Journal of pain and symptom management最新文献

{"title":"Racism in Pediatric Serious Illness and Palliative Care: A Scoping Review of Qualitative Research","authors":"J'Mag Karbeah PhD, MPH ,&nbsp;Camille R. Murray MPH, CHES ,&nbsp;Corelle Nakamura MPH ,&nbsp;Haley Brahmbhatt MSPH ,&nbsp;Elena Cattaneo BS ,&nbsp;Hailey Frye BS ,&nbsp;Erin Shen BS ,&nbsp;Dio Kavalieratos PhD, FAAHPM ,&nbsp;Khaliah A. Johnson MD","doi":"10.1016/j.jpainsymman.2024.09.021","DOIUrl":"10.1016/j.jpainsymman.2024.09.021","url":null,"abstract":"<div><h3>Context</h3><div>Racial disparities in health outcomes have historically impacted Black and Native American children with serious illness, yet little is known about how racism shapes the healthcare experiences of these families. To improve care experiences for this population, we must understand the myriad of ways that racism may impact their experiences with serious illness.</div></div><div><h3>Objectives</h3><div>1) To assess the extent to which the experiences of Black and Native American families have been captured in existing serious illness and palliative care literature and 2) explore how experiences of racism uniquely impact this population.</div></div><div><h3>Methods</h3><div>We conducted a scoping review and qualitative meta-synthesis of peer-reviewed articles from 1980 to 2022 that included Black and/or Native American parents’ or caregivers’ experiences of serious illness care. We abstracted study characteristics, and forms of racism mentioned.</div></div><div><h3>Results</h3><div>Searches yielded 2762 articles, of which six were reviewed based on inclusion criteria. Three key themes emerged from the literature on the experiences of Black families navigating pediatric serious illness that highlight how parents navigate their future after a serious illness diagnosis; how relationships and support networks change after diagnosis; and the challenges associated with navigating grief and suffering after a diagnosis. Institutionalized racism and interpersonal racism were the most identified forms of racism experienced by Black families. None of the articles identified included Native American families.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the pressing need for further qualitative research to explore the lived experiences of racially minoritized families—especially studies focusing on the experiences of Native American families.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 1","pages":"Pages 44-52"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372080","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":"Interview Results From a Telehealth Hospice Intervention for Children and Young Adults With Cancer.","authors":"Shaheen Rana, Nicholas P DeGroote, Ebonee Harris, Anna Lange, Karen Wasilewski-Masker, James L Klosky, Joanne Wolfe, Dio Kavalieratos, Katharine E Brock","doi":"10.1016/j.jpainsymman.2024.12.018","DOIUrl":"10.1016/j.jpainsymman.2024.12.018","url":null,"abstract":"<p><strong>Background and aims: </strong>Surveyed families of children and young adults with cancer who participated in a pilot study of three coordinated telehealth visits (triad of patient/family, hospital clinician, and hospice nurse) during the first month of hospice enrollment found telehealth feasible and were highly satisfied with hospice care. The aim of this study is to further explore adult patient and caregiver perspectives on telehealth, specifically the benefits of telehealth, trade-offs with in-person appointments, and the impact on patient care and family end-of-life preparations.</p><p><strong>Methods: </strong>This is a single-arm prospective pilot study of patients aged 0-29-with cancer initiating hospice care between 2021 and 2022 and their caregivers. Semi-structured qualitative interviews were conducted with adult patients after the first telehealth visit and with caregivers during bereavement. Traditional content analysis methods were employed to analyze the interviews.</p><p><strong>Results: </strong>The primary themes identified were (1) convenience and positive experiences with technology (addressing family questions and concerns, comfort of home, user-friendliness of technology), (2) benefits of coordinated appointments (improved collaboration/communication among team members and patient/caregiver understanding), (3) the positive impact of telehealth visits on care (symptom management, support, and preparation for end-of-life).</p><p><strong>Conclusions: </strong>Adult patients enrolled in hospice and bereaved caregivers found coordinated telehealth visits to be beneficial, notably the convenience, comfort, time and cost savings of participating from home. Coordinated telehealth visits provide opportunities for hospice and hospital clinicians to communicate and collaborate on symptom management plans while supporting and guiding families in end-of-life preparations.