Pain and symptom management in palliative care and at end of life

Wilkie, Diana J.; Ezenwa, Miriam O.

doi:10.1016/j.outlook.2012.08.002

Cited by 81 publications

(73 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This review identified themes similar to those of previous reviews on family caregivers of patients with cancer or in palliative care: inadequate knowledge and assessment skills in pain management, misunderstanding of pain medications, and poor communication with the care team. 11,20,22 However, one of the major limitations of this present review was that most of the studies included female and Caucasian family caregivers of patients with cancer from a geographic area, which limited the generalizability of the results to family caregivers with different background. As the number of hospice patients is growing and demographics of patients are changing, more studies including a representative sample will help understand this issue.…”

Section: Resultsmentioning

confidence: 95%

Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review

Chi

Demiris

2016

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Context: Pain management was the most identified burden faced by family caregivers in end-of-life caregiving. Objectives: To synthesize current scientific evidence on family caregivers' experience of pain management in end-of-life care. Methods: A systematic review was conducted using CINAHL, Embase, PubMed, and Cochrane Library electronic databases. Data were extracted from each included paper and organized into tables to synthesize the findings. Results: Fourteen research papers focusing on family caregivers' experience of pain management and strategies in end-of-life care were included. Nine were observational studies, 3 were case studies, and 2 were experimental studies. These studies mainly focused on exploring family caregivers' engagement in pain management and communication with the hospice care team about pain control; family caregivers' knowledge, skills, and self-efficacy in pain management; and family caregivers' concerns and experience of pain management. Conclusion: This review identified themes similar to previous reviews on family caregivers of patients with cancer or in palliative care: inadequate knowledge and assessment skills in pain management, misunderstanding of pain medications, and poor communication with the care team. Future research should design educational programs and material for family caregivers to improve their pain management knowledge and skills, communication, and engagement in care. The scientific knowledge on this topic is scarce, and level of evidence is low; it is therefore imperative to have more exploratory studies to expand the quality and quantity of evidence and increase our understanding of family caregivers' needs and barriers to pain management based on larger and more diverse patient and caregiver samples.

show abstract

Section: Resultsmentioning

confidence: 95%

Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review

Chi

Demiris

2016

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

“…Hospice aims to provide compassionate care to individuals facing a life‐limiting illness, such as pancreatic cancer . Hospice has been associated with improved patient functioning, decreased symptom burden, and for some, even longer survival times …”

Section: Introductionmentioning

confidence: 99%

Hospice utilization among Medicare beneficiaries dying from pancreatic cancer

Paredes

Hyer

Tsilimigras

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background: Use of hospice services among patients with pancreatic cancer following pancreatic resection remains unknown. Methods: Patients with pancreatic cancer who underwent resection were identified in the Medicare Standard Analytic Files. Outcomes included overall hospice use, early hospice enrollment (≥4 weeks before death), late hospice enrollment (initiation within 3 days of death), and Medicare expenditures. Results: Among the 4369 deceased individuals, three-fourths of patients (n = 3252, 74.4%) used hospice at the time of death. Patients who did not use hospice were more likely to be male, have a complication on index admission and receive life sustaining treatments on subsequent admissions (P < .05). Only one-third (32.2%) of patients initiated hospice services early. Medicare expenditure during the last month of life was $10 000 lower among patients who initialized hospice services at least 1 month before death versus within 3 days of death (late: $10 581 [$5454-$17 200], early: $221 [$46-$733]; P < .001) Conclusion: While three-fourths of patients utilized hospice services after pancreatic resection, only one-third of patients initiated hospice services at least one-month before death. Late hospice use was associated with higher Medicare expenditures during the last month of life. Further research is needed to understand barriers to early hospice utilization.

show abstract

“…[4] Moreover, pain has been positively associated with poorer quality of life [5][6][7] depression, [8,9] and greater caregiver burden. [10,11] Patient self-reporting has shown to be the best way to determine the depth and breadth of pain; [12] however, homebound patients not in immediate or constant contact with doctors and other healthcare staff often feel at a disadvantage in relation to communicating issues concerning pain.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of smartphone use in monitoring pain and symptoms among patients with serious illness

Valenti

Portanova

Laguna

et al. 2016

Clinical Nursing Studies

View full text Add to dashboard Cite

Background: Little is known about the feasibility and acceptability of using mobile technology among seriously ill older adults experiencing moderate to severe pain. Objective: A smartphone application was tested for feasibility and acceptability of use among ethnically-diverse older adults experiencing moderate to severe pain. Additionally, authors aimed to document patient perceived barriers and facilitators of using the mobile device for pain monitoring. Methods: Twenty-three participants were enrolled in a prospective feasibility study and followed for 75 days. Participants were provided prepaid smartphones with a preloaded pain application and were asked to send daily reports of pain to a palliative care physician within a managed care clinic. Pain was measured on an 11-point numeric rating scale (NRS) from no pain to worst ever; patients reporting a pain scale of greater than 3 were contacted by a palliative care physician. Surveys on technology ease of use, usefulness, and intrusiveness were conducted at 30 days; qualitative interviews were conducted at the end of the 75-day study period. Results: The study was completed fully by 74% of the sample. Qualitative analyses revealed several themes related to benefits of smartphone use in monitoring pain and symptoms While participants reported the physical challenges using the mobile application, most reported application useful, and 100% would recommend to others. Conclusions: Older adults experiencing significant pain may be receptive to using mobile technology to monitor pain and transmit pain reports to physicians. However, simplified technological interactions are needed to overcome challenges experienced by older adults.

show abstract

Pain and symptom management in palliative care and at end of life

Cited by 81 publications

References 77 publications

Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review

Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review

Hospice utilization among Medicare beneficiaries dying from pancreatic cancer

Feasibility of smartphone use in monitoring pain and symptoms among patients with serious illness

Contact Info

Product

Resources

About