Abstract：
:Advanced dementia patients may be at substantial risk for undetected or undertreated pain. To examine the treatment of pain following hip fracture, a prospective cohort study was conducted in an academic teaching hospital. Fifty-nine cognitively intact elderly patients with hip fracture and 38 patients with hip fracture and advanced dementia were assessed daily. The cognitively intact patients rated their pain on a numeric scale ranging from 0 (none) to 4 (very severe). Analgesics prescribed and administered were recorded and compared to hip fracture patients with advanced dementia. The advanced dementia patients received one-third the amount of morphine sulfate equivalents as the cognitively intact patients. Forty-four percent of cognitively intact individuals reported severe to very severe pain preoperatively and 42% reported similar pain postoperatively. Half the cognitively intact patients who experienced moderate to very severe pain were prescribed inadequate analgesia for their level of pain. Eighty-three percent of cognitively intact patients and 76% of dementia patients did not receive a standing order for an analgesic agent. These data reveal that a majority of elderly hip fracture patients experienced undertreated pain. The fact that advanced dementia patients received one-third the amount of opioid analgesia as compared to cognitively intact subjects-40% of whom reported severe pain postoperatively-suggests that the majority of dementia patients were in severe pain postoperatively. This study and others suggest that directed interventions to improve pain detection and alter physician prescribing practices in the cognitively impaired are needed.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Morrison RS,Siu ALdoi
10.1016/s0885-3924(00)00113-5subject
Has Abstractpub_date
2000-04-01 00:00:00pages
240-8issue
4eissn
0885-3924issn
1873-6513pii
S0885-3924(00)00113-5journal_volume
19pub_type
临床试验,杂志文章,随机对照试验abstract：CONTEXT:Fatigue is one of the most common symptoms reported by cancer survivors, and fatigue worsens when patients are engaged in muscle exertion, which results in early motor task failure. Central fatigue plays a significant role, more than muscle (peripheral) fatigue, in contributing to early task failure in cancer-r...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.08.007
更新日期：2012-09-01 00:00:00
abstract：:The aim of this study was to longitudinally assess breakthrough pain (BP) in advanced cancer patients who were admitted to home palliative care. One hundred and one consecutive patients who were admitted to one of the two home care programs and were representative of the cancer population followed at home in Italy wer...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2008.12.008
更新日期：2009-10-01 00:00:00
abstract：:Gabapentin was administered as an "add on" therapy to 22 patients with neuropathic cancer pain only partially responsive to opioid therapy. Global pain, burning pain, shooting pain episodes, and allodynia were assessed separately. Gabapentin was given for at least a week and efficacy was assessed after 7 to 14 days of...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/s0885-3924(99)00033-0
更新日期：1999-06-01 00:00:00
abstract：CONTEXT:Advanced, life-limiting illnesses are likely to have a predictable functional decline through a terminal phase to death, but some patients may also die suddenly. To date, empirical evidence characterizing "sudden death" in hospice/palliative care is lacking. OBJECTIVES:The aim of this study was to determine pr...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2016.02.015
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Dying patients whose implantable cardioverter defibrillators (ICDs) continue to deliver shocks may experience significant pain, and the National Quality Forum has endorsed routine deactivation of ICDs when patients near the end of life. The overarching goal of this quality improvement project was to increase...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2013.09.010
更新日期：2014-09-01 00:00:00
abstract：CONTEXT:Mindfulness-based interventions have been receiving growing attention in cancer care. OBJECTIVES:The purpose of this randomized controlled trial is to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) for psychological distress (anxiety and depression), fear of cancer recurrence (FCR), fa...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.02.017
更新日期：2020-08-01 00:00:00
abstract：CONTEXT:Few studies have evaluated outcomes of combined chemoradiotherapy for Stage III-IV head and neck squamous cell carcinoma in terms of the use of nutritional support by means of percutaneous endoscopic gastrostomy (PEG). OBJECTIVES:To compare nutritional status and treatment interruption because of acute toxicit...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.01.009
更新日期：2011-10-01 00:00:00
abstract：CONTEXT:Coronavirus disease 2019 (COVID-19) led to increased attention nationally on advance care planning. OBJECTIVES:To describe the impact COVID-19 had on advance care planning based on changes in the calls to the West Virginia Center for End-of-Life Care (center) and in the volume and types of documents requested ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.09.021
更新日期：2020-12-01 00:00:00
abstract：CONTEXT:Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. OBJECTIVES:The primary aim of thi...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2014.10.010
更新日期：2015-05-01 00:00:00
abstract：:Pain is a multidimensional phenomenon with physical, psychological, and social components and is a significant problem for 50% of hemodialysis (HD) patients. Failure to treat pain adequately may lead to disruption in many aspects of life. This study examines the relationship between moderate to severe chronic pain and...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2005.05.013
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:Despite significant morbidity and mortality among patients with decompensated cirrhosis, reported rates of advance directive (AD) completion and goals of care discussions (GCDs) between patients and providers are very low. We aimed to improve these rates by implementing a hepatologist-led advance care planni...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.12.355
更新日期：2020-04-01 00:00:00
abstract：:Cancer-related pain is complex and multi-dimensional; yet, the mainstay of cancer pain management has been the biomedical approach. There is a need for nonpharmacological and innovative pain management strategies. Transcutaneous electrical nerve stimulation (TENS) may have a role. The aim of this systematic review was...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2008.03.022
更新日期：2009-04-01 00:00:00
abstract：:Data on pain prevalence and severity were collected prospectively from advanced cancer patients as an integral part of two service evaluations. Six multidisciplinary palliative care teams working in Ireland formed the basis of one study and five teams based in the South of England were included in the second. A total ...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,多中心研究,评审
