Abstract：
:Locked-in syndrome (LIS) is a rare neurologic disorder rendering an individual quadriplegic and anarthric with preserved self-awareness and normal if not near-normal cognition. A lesion to the ventral pons causes the classic form of LIS, and patients can typically interact with their environment with eye/eyelid movements. LIS patients may live for years with preserved quality of life (QoL) and cognitive function, but with severe disability. However, medical providers and family often underestimate the patient's QoL, and choose less aggressive care. Prompt assessment of decisionality in LIS patients is challenging, but it must be done to allow these patients to participate in their care. We present the case of a 54-year-old man with LIS. The medical team recommended comfort measures, but the family advocated involving the patient in goals of care discussions. The patient was determined to be decisional during the acute hospitalization, and he elected for life-prolonging care. This case emphasizes the importance of unbiased shared decision making, but also the importance of utilizing a practical framework to assess the decision-making capacity in these patients. We provide a suggested approach to determining decision-making capacity in similar cases or conditions.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Maiser S,Kabir A,Sabsevitz D,Peltier Wdoi
10.1016/j.jpainsymman.2015.10.021subject
Has Abstractpub_date
2016-04-01 00:00:00pages
789-793issue
4eissn
0885-3924issn
1873-6513pii
S0885-3924(15)00637-5journal_volume
51pub_type
杂志文章abstract：CONTEXT:Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE:The objective of this study was to create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS:This study convened a Delphi panel consisting of 52 multidisciplinary, ...
journal_title：Journal of pain and symptom management
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jpainsymman.2017.08.025
更新日期：2018-02-01 00:00:00
abstract：CONTEXT:Despite current advances in antiemetic treatments, between 19% and 58% of oncology patients experience chemotherapy-induced nausea (CIN). OBJECTIVES:Aims of this post hoc exploratory analysis were to determine occurrence, severity, and distress of CIN and evaluate for differences in demographic and clinical ch...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.05.019
更新日期：2018-09-01 00:00:00
abstract：:To evaluate the role of oral ketamine as an adjuvant to oral morphine in cancer patients experiencing neuropathic pain, 9 cancer patients (5 men, 4 women) taking maximally tolerated doses of either morphine, amitriptyline, sodium valproate, or a combination of these drugs for intractable neuropathic pain, and reportin...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/s0885-3924(01)00373-6
更新日期：2002-01-01 00:00:00
abstract：:Continuing the transition to competency-based education, Hospice and Palliative Medicine (HPM) fellowship programs began using context-free reporting milestones (RMs) for internal medicine subspecialties in 2014 but quickly recognized that they did not reflect the nuanced practice of the field. This article describes ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.01.008
更新日期：2020-07-01 00:00:00
abstract：CONTEXT:This scoping review maps the existing literature on narrative interventions within a palliative care and end-of-life context. OBJECTIVES:A scoping review was performed to address the following research question: What observational or randomized controlled trials have been performed to evaluate narrative interv...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2019.06.009
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVES:Decisional regret is an indicator of satisfaction with the treatment decision and can help to identify those patients who need more support and evaluate the efficacy of decision support interventions. The objectives of this study are, 1) to evaluate the psychometric properties of the Decision Regret Scale an...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.11.017
更新日期：2019-04-01 00:00:00
abstract：:There is little objective data on how cancer and its therapy affect physical activity. The main aims of this pilot study were 1) to compare physical activity in patients receiving palliative chemotherapy and healthy controls, and 2) to explore the relationship between patients' activity, quality of life (QoL), and cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2006.09.024
更新日期：2007-06-01 00:00:00
abstract：:The purpose of this study was to determine physicians' attitudes toward and preferences for palliative management of malignant ascites. A random sample of eighty physicians practicing in Canada was selected from the memberships of the Canadian Association of Medical Oncologists, the Canadian Association of Gastroenter...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(98)00037-2
更新日期：1998-08-01 00:00:00
abstract：:Palliative care development and services were reviewed in the region represented by the six members of the Middle East Cancer Consortium: Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and Turkey. The multimethod review synthesized evidence from ethnographic field visits to inpatient units, home care hospic...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2008.02.014
更新日期：2009-03-01 00:00:00
abstract：:The aims of this study were (a) to estimate the prevalence of pain and eight other common symptoms in a large population of patients with advanced cancer from different palliative care centers, and (b) to assess the differences in prevalence of the symptoms by primary site. In 1990-1991, the prevalence of eight major ...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/0885-3924(96)00042-5
更新日期：1996-07-01 00:00:00
abstract：CONTEXT:In patients with cancer pain, identifying a neuropathic pain component (NPC) may inform the selection of subsequent therapeutic interventions. OBJECTIVES:The objective of this study was to determine the prevalence, clinical characteristics, associated psychological distress, pre-referral treatment, and predict...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.08.028
更新日期：2018-02-01 00:00:00