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921947","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":"Cigarette Smoking and Symptom Burden: Baseline Results From Nine ECOG-ACRIN Cancer Clinical Trials.","authors":"Sarah N Price, Ju-Whei Lee, Ilana F Gareen, Sheetal M Kircher, Shaji K Kumar, Ingrid A Mayer, Nabil F Saba, Timothy S Fenske, Michael B Atkins, F Stephen Hodi, Christos E Kyriakopoulos, Clare M Tempany-Afdhal, Tait D Shanafelt, Elyse R Park, Lynne I Wagner","doi":"10.1016/j.jpainsymman.2024.12.021","DOIUrl":"10.1016/j.jpainsymman.2024.12.021","url":null,"abstract":"<p><strong>Context: </strong>Approximately 11% of cancer survivors smoke postdiagnosis.</p><p><strong>Objectives: </strong>Understanding the relationship between smoking and perceived cancer-related symptoms may inform tobacco treatment interventions for this population.</p><p><strong>Methods: </strong>From 2017 to 2021, 740 adults in 9 ECOG-ACRIN trials provided baseline data. The effects of smoking status on symptoms were evaluated using logistic regression, adjusting for age, gender, race, performance status, treatment setting, and anxiety. Fisher's exact test was used to compare the prevalence of patients reporting that smoking helps/worsens each symptom by smoking status (current vs. former).</p><p><strong>Results: </strong>Among participants (mean age = 58.8, 93.9% white, 30.3% female, most common cancer types: leukemia [35.5%], lymphoma [19.1%], and prostate [17.7%]), smoking statuses were: 81 current (10.9%), 257 former (34.7%), and 402 (54.3%) never. Patients currently smoking were more likely to experience cough compared to those who formerly (OR = 3.25, P < .0001) or never (OR = 3.70, P < .0001) smoked. Current smoking was associated with greater severity of cough and pain and greater pain interference compared to former and never smoking (OR's > 2.26, P's < .005). Patients currently smoking were more likely to report that smoking helps with nausea (29.4% vs. 1.3%, P < .0001), insomnia (16.4% vs. 0.6%, P < .0001), and pain (16.1% vs. 2.8%, P = .002) compared to those who formerly smoked.</p><p><strong>Conclusion: </strong>Patients currently smoking report greater severity of cancer-related symptoms (i.e., cough, pain) yet were also more likely to believe that smoking helps with nausea, insomnia, and pain. Symptom management should include tobacco cessation, education on smoking and its relationship to symptoms, and strategies to reduce reliance on smoking for symptom relief.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922019","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":"Quality of Nonprofit Hospice Affiliated With Integrated Healthcare Systems.","authors":"Gulmeena Khan, Emmanuelle Belanger, Joan Teno","doi":"10.1016/j.jpainsymman.2024.12.019","DOIUrl":"10.1016/j.jpainsymman.2024.12.019","url":null,"abstract":"<p><strong>Context: </strong>Research shows hospice primary caregivers report better quality of care at Nonprofit (NP) than For-Profit (FP) hospices, but there is variation in quality across NP hospices.</p><p><strong>Objective: </strong>Examine bereaved caregiver reports of the quality as a factor of whether NP hospices are part of an integrated healthcare system that included an acute care hospital.</p><p><strong>Methods: </strong>Cross-sectional study of NP Hospices used star ratings and adjusted hospice composite quality scores May 2023 publicly data reported on the Care Compare website. Using organizational website information, we compared hospices part of an integrated healthcare system with at least one acute care hospital to hospices without that affiliation. Primary outcomes were overall hospice adjusted CAHPs score and star ratings.</p><p><strong>Results: </strong>Nearly one-half (44.5%) of 645 NP hospices were part of integrated healthcare systems. Overall hospice CAHPs scores did not differ by organizational affiliation, mean score 82 [95% CI 82.8-83.6] for hospice part of integrated system vs 83.3 [95% CI 82.9-83.7] those without that affiliation), nor did mean star ratings (3.7 [ 95% CI 3.6-3.8] vs. 3.8[ 95% CI 3.7-3.8]) and CAHPs scores 3 points or more below the national average (29.5%[95% CI 24.3-35.1] vs 30.8%[ 95% CI 26.0-35.9]). State fixed-effects models showed a trend towards lower quality among hospice in integrated systems but did not reach conventional statistical significance.</p><p><strong>Conclusion: </strong>CAHPs hospice scores did not differ if a hospice was part of integrated healthcare system or not. Further research is needed on variation in quality in NP hospices.