Journal of pain and symptom management最新文献

{"title":"\"Matters\".","authors":"Mark J Marshall","doi":"10.1016/j.jpainsymman.2025.06.005","DOIUrl":"10.1016/j.jpainsymman.2025.06.005","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PC-FACS June 6, 2025","authors":"","doi":"10.1016/j.jpainsymman.2025.06.003","DOIUrl":"10.1016/j.jpainsymman.2025.06.003","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"70 2","pages":"Pages 214-220"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal Drug Infusion for Refractory Cancer Pain in Esophageal Cancer with Severe Scoliosis.","authors":"Weiwei Lin, Qin Li, Aimin Zhang","doi":"10.1016/j.jpainsymman.2025.05.019","DOIUrl":"10.1016/j.jpainsymman.2025.05.019","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Prognostic Awareness: Relations to Patient and Caregiver Quality of Life and Care Preferences.","authors":"Ellen Krueger, Catherine E Mosher, Ashley Lewson, Susan E Hickman, Wei Wu, Holly G Prigerson","doi":"10.1016/j.jpainsymman.2025.06.002","DOIUrl":"10.1016/j.jpainsymman.2025.06.002","url":null,"abstract":"<p><strong>Context: </strong>Patients who are prognostically aware are more likely to receive end-of-life care consistent with their values. However, prognostic awareness has shown mixed associations with patients' quality-of-life (QoL) outcomes. Theory suggests that acceptance of cancer may moderate relationships between prognostic awareness and outcomes of QoL and end-of-life treatment preferences. Patients' degree of prognostic awareness and illness acceptance may also impact their family caregivers' QoL and end-of-life treatment preferences for the patient.</p><p><strong>Objectives: </strong>To examine the potential moderating role of patient acceptance of cancer in the relationships between patient prognostic awareness and both patient and caregiver QoL and end-of-life treatment preferences.</p><p><strong>Methods: </strong>A cross-sectional, secondary analysis was conducted using data from patients with advanced cancer (n = 243) and their caregivers (n = 87) in the multi-institutional Coping with Cancer-II cohort study. Patient physical, psychological, and existential QoL were examined in a moderation path analysis. Caregiver physical and psychological QoL were examined in separate linear regression analyses. Patient and caregiver end-of-life treatment preferences were examined in multiple logistic regression moderation models.</p><p><strong>Results: </strong>No significant moderations were found. Greater patient illness acceptance was associated with better patient QoL outcomes and caregiver psychological QoL but was unrelated to end-of-life treatment preferences. Greater patient prognostic awareness was associated with worse patient physical QoL and both patients' and caregivers' preference for comfort care.</p><p><strong>Conclusion: </strong>Increasing patients' prognostic awareness and cancer acceptance may improve values-consistent end-of-life care and patient and caregiver QoL outcomes. Findings support timely conversations to promote prognostic awareness and further testing of acceptance-based interventions in advanced cancer.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the MASC-20 and Development of a Short Form to Assess Suicide Risk in Cancer Patients.","authors":"Eun-Jung Shim, Hae-Lim Noh, Bong-Jin Hahm, Young-Jin Lee, Jong Won Lee, Hyun Jo Youn, Seun Ja Park","doi":"10.1016/j.jpainsymman.2025.06.001","DOIUrl":"10.1016/j.jpainsymman.2025.06.001","url":null,"abstract":"<p><strong>Context: </strong>Despite the heightened risk of suicide in cancer patients, effective tools identifying those at risk remain limited.</p><p><strong>Objectives: </strong>This study validates the multi-dimensional assessment of suicide risk in chronic illness (MASC-20) for cancer patients and examine the psychometric properties of its short-form (MASC-8).</p><p><strong>Methods: </strong>A total of 298 patients with cancer from four teaching hospitals in South Korea completed an on-site survey, including the MASC-20, the schedule of attitudes toward hastened death-abbreviated version, Attitudes toward end-of-life interventions (e.g., euthanasia, and physician-assisted suicide), and the Hospital Anxiety and Depression scale.</p><p><strong>Results: </strong>The MASC-20 showed excellent reliability (α=.93), and exploratory structural equation modeling confirmed its four-factor structure (physical distress, psychological distress, social distress and suicidal behavior) with acceptable model fit (CFI=.947, RMSEA=.069). A higher-order factor correlated strongly with psychological (.98) and social distress (.91). The MASC-8 retained good reliability (α=.84) and demonstrated known group validity, differentiating clinical depression/anxiety. It also showed incremental validity, explaining additional variance in desire for hastened death (ΔR²=.10, P<.001). Using a cutoff score of 6, the MASC-8 showed good sensitivity (81.8%) and specificity (73.3%; AUC=.84), performing comparably to the MASC-20.