abstract：:Potential iatrogenic mood and cognitive declines associated with long-acting opioid therapy were examined in 19 patients receiving long-acting oral opioid medications and compared to ten patients receiving usual care. Pain, mood, and cognitive function were measured before and after achieving stable doses. In addition...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/s0885-3924(97)00352-7
更新日期：1998-03-01 00:00:00
abstract：:The effectiveness of docusate for constipation has not been studied in the terminally ill. Controversy also exists concerning its effectiveness in the chronically ill. Because chronically ill patients and terminally ill patients have several risk factors for constipation in common, we undertook a systematic review of ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析
doi：10.1016/s0885-3924(99)00157-8
更新日期：2000-02-01 00:00:00
abstract：:The authors report the data from two studies on the use of controlled-release morphine sulphate tablets for cancer pain relief. This preparation allows just two administrations per day, in comparison with immediate release oral aqueous morphine solution. The first study, a randomized trial carried out on 70 patients s...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0885-3924(89)90005-5
更新日期：1989-09-01 00:00:00
abstract：CONTEXT:Attrition is common in longitudinal observational studies in palliative care. Few studies have examined predictors of attrition. OBJECTIVES:To identify patient characteristics at enrollment associated with attrition in palliative oncology outpatient setting. METHODS:In this longitudinal observational study, a...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2017.11.009
更新日期：2018-03-01 00:00:00
abstract：:A significant proportion of health care resources are consumed at end of life. As a result, decision and policy makers seek cost savings to enhance program planning. Most literature, however, combines the cost of all dying patients and, subsequently, fails to recognize the variation between trajectories of functional ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2009.04.007
更新日期：2009-07-01 00:00:00
abstract：:The rectal route for the administration of opioid analgesics is often forgotten by physicians seeking alternatives to the oral route. This article reviews the physiology of rectal drug absorption and such data as exists on the different opioids that have been administered by this route. Conventional fatty-based suppos...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/s0885-3924(05)80025-9
更新日期：1990-04-01 00:00:00
abstract：:Cytokines have a major role in promoting the growth and spread of cancers. Elevated levels of several cytokines have been described in cancer patients. Evidence from animal and human studies suggests that cytokines may contribute to a wide range of symptoms in advanced cancer, including: asthenia, pain, drowsiness, co...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/s0885-3924(00)00199-8
更新日期：2000-09-01 00:00:00
abstract：CONTEXT:Aggregates of concurrent symptoms, known as symptom clusters (SxCls), have been described in predominantly cross-sectional samples of lung cancer (LC) patients undergoing treatment. OBJECTIVES:The objective of this study was to delineate SxCls in LC survivors up to five years after diagnosis, investigate their...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2010.10.257
更新日期：2011-08-01 00:00:00
abstract：:Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute ki...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2016.10.371
更新日期：2017-03-01 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
abstract：CONTEXT:Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). OBJECTIVES:This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwa...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2017.02.018
更新日期：2017-07-01 00:00:00
abstract：:The problem of undertreatment of acute postoperative pain has been documented in many studies. This article reviews this evidence and defines the problem of undertreatment as a group of attitudes about pain treatment that originate with deficiencies in knowledge and skills and lead to the development of inappropriate ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：
更新日期：1990-02-01 00:00:00
abstract：CONTEXT:Cancer-related fatigue is a highly prevalent symptom with a strong negative impact on patients' daily life. OBJECTIVES:To evaluate the efficacy of methylphenidate as needed for the management of fatigue in patients with advanced cancer. METHODS:A prospective, controlled, double-blind, and paired design, where...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.05.023
更新日期：2020-11-01 00:00:00
abstract：CONTEXT:Breakthrough cancer pain (BTCP) is a heterogeneous condition, and there are no internationally agreed standardized criteria to diagnose it. There are published algorithms to assist with diagnosis, but these differ in content. There are no comparative data to support use. OBJECTIVES:To compare the diagnostic ab...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2015.05.006
更新日期：2015-10-01 00:00:00
abstract：CONTEXT:Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. OBJECTIVES:To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actua...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jpainsymman.2015.11.022
更新日期：2016-04-01 00:00:00
abstract：CONTEXT:Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. OBJECTIVES:To describe MAID cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.08.018
更新日期：2020-08-21 00:00:00
abstract：CONTEXT:Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. OBJECTIVES:To conduct a rand...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2013.11.012
更新日期：2014-10-01 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：:Disturbances caused by skin problems may compromise the quality of life of cancer patients. The main complications affecting the skin comprise the dermatologic toxicity of anticancer therapy, bedsores, malignant ulcers, sores due to nonmetastatic cancer, pruritus, and infections. Most of the information available abou...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/0885-3924(91)90015-v
更新日期：1991-05-01 00:00:00
