, subjectivity, and therefore clinical utility, and the Glasgow Prognostic Score would seem the most favorable.

TL;DR: Severe preloss grief and depressive symptoms were key predictors of postloss complicated grief and depression symptoms, and systematic assessment may identify caregivers with a high risk profile who need targeted support.

TL;DR: Clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters is provided, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSRs training.

TL;DR: Findings from this report point to the need for screening and assessment tools that are rigorously developed, clinically relevant, and adapted to a diversity of clinical and cultural settings.

TL;DR: Shorter versions of the ACP Engagement Survey are valid, internally consistent, and able to detect change across a broad range of ACP behaviors for English and Spanish speakers.

TL;DR: This study is the first to provide a detailed phenotypic characterization of CIN in cancer survivors who received a platinum and/or a taxane compound and can serve as a benchmark for future studies of Cin in cancer Survivors.

TL;DR: A navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL, and key facilitators of successful implementation included physician buy-in, patient readiness, and prior ACP experience.

TL;DR: Many families wished to be present at the moment of the patient's death; however, meaningful communication (saying "goodbye") between the patient and family members, and not their presence or absence itself, was associated with better outcomes on measures of depression or complicated grief.

TL;DR: Depressive symptoms, loss of meaning and purpose,loss of control, and low self-worth are strong clinical markers for desire to hasten death, and targeting these symptoms through existentially oriented therapies, such as meaning-centered therapy, may ameliorate suicidal thinking.

TL;DR: Both spiritual well-being and meaning in life appear to be potential protective factors against psychological distress at the end of life.

TL;DR: Re receiving a PCC in the ICUs was significantly associated with more frequent DNR code status and hospice referrals, but not 30-day readmissions or hospital utilization, and early PCC was associated with significant LOS and direct cost reductions.

TL;DR: Surgeons can learn to use "Best Case/Worst Case" (BC/WC) with older patients considering acute high-risk surgical interventions and endorse it as a strategy to support complex decision making.

TL;DR: Ethical challenges and prognostic issues raised are reported and the need for research to test the various tools and models to generate evidence about the benefits of these approaches to patients, their families, and to the health system is emphasized.

TL;DR: The ProQOL shows psychometric goodness in its Spanish and Portuguese versions, although some items should be revised and is sensitive enough to distinguish nuances as that found between Brazilian and Spanish professionals.

TL;DR: Initial evidence that the specific process of legacy creation is able to positively affect sense of generativity, meaning, and acceptance near end of life is provided.

TL;DR: The results reinforce and expand on the severity and potential ramifications of burnout on the palliative care workforce and proposed antiburnout solutions, including promoting the provision of generalist palliatives care, frequent rotations on-and-off service, and organizational support for self-care.

TL;DR: End- of-life discussions may contribute to reducing depression and complicated grief in bereaved family members and enable patients to experience quality end-of-life care and a good death.

TL;DR: Training can improve clinicians' ability to show empathy and discuss emotions, at least in simulated consultations, and personalized feedback on recorded patient interactions may be beneficial.

TL;DR: The selected subscales of the Brief COPE are appropriate measures of coping among individuals newly diagnosed with incurable lung and gastrointestinal cancers.

TL;DR: A systematic review and meta-analysis of randomized controlled trials demonstrates that distraction is a promising intervention for procedural pain management.

TL;DR: Evidence of the effectiveness of EoLC communication skills training interventions for generalist palliative care providers is limited by poor reporting and weak methodology.

TL;DR: Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients, reflective of the slower and more varied trajectory of non-cancer serious illness.

TL;DR: Analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both.

TL;DR: Support is provided for the reliability and validity of the ZBI-22 and its various short forms for use among PD family caregivers and in studies where caregiver burden is a central outcome.

TL;DR: The innovative nature of this parent-driven, comprehensive bereavement program may serve as a paradigm for the development of bereavement programs in the fields of pediatrics, palliatives oncology and hospice and palliative medicine.