Abstract
Letters to the Editor
As part of a larger project evaluating patient beliefs about their cancer symptoms and stress response, information was collected about performance status, quality of life, distress, and survival status. Secondary analysis was performed to explore the use of Patient Reported Outcomes to predict survival in patients with advanced cancer. (page 800)
Brief Reports
Retrospective cohort study conducted at a designated cancer center hospital to clarify changes in oral food intake in terminally ill cancer patients during the last two weeks before death. (page 879)
Fast Facts and Concepts
Opioids for Chronic Pain in Patients with History of Substance Use Disorders, Part 1: Assessment and Initiation #311 (page 888)
Opioids for Chronic Pain in Patients with History of Substance Use Disorders, Part 2: Management and Monitoring #312 (page 890)
Personal Reflection
Although the service was meant for her neighbor, amidst the Oms and rhythmic chants of the monks, the crescendos and decrescendos in a foreign language, Angela's chest rose and fell and slowly her labored breaths and restlessness quieted down. She did not require any pain medications during that time. (page 892)
Book and Media Reviews
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Recent Literature
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Training Clinicians as Spiritual Care Generalists
The authors report on the effectiveness of one-day, simulation-based workshops to prepare interprofessional clinicians (physicians, nurses, social workers, psychologists, and child life specialists) to function as capable, confident, and ethical spiritual care generalists. (page 814)
Impact of Early Palliative Care on Medical Costs
In this secondary data analysis, Temel and colleagues found that the delivery of early palliative care for patients with metastatic lung cancer does not appear to increase overall medical care expenses. (page 842)
Transplant Teams' Attitudes About Palliative Care
In a survey, liver transplant providers overwhelmingly reported that palliative care benefits patients even while they are listed for liver transplantation. Barriers included confusion over referral criteria and physicians' view of palliative care as “end-of-life care.” The authors suggest that palliative care teams might reach more liver transplant patients by establishing clear criteria for referral and targeting education to attending physicians. (page 836)
Association between Activity and Symptoms in Cancer Patients
In this preliminary report, Bruera and colleagues describe a significant association between cancer patients' daytime activity and age, gender, fatigue, dyspnea, anxiety, and total sleep time. Sleep quality and cancer-related fatigue scores were strongly associated with depression and anxiety. (page 849)
Quality of Life in Metastatic Breast Cancer
The authors conducted a cross-sectional, quality-of-life study of 140 patients with metastatic breast cancer, stratified by receipt of endocrine or chemotherapy. They conclude that patients, especially those treated with chemotherapy, would benefit from interventions to address their physical and functional symptoms as well as improve their prognostic understanding. (page 863)
Palliative Care in Motor Neuron Disease
Researchers conducted semistructured interviews with family caregivers of people with motor neuron disease to identify unmet needs and gaps in end-of-life support. (page 857)
Abnormal Laboratory Results at End of Life
The authors examined the prevalence and implications of abnormal laboratory results in 125 terminally ill patients in their final days of life. Remarkably, electrolytes (sodium and potassium) were balanced even shortly before death. Kidney function was the most clinically relevant laboratory test, as it guided drug choice and dosing. (page 822)
Young Adults' Developmental Goals
This descriptive study used an innovative bulletin-board focus group to examine the goals of young adults with life-limiting conditions. Some participants demonstrated capacity to navigate system barriers and achieve their goals, whereas others “got stuck.” The authors argue that palliative care can mitigate unnecessary hardships for these young adults and help support their goals. (page 830)