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922021","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":"Highlighting the Importance of Trainee Distress in Palliative Care and Ethics Consultations","authors":"Emily Pinto Taylor MD ,&nbsp;Ashima Lal MD ,&nbsp;Maura George MD","doi":"10.1016/j.jpainsymman.2024.12.015","DOIUrl":"10.1016/j.jpainsymman.2024.12.015","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 3","pages":"Pages e245-e246"},"PeriodicalIF":3.2,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906962","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":"\"You Want to Shield Your Kids\": Patients' and Their Adult-Children's Serious Illness Conversations.","authors":"Anny Thr Fenton, Bernadette Blashill, Anna C Revette, Alexis Mann, Maija Reblin, Andrea C Enzinger, Katherine A Ornstein, Supriya Jain, Christopher R Manz, James A Tulsky, Alexi A Wright","doi":"10.1016/j.jpainsymman.2024.12.014","DOIUrl":"10.1016/j.jpainsymman.2024.12.014","url":null,"abstract":"<p><strong>Context: </strong>Timely and transparent serious illness conversations (SIC) between family caregivers and patients facilitate high-quality end-of-life care and patients' and family caregivers' mental wellbeing, but frequently do not occur, happen too late, or are incomplete. While social relations and roles shape communication, few studies explore their influence on patient-caregiver SICs.</p><p><strong>Objectives: </strong>Investigate how the parent-child relation and roles shape SICs between cancer patients and their adult-child caregivers (ACC), the largest caregiver population.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with 47 participants: advanced cancer patients (n = 16), their ACCs (n = 23), and bereaved ACCs (n = 8). Interviews were transcribed and analyzed using a theoretical thematic approach.</p><p><strong>Results: </strong>Respondents' experiences with SICs centered on three key themes: (1) the parent role could hinder SICs in an attempt to protect their ACC while expectations to prepare one's child promoted SICs; (2) adult-children's busy life phase (e.g., marriage, children, career) hampered their prognostic awareness and added emotional weight to parent-child SICs; and (3) the child role dictated expectations for SICs and amplified distress when ACCs felt they were expected to engage in SICs in ways concordant with another role (e.g., patient's spouse or nurse).</p><p><strong>Conclusion: </strong>The fundamental rebalancing of the parent-child relation and roles when an adult-child cares for their parent creates unique challenges for patients and their ACC to discuss and plan for end-of-life. To encourage timely, effective SICs, clinicians and caregiver services in and outside the clinic need awareness and guidance on how goals of care conversations must incorporate family caregivers' and patients' familial role expectations.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895466","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":"AAHPM Assessment Workgroup: Hospice and Palliative Medicine Fellowship Assessment Needs and Directions","authors":"Briana Ketterer MD, MS, FACP ,&nbsp;Laura Dingfield MD, MSEd, FAAHPM ,&nbsp;Katie H. Stowers DO, FAAHPM ,&nbsp;Katherine Morrison MD, FAAHPM ,&nbsp;Amos Bailey MD, FACP, FAAHPM ,&nbsp;Hilary Flint DO, MEd ,&nbsp;Gary Buckholz MD, HMDC, FAAHPM ,&nbsp;Laura J. Morrison MD, FAAHPM ,&nbsp;Holly Yang MD, MSHPEd, HMDC, FAAHPM ,&nbsp;Stephen Berns MD, FAAHPM","doi":"10.1016/j.jpainsymman.2024.12.009","DOIUrl":"10.1016/j.jpainsymman.2024.12.009","url":null,"abstract":"<div><h3>Context</h3><div>Medical education is moving towards competency based medical education (CBME). This provides opportunities and challenges for the field of Hospice and Palliative Medicine (HPM). The American Academy of Hospice and Palliative Medicine (AAHPM) created the Assessment Workgroup to spearhead a shared vision and process to implement high-quality assessment of fellow performance.</div></div><div><h3>Objectives</h3><div>The workgroup solicited the assessment experiences of program directors (PD) and recently graduated fellows across HPM fellowship programs to understand the needs of the community and inform the group's next steps.</div></div><div><h3>Methods</h3><div>In 2022, a RedCap survey was emailed to HPM PDs asking about the methods of fellow assessment in their program and their confidence in those methods. Those PDs then sent a similar survey to their graduating fellows. Survey data was analyzed using SPSS. Qualitative analysis of narrative responses was conducted by the workgroup.