Palliative medicine reports最新文献

{"title":"Finnish Palliative Care Nurses' and Physicians' Perceptions of Spirituality and Spiritual Care Related to Their Attitudes toward End-of-Life Care.","authors":"Raimo Goyarrola, Annamarja Lamminmäki, Virpi Sipola, Ikali Karvinen, Minna Peake, Suvi-Maria Saarelainen, Nina Santavirta, Leila Niemi-Murola, Reino Pöyhiä","doi":"10.1089/pmr.2023.0078","DOIUrl":"10.1089/pmr.2023.0078","url":null,"abstract":"<p><strong>Background: </strong>Spiritual care constitutes an indispensable aspect of palliative care (PC). Health care professionals encounter challenges when addressing spiritual care at the end of life. Developing appropriate attitudes toward end-of-life care can facilitate the acquisition of competencies needed for effective delivery of spiritual care.</p><p><strong>Aim: </strong>To explore the perceptions of spiritual care and attitudes toward end-of-life care among PC professionals.</p><p><strong>Design: </strong>The Finnish version of the \"Spirituality and Spiritual Care Rating Scale\" (SSCRS-FIN) and a newly developed \"Attitudes toward End-of-Life Issues\" (AEOLI) questionnaire were validated and utilized.</p><p><strong>Setting/participants: </strong>Both questionnaires were distributed to PC professionals involved in PC through an online survey. Exploratory and confirmatory factor analyses were conducted. The newly derived factors were subsequently examined for their associations with age, gender, profession, affiliation with a religious community, personal interpretation of spirituality, and years of professional experience.</p><p><strong>Results: </strong>A total of 204 participants took part in the study (163 nurses, 19 nursing students, and 22 physicians). Exploratory factor analysis demonstrated satisfactory internal consistency, as indicated by Cronbach's alpha coefficients, for the five factors of SSCRS-FIN: \"Spirituality\" (0.733), \"Existential\" (0.614), \"Spiritual Needs\" (0.599), \"Passive Spiritual Care\" (0.750), and \"Active Spiritual Care\" (0.665); and for the seven factors of AEOLI: \"Anxiety\" (0.823), \"Discussion\" (0.924), \"End-of-Life\" (0.573), \"Education\" (0.692), \"Medically Induced Death\" (0.859), \"Suffering\" (0.671), and \"Knowledge\" (0.444). Confirmatory factor analysis demonstrated satisfactory fit values for both questionnaires. Significant positive correlations were observed between end-of-life care and the factors \"Existential,\" \"Spiritual Needs,\" and spiritual care factors, whereas an inverse correlation was found among \"Anxiety,\" \"Medically Induced Death,\" and all factors of SSCRS-FIN.</p><p><strong>Conclusions: </strong>Valid and reliable questionnaires for assessing spiritual care (SSCRS-FIN) and attitudes toward end-of-life care (AEOLI) were developed. Attitudes toward end-of-life care were positively correlated with perceptions of spiritual care.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"247-257"},"PeriodicalIF":1.1,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Good Death and Quality of End-of-Life Care in Patients with Coexisting Cancer and Dementia: Perspective of Bereaved Families.","authors":"Ayumi Takao, Harue Arao, Sena Yamamoto, Miwa Aoki, Katsuyasu Kouda, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita","doi":"10.1089/pmr.2023.0083","DOIUrl":"10.1089/pmr.2023.0083","url":null,"abstract":"<p><strong>Background: </strong>Patients with coexisting cancer and dementia often have complex health care needs and face challenges in achieving a good death.</p><p><strong>Objectives: </strong>To evaluate good death achievement and end-of-life (EOL) care in patients with coexisting cancer and dementia from the perspective of bereaved families.</p><p><strong>Design: </strong>Cross-sectional nationwide postal survey.</p><p><strong>Setting/subjects: </strong>Bereaved families of patients with cancer who died in hospice and palliative care units across Japan.</p><p><strong>Measurements: </strong>Bereaved families completed an anonymous, self-reported questionnaire. Their perspective on achieving a good death was assessed using the Good Death Inventory (GDI) (total score: 18-126). The Revised Care Evaluation Scale-short version (CES2) was used to assess EOL care (total score: 10-60). We examined the Brief Grief Questionnaire (BGQ) (total score: 0-10) and Patient Health Questionnaire 9 (PHQ9) (total score: 0-27).