</p><p><strong>Conclusions: </strong>The MASC-20 is a valid measure of distress and suicidal behavior in patients with cancer. The MASC-8 maintains acceptable psychometric properties, offering a brief yet effective tool for suicide risk assessment in oncology settings.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Uncertainty of Euthanasia.","authors":"Juan Luis Torres-Tenor","doi":"10.1016/j.jpainsymman.2025.05.020","DOIUrl":"10.1016/j.jpainsymman.2025.05.020","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demoralization, Pain, and Hope as Predictors of Desire for Death in Cancer Patients: A Cross-Sectional Study.","authors":"Maria Nikoloudi, Petros Galanis, Ioanna Tsatsou, Kyriaki Mystakidou","doi":"10.1016/j.jpainsymman.2025.05.018","DOIUrl":"10.1016/j.jpainsymman.2025.05.018","url":null,"abstract":"<p><strong>Context: </strong>The desire to hasten death is a critical issue in palliative and end-of-life care for patients with cancer, reflecting physical suffering, psychological distress, and existential concerns. Pain, demoralization, and hope are key factors shaping patients' perspectives on life and death. A deeper understanding of these factors is crucial for developing holistic interventions that address both physical and emotional needs.</p><p><strong>Objectives: </strong>This study aimed to explore the relationships between pain, demoralization, and hope with the desire to hasten death among patients with cancer. Additionally, it sought to identify significant psychological and clinical predictors while adjusting for potential confounders.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 112 patients with cancer receiving palliative care in Greece. Validated tools were used to assess pain, demoralization, hope, and the desire to hasten death. Various demographic and clinical factors were considered as confounders. Logistic regression analysis was performed to examine the influence of pain, demoralization, and hope on the desire for hastened death.</p><p><strong>Results: </strong>Univariate analysis revealed significant associations between pain, demoralization, hope, and the desire to hasten death. In multivariable analysis, demoralization was positively associated with a greater desire to hasten death (adjusted OR = 1.184, P = 0.016), while hope was negatively associated (adjusted OR = 0.807, P = 0.027). Pain was not a significant predictor in the final model.</p><p><strong>Conclusion: </strong>Demoralization and hope significantly influence the desire to hasten death in patients with cancer, with demoralization increasing and hope decreasing this desire. These findings highlight the need for psychological and existential interventions alongside physical symptom management.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Study of Preclinical Medical Student Reflections on Required Palliative Care Experience.","authors":"Ann A Soliman, Jennifer M Olenik, Alana Sagin, Bridget Durkin","doi":"10.1016/j.jpainsymman.2025.05.017","DOIUrl":"10.1016/j.jpainsymman.2025.05.017","url":null,"abstract":"<p><strong>Introduction: </strong>Medical schools are increasingly incorporating palliative care (PC) experiences to promote knowledge about patient-centered care and improve primary PC skills of future physicians; however, best practices for doing so remain underdeveloped. As part of a longitudinal four-year medical school curriculum, all preclinical second-year medical students spend one half-day embedded in a PC team in an academic hospital or in a home setting.</p><p><strong>Objectives: </strong>To evaluate written reflections of preclinical medical students for themes and experience impact following a PC experience with an interdisciplinary clinical team.</p><p><strong>Methods: </strong>Qualitative analysis was used to evaluate students' reflections written within 1 week of completing the palliative medicine experience. Conventional content analysis was used using NVivo statistical software. Authors inductively developed a codebook based on a small sample of reflections which was subsequently used for coding all reflections.</p><p><strong>Results: </strong>138 reflections were completed and included in this analysis. Five primary themes were identified: (1) introduction to the content and substance of PC as a field; (2) understanding PC as a collaborative effort that relies on an interdisciplinary team; (3) observation leading to deeper understanding of communication techniques; (4) understanding of systems-level considerations and barriers to care; and (5) early PC shadowing influences early professional identify consideration.</p><p><strong>Conclusion: </strong>Students developed deeper understanding of PC, including communication skills and interdisciplinary collaboration, as well as insights about future professional identity formation. Findings highlight the value of incorporating a required PC experience for all preclinical medical students. Themes identify opportunities to support students in their professional growth.