</div></div><div><h3>Results</h3><div>56 PDs and 64 fellows responded. Nearly 50% use four or less assessment tools. Fellows reported greater confidence in assessment tools compared to PDs (83% vs. 68%). The most common assessors were physicians followed by interdisciplinary faculty. Many PDs (61%) reported no formal training in assessment and most reported dissatisfaction with faculty development in assessment (66%).</div></div><div><h3>Conclusion</h3><div>There is a lack of training and resources for HPM PDs in fellow assessment, and a need for faculty development. Fellows are engaged and should be invited as collaborators in this work. The AAHPM Assessment Workgroup is creating a nationally available resource of tools and accompanying faculty development materials.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 3","pages":"Pages e220-e227"},"PeriodicalIF":3.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872265","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":"Effects of a Comprehensive Program on Reducing Cancer-Related Fatigue: A Randomized Controlled Trial.","authors":"Shijiao Zhang, Feifei Zhang, Hong Chen, Lei Wang, Xiaolian Jiang","doi":"10.1016/j.jpainsymman.2024.12.013","DOIUrl":"10.1016/j.jpainsymman.2024.12.013","url":null,"abstract":"<p><strong>Context: </strong>Cancer-related fatigue (CRF) can affect patients undergoing chemotherapy severely. A comprehensive intervention targeted for reducing CRF is lacking.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of an innovative multifaceted web-based patient-empowered CRF management program for improving CRF, perceived self-efficacy for fatigue self-management (PSEFSM), physical activity, quality of sleep, anxiety, depression, pain and quality of life (QoL) among gastric cancer patients undergoing chemotherapy in China.</p><p><strong>Methods: </strong>A total of 92 eligible gastric cancer patients undergoing chemotherapy were recruited and randomly assigned to two groups. Participants in the intervention group received a 12-week CRF intervention including eight online sessions, patient diary for self-management practice; telephone follow-up and online support via WeChat. The control group received routine care. Primary outcome was CRF. Secondary outcomes included PSEFSM, physical activity, quality of sleep, anxiety, depression, pain, and QoL. Outcome variables were measured three times: at admission(T0), post-intervention(T1) and one-month post-intervention(T2). Repeated measures ANOVA or generalized estimating equations were used to evaluate the intervention effect.</p><p><strong>Results: </strong>Significant group by time interaction was found in the scores of total CRF and its three dimensions, PSEFSM, total physical activities, quality of sleep, anxiety, depression, and QoL of the two groups (P <0.05). No significant difference was found in pain scores (P >0.05).</p><p><strong>Conclusion: </strong>This study provides evidence that an innovative multifaceted web-based patient-empowered CRF management program is effective in reducing CRF and improving related symptoms (depression, anxiety, quality of sleep), physical activity, PSEFSM and QoL for gastric cancer patients undergoing chemotherapy.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872349","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":"Clinician Perspectives Highlight the Need for Early Dyadic Coping Skills for People Living With Amyotrophic Lateral Sclerosis","authors":"Christina L. Rush PhD ,&nbsp;Chris Lyons MS ,&nbsp;Jenna Gittle ,&nbsp;Morgan Seward BS ,&nbsp;Jennifer Scalia NP ,&nbsp;Doreen Ho MD ,&nbsp;Suma Babu MBBS, MD ,&nbsp;Mark A. Garret MD ,&nbsp;Kate Brizzi MD ,&nbsp;James D. Berry MD, MPH ,&nbsp;Maurizio Fava MD ,&nbsp;Elizabeth Lindenberger MD ,&nbsp;Ana-Maria Vranceanu PhD ,&nbsp;Sean M. Healey and AMG Center for ALS Resilient Together-ALS (RT-ALS) Team","doi":"10.1016/j.jpainsymman.2024.12.010","DOIUrl":"10.1016/j.jpainsymman.2024.12.010","url":null,"abstract":"<div><h3>Context</h3><div>A diagnosis of ALS can be challenging, and many people find ways to adapt. At the same time, emotional distress can arise early after an ALS diagnosis even when high quality multidisciplinary care is provided. When emotional distress occurs, it can become chronic over time, and can affect both the person living with ALS and their care-partner (together called a dyad).</div></div><div><h3>Objectives</h3><div>We set out to understand ALS multidisciplinary clinicians’ perception of the challenges experienced by people with ALS and care-partners who experience emotional distress after diagnosis and potential benefits of a coping skills program to help these patients and their care-partners, Resilient Together-ALS (RT-ALS).