</p><p><strong>Results: </strong>Data from 670 participants were analyzed, including 83 (12.4%) bereaved families of patients with coexisting cancer and dementia. No statistical differences were observed in the total GDI score for 18 items (dementia comorbidity vs. nondementia comorbidity groups, mean ± standard deviation, respectively, 78.4 ± 17.7 vs. 80.0 ± 15.5, adjusted [adj] <i>P</i> = 0.186), CES2 score (49.70 ± 9.22 vs. 48.82 ± 8.40, adj <i>P</i> = 0.316), BGQ score (3.40 ± 2.41 vs. 4.36 ± 2.28, adj <i>P</i> = 0.060), and PHQ9 score (4.67 ± 4.71 vs. 5.50 ± 5.37, adj <i>P</i> = 0.788).</p><p><strong>Conclusions: </strong>GDI, CES2, BGQ, and PHQ9 scores did not differ significantly between groups, regardless of the presence of dementia in hospice and palliative care units. Patients with coexisting cancer and dementia can achieve a good death by high-quality EOL care.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"215-224"},"PeriodicalIF":1.1,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Differences in Physicians' Attitudes toward Percutaneous Endoscopic Gastrostomy Feeding in Older Adults Receiving End-of-Life Care in Japan: A Cross-Sectional Study.","authors":"Yoko Sakamoto, Toshiharu Mitsuhashi, Katsuyuki Hotta","doi":"10.1089/pmr.2023.0088","DOIUrl":"10.1089/pmr.2023.0088","url":null,"abstract":"<p><strong>Background: </strong>Although percutaneous endoscopic gastrostomy (PEG) placement is still widely practiced in Japan, studies from Western countries report that it is less beneficial for patients in end-of-life care with cognitive decline. Decisions regarding PEG placement are largely influenced by physician judgment.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the background and perceptions of Japanese physicians regarding PEG for older adults in end-of-life care and to identify the factors associated with differences in physician judgment regarding PEG.</p><p><strong>Design: </strong>The study employed a cross-sectional design.</p><p><strong>Setting/subjects: </strong>A questionnaire on PEG for older adults in end-of-life care was sent to Japanese physicians. Logistic regression analysis was used to calculate the odds ratios (ORs) and confidence intervals (CIs) of the association between PEG recommendations and each factor.</p><p><strong>Results: </strong>PEG placement was advised for bedridden patients and older adults with cognitive decline by 26% of the physicians who responded to the survey. Differences in physician perceptions of PEG feeding were associated with the recommendation for PEG, benefits of preventing aspiration pneumonia (OR: 4.9; 95% CI: 3.1-8.2), impact on post-discharge accommodation decisions (OR: 6.1; 95% CI: 1.9-30.9), and hesitancy to recommend a PEG placement (OR: 1.9; 95% CI: 1.3-4.5). Working in a facility with PEG placement (OR: 2.0; 95% CI: 1.2-3.5) was an associated background factor.</p><p><strong>Conclusions: </strong>Differences in Japanese physicians' attitudes toward using PEG feeding for older adults in end-of-life care were significantly associated with differences in their perceptions of the impact of PEG feeding and working in a facility with PEG placement.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"206-214"},"PeriodicalIF":1.1,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Utility of Less Than Six-Month Prognosis Using Administrative Data Among U.S. Nursing Home Residents With Cancer.","authors":"Long Vu, Siran M Koroukian, Sara L Douglas, Hannah L Fein, David F Warner, Nicholas K Schiltz, Jennifer Cullen, Cynthia Owusu, Martha Sajatovic, Johnie Rose, Richard Martin","doi":"10.1089/pmr.2023.0047","DOIUrl":"10.1089/pmr.2023.0047","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of studies evaluating the utility of reporting prognostication among nursing home (NH) residents with cancer.</p><p><strong>Objective: </strong>To study factors associated with documented less than six-month prognosis, and its relationship with end-of-life (EOL) care quality measures among residents with cancer.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results linked with Medicare, and the Minimum Data Set databases was used to identify 20,397 NH residents in the United States with breast, colorectal, lung, pancreatic, or prostate cancer who died between July 2016 and December 2018. Of these, 2205 residents (10.8%) were documented with less than six-month prognosis upon NH admission. Main outcomes were more than one hospitalization, more than one emergency department visit, and any intensive care unit admission within the last 30 days of life as aggressive EOL care markers, as well as admission to hospice, receipt of advance care planning and palliative care, and survival. Specificity and sensitivity of prognosis were assessed using six-month mortality as the outcome. Propensity score matching adjusted for selection biases, and logistic regression examined association.