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Symptom Reporting by Children With Cancer, Caregivers, and Care Teams.","authors":"Anna L Olsavsky, Kathleen E Montgomery, Mariam Kochashvili, Ashley Benhayoun, Mark Ranalli, Micah A Skeens","doi":"10.1016/j.jpainsymman.2025.05.016","DOIUrl":"10.1016/j.jpainsymman.2025.05.016","url":null,"abstract":"<p><strong>Context: </strong>Research indicates substantial disagreement between symptom reports from children, caregivers, and care teams, though triadic agreement is rarely assessed.</p><p><strong>Objectives: </strong>To assess agreement for 31 cancer-related symptoms between child-caregiver-care team triads.</p><p><strong>Methods: </strong>Children (n = 55) were within 1 year of cancer treatment (M = 68.44 days since treatment, SD = 159.09) and aged 6-17 years (M = 12.02, SD=3.50). Caregivers (n = 55) were mostly female (65.5%). Thirty-one symptoms were collected via child and caregiver reports on the Memorial Symptom Assessment Scale and extracted from the medical record for care team documentation. McNemar tests evaluated symptom report differences. Weighted kappa statistics assessed agreement.</p><p><strong>Results: </strong>Caregivers and care teams consistently under-reported child symptoms. Caregivers significantly under-reported 3 child symptoms. Care teams significantly under-reported 13 symptoms and 11 symptoms were not endorsed by care team. Child-caregiver agreement ranged from κ = -0.059 (swelling of arms/legs) to κ = 0.751 (nausea); 61% of symptoms were none to fair agreement. Child-care team agreement ranged from κ = -0.033 (swelling of arms/legs) to κ = 0.466 (nausea); 96.7% of symptoms were none to fair agreement. Caregiver-care team agreement ranged from κ = -0.029 (swelling of arms/legs) to κ = 0.565 (vomiting); 87% of symptoms were none to fair agreement.</p><p><strong>Conclusion: </strong>We found substantial triadic disagreement between child, caregiver, and care team symptom reports; the greatest disagreement existed between child-care team reports. Children consistently reported more symptoms than caregivers and their care team, suggesting the child's voice may not be solicited or documented. Further research is needed to understand how best to identify and solicit child reports of symptoms to optimize treatment.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lidocaine for Neuropathic Cancer Pain (LiCPain): A Pilot Randomized Controlled Trial.","authors":"Jessica T Lee, Melanie R Lovell, Megan Ritchie, Belinda E Butcher, Caitlin Sheehan, Belinda Fazekas, Andrew McLachlan, Nikki McCaffrey, Jane L Phillips, Anthony Linton, Rajesh Aggarwal, Davinia Seah, Marian Kow, Rachel George, Richard Chye, Bev Noble, David Currow, Ghauri Aggarwal, Dipti Mittal, Chadi Ayoub, Eugenia Hutton, Angela Rao, Kat Urban, Priyanka Vandersman, Christine Sanderson, Meera Agar","doi":"10.1016/j.jpainsymman.2025.05.015","DOIUrl":"10.1016/j.jpainsymman.2025.05.015","url":null,"abstract":"<p><strong>Context: </strong>Extended continuous subcutaneous infusion of lidocaine for neuropathic cancer pain is currently used in clinical practice.</p><p><strong>Objective: </strong>To determine the feasibility of conducting an adequately powered, multisite, double-blind, parallel group, titrated dose, randomized controlled trial of continuous subcutaneous infusion of lidocaine versus placebo in palliative care patients with neuropathic cancer pain.</p><p><strong>Methods: </strong>Adults with neuropathic cancer pain were randomized to receive lidocaine hydrochloride 10%w/v (3000 mg/30 mL) diluted in sodium chloride 0.9% or sodium chloride 0.9% as a continuous subcutaneous infusion titrated daily for 72 hours. The dose increased from 1 to 2 mg/kg/h, capped at 120mg/hour (2800mg/day, rounded down).</p><p><strong>Results: </strong>Seventeen participants were recruited over 54 months. There was a 93% [95%CI 88%-98%] completion rate of study medication and procedures meeting the predefined feasibility criteria. Eighty-eight percent of participants completed 72 hours of study medication. Treatment-emergent adverse events were infrequent and generally mild or moderate nervous system, cardiac and vascular abnormalities. There were no electrocardiogram abnormalities. Rapid titration from 1 to 2 mg/kg/h was tolerated. Both intervention and control groups demonstrated a reduction in pain intensity with no significant difference.</p><p><strong>Conclusion: </strong>This pilot demonstrates that a phase III clinical trial of extended continuous subcutaneous infusion of lidocaine for neuropathic cancer pain is feasible and provides important insights into modifications required to improve recruitment. Serum levels and relative safety suggest higher lidocaine doses could be cautiously evaluated. As the only prospective trial we are aware of to date, this trial informs clinical use of subcutaneous lidocaine infused over days.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}