</div></div><div><h3>Methods</h3><div>We conducted semi-structured focus groups and individual interviews with 17 clinicians at the Sean M. Healey &amp; AMG Center for ALS at MGH (N = 2 focus groups and five interviews) to elicit feedback on four domains: 1) Psychosocial Needs of ALS Dyads seen in the clinic; 2) Clinic Flow and Referral System to RT-ALS; 3) Clinic Partnership Approach in Support of RT-ALS; 4) RT-ALS Program Content and Manual Format. We conducted rapid data analyses for a time-efficient hybrid inductive-deductive thematic approach.</div></div><div><h3>Results</h3><div>Clinicians noted that dyadic distress (distress experienced by both patient and their care-partner individually and as a unit), though not universal, is often present early after diagnosis. The response to the proposed program content (dyadic and individual coping skills) and structure (6 weekly virtual sessions delivered within about 2 months after diagnosis) was positive. Multidisciplinary clinicians emphasized the importance of a skills-based program for dyads experiencing elevated early emotional distress for which referral can be easily integrated within clinic flow so as not to not increase provider and dyad burden.</div></div><div><h3>Conclusion</h3><div>RT-ALS program content and structure is acceptable to clinicians. It is imperative to next seek further input from dyads about whether this type of program would be of interest and if yes, to pilot and refine the program for feasibility testing and then efficacy.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 3","pages":"Pages 236-242.e4"},"PeriodicalIF":3.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872347","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 Benefits of Virtual Reality Travel on Symptom Burden and Mental Health of Hemodialysis Patients","authors":"Siyuan Qi MN(c) ,&nbsp;Qianqian Yang MN(c) ,&nbsp;Shihai Hu MN(c) ,&nbsp;Yitong Wang MN(c) ,&nbsp;Jiaqi Yang MN(c) ,&nbsp;Jie Li MN(c) ,&nbsp;Lina Wang MN ,&nbsp;Yan Zhang BSN","doi":"10.1016/j.jpainsymman.2024.11.018","DOIUrl":"10.1016/j.jpainsymman.2024.11.018","url":null,"abstract":"<div><h3>Context</h3><div>Hemodialysis (HD) patients often face a heavy symptom burden, low subjective well-being, and high perceived stress. Traditional nonpharmacological interventions have limited effectiveness in improving this situation. Virtual reality (VR) technology, as an emerging approach, has shown significant advantages in alleviating symptom burden and enhancing mental health.</div></div><div><h3>Objective</h3><div>To assess the feasibility of a single VR travel session for HD patients and to examine its impact on symptom burden, subjective well-being, and perceived stress.</div></div><div><h3>Methods</h3><div>This study adopted an embedded design, providing approximately 10 minutes of natural VR travel experience using VR head-mounted displays (HMD). The effectiveness of a single VR travel session for HD patients was evaluated. Quantitative data were collected through self-reported surveys using the Dialysis Frequency Severity and Symptom Burden Index (DFSSBI) to assess symptom burden, the General Well-Being Schedule (GWBS), and the Perceived Stress Scale (PSS) to evaluate well-being and stress. Postintervention, a modified single-item questionnaire assessed patient satisfaction with the VR travel experience. An open-ended question was included to capture patients’ experiential feedback.</div></div><div><h3>Results</h3><div>Twenty HD patients, with a mean age of 41.30 (9.82) years, completed the VR travel and subsequent assessments. The cohort comprised 35% female and 65% male participants. The VR travel significantly improved symptom burden (<em>t</em> = 3.64, <em>P</em> = 0.002), increased subjective well-being (<em>t</em> = -6.12, <em>P</em> &lt; 0.001), and reduced perceived stress (<em>t</em> = 4.16, <em>P</em> = 0.001). The postintervention satisfaction score was 7.35 (1.35) out of 10, and participants provided positive feedback on their VR travel experience.</div></div><div><h3>Conclusion</h3><div>A single VR travel session can alleviate symptom burden, enhance subjective well-being, and reduce perceived stress in HD patients. Participants reported high satisfaction and positive emotional responses, suggesting that this experience could be integrated into care routines as a nonpharmacological intervention to improve symptom burden and mental health in HD patients.</div></div><div><h3>Clinical Trial Registration</h3><div>[<span><span>www.chictr.org.cn</span><svg><path></path></svg></span>], identifier [ChiCTR2400082781].</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 3","pages":"Pages e247-e256"},"PeriodicalIF":3.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872355","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}