doi：10.1016/S0885-3924(97)00006-7
更新日期：1997-07-01 00:00:00
abstract：:Cancer-related fatigue (CRF) is a significant clinical symptom. Effective assessment of CRF attributes from the patients' perspective is essential. This study tested the psychometric properties of the Wu Cancer Fatigue Scale (WCFS). A total of 172 outpatients with breast cancer, who were at various stages and on vario...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2006.06.001
更新日期：2006-09-01 00:00:00
abstract：:Assessing quality of care at the end of life involves measurements in several domains-use of evidence-based guidelines, patient and family satisfaction, quality of life, and incidence of adverse events, among others. There are several different data sources from which to calculate quality measures. Each data source ha...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(01)00329-3
更新日期：2001-09-01 00:00:00
abstract：:To validate the Greek version of the Brief Fatigue Inventory (BFI-Gr) in a sample of cancer patients, the scale was translated with the "forward-backward" procedure to Greek. It was administered twice, at a three-day interval, to 102 eligible patients with cancer. Together with the BFI-Gr scale, the patients also comp...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2007.10.021
更新日期：2008-10-01 00:00:00
abstract：:The relationships between plasma morphine and metabolite (M3G and M6G) concentrations and analgesic efficacy were investigated in an open study of 39 cancer pain patients receiving chronic oral morphine therapy with either morphine sulfate solution or controlled-release morphine tablets. There were no differences in m...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/0885-3924(95)00148-4
更新日期：1996-02-01 00:00:00
abstract：:Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2007.12.018
更新日期：2008-12-01 00:00:00
abstract：CONTEXT:Nursing home (NH) residents with advanced dementia are commonly suspected of having infections. Most episodes are treated with antimicrobials, although evidence supporting bacterial infections is often lacking. The extent to which other interventions are used in managing suspected infections is unknown. OBJECT...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2015.06.011
更新日期：2015-12-01 00:00:00
abstract：:In 2005, Vietnam's Ministry of Health (MoH) launched a palliative care initiative that uses the World Health Organization (WHO) public health strategy for national palliative care program development. With international financial and technical support, the initiative has made significant early progress. A rapid situat...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2010.04.009
更新日期：2010-07-01 00:00:00
abstract：:Many painful disorders, including joint dysfunctions such as rheumatoid arthritis (RA) or temporomandibular joint disorders (TMD), are associated with hyperthermia of the overlying skin. The same is true of certain intractable chronic pain conditions, such as chronic orofacial pain, which may be associated with TMD. W...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/s0885-3924(97)00178-4
更新日期：1997-10-01 00:00:00
abstract：:Patients and families facing serious illness often want and need their clinicians to help guide medical decision making by offering a recommendation. Yet clinicians worry that recommendations are not compatible with shared decision making and feel reluctant to offer them. We describe an expert approach to formulating ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.12.488
更新日期：2018-04-01 00:00:00
abstract：:The technology of telemedicine has been used for over 20 years, involving different areas of medicine, providing medical care for the geographically isolated patients, and uniting geographically isolated clinicians. Today audio-visual technology may be useful in palliative care for the patients lacking access to medic...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(01)00402-x
更新日期：2002-02-01 00:00:00
abstract：CONTEXT:Although episodic breathlessness (EB) is reported to be highly prevalent in advanced disease, our understanding about it is limited. OBJECTIVES:The aim of this study was to systematically review and synthesize the evidence on EB regarding definition, characteristics, and patients' experiences. METHODS:Systema...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2012.02.022
更新日期：2013-03-01 00:00:00
abstract：:Radiotherapy is an indispensable modality in the palliation of cancer. All palliative care programs should be acquainted with its indications and have a close working relationship with a radiation oncology department. The technical aspects of the subject may be intimidating to many staff and patients, and departments ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/0885-3924(91)90030-8
更新日期：1991-08-01 00:00:00
abstract：CONTEXT:The Edmonton Symptom Assessment System (ESAS) measures the severity of nine symptoms. Constipation and sleep disturbance are common in patients with cancer, but are not currently included in the ESAS. OBJECTIVES:To validate the numerical rating scale (NRS) versions of ESAS and its revised version (ESAS-r), wit...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.10.013
更新日期：2015-05-01 00:00:00
abstract：CONTEXT:Assessment and response to patients' spiritual concerns are crucial components of high-quality supportive care. Better measures of spiritual needs across the cultural spectrum may help direct necessary interventions. OBJECTIVES:The objective of this study was to assess spiritual needs in a racially/ethnically ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2017.08.009
更新日期：2018-01-01 00:00:00
abstract：CONTEXT:Guidelines about palliative sedation typically include recommendations to protect the well-being of relatives. OBJECTIVES:The aim of this study was to systematically review evidence on the experiences of relatives with the practice of palliative sedation. METHODS:PubMed, Embase, Web of Science, PsycINFO, and ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2011.09.006
更新日期：2012-09-01 00:00:00
abstract：:Increasing numbers of patients with refractory pain are receiving intrathecal drug delivery systems (IDDS). We describe a case to illustrate the clinical manifestations and management implications of inadvertent overdose with drugs used in IDDS, including opioids, clonidine, baclofen, and local anesthetics. An IDDS pa...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2003.11.011
更新日期：2004-09-01 00:00:00
abstract：:The aim of this study was to examine the relationship of changes in hemoglobin levels to changes in fatigue and cognitive functioning in cancer patients undergoing chemotherapy treatment. Seventy-seven (77) patients completed a self-administered measure of fatigue and a battery of psychometrician-administered measures...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2003.11.002
更新日期：2004-07-01 00:00:00