</p><p><strong>Results: </strong>Specificity and sensitivity of documented less than six-month prognosis for mortality were 94.2% and 13.7%, respectively. Residents with documented less than six-month prognosis had greater odds of being admitted to hospice than those without (adjusted odds ratio: 3.27, 95% confidence interval: 2.86-3.62), and lower odds to receive aggressive EOL care.</p><p><strong>Conclusion: </strong>In this cohort study, documented less than six-month prognosis was associated with less aggressive EOL care. Despite its high specificity, however, low sensitivity limits its utility to operationalize care on a larger population of residents with terminal illness.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"127-135"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric End-of-Life Simulation Workshop to Clinical Care: Lasting Implications on Clinical Practice.","authors":"Kayla Solstad, Heidi Kamrath, Sonja Meiers, Naomi Goloff, Johannah M Scheurer","doi":"10.1089/pmr.2023.0065","DOIUrl":"10.1089/pmr.2023.0065","url":null,"abstract":"<p><strong>Background: </strong>Simulations are an important modality for practicing high-acuity, low-frequency events. We implemented a deliberate practice simulation-based workshop to improve pediatric end-of-life care skills (PECS) competence.</p><p><strong>Purpose: </strong>To understand pediatric subspecialty fellows' perceptions about influences of a simulation-based workshop on PECS provided at the bedside several months following participation.</p><p><strong>Methods: </strong>Pediatric subspecialty fellows were recruited to voluntary focus groups during regular educational sessions six months following PECS workshop participation with aims to identify perceptions about their workshop participation and any implication on their clinical practice. Inductive qualitative content analysis of focus group interview data was performed adhering to the Standards for Reporting Qualitative Research.</p><p><strong>Results: </strong>Ten fellows participated in one of three focus groups. Researchers identified three major themes of fellow experience: burden, safe practice space, and self-efficacy. Fellows described practice implications from workshop participation, including incorporation of specific practices, improved anticipatory guidance, and increased team leader confidence.</p><p><strong>Conclusions: </strong>Targeted, deliberate simulation-based practice of PECS can help close the gap from learning to practice, contributing to provider self-efficacy and potentially improving clinical care for pediatric patients and families at end of life.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"136-141"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation of the Serious Illness Conversation Guide to Singapore's Multicultural Setting for Patients With Heart Failure, Renal Failure, or Cancer.","authors":"Anna So Youn Lee, Swee Noi Tang, Gillian Li Gek Phua, Alethea Chung-Pheng Yee, Shirlyn Hui-Shan Neo","doi":"10.1089/pmr.2023.0086","DOIUrl":"10.1089/pmr.2023.0086","url":null,"abstract":"<p><strong>Background: </strong>The Serious Illness Conversation Guide (SICG) was developed by Ariadne Labs in the United States. However, there is a scarcity of literature on the cross-cultural adaptations of the SICG in Asian settings.</p><p><strong>Objectives: </strong>We aimed to adapt the SICG for English-speaking patients with serious illnesses in Singapore.</p><p><strong>Methods: </strong>We purposively recruited 28 patients with advanced stages of heart failure, renal failure, or cancer from a tertiary hospital. A designated research team member conducted semistructured interviews to obtain participants' feedback on the SICG. The interviews were transcribed by the designated study team member. Participants' response to each item on the SICG was coded quantitatively into categories to denote participant acceptance, partial acceptance, or nonacceptance. Transcripts were further analyzed using content analysis to understand participants' rationale regarding feedback of the specific SICG item. Modifications to the SICG were iteratively made over time to obtain its current version.</p><p><strong>Results: </strong>Participants indicated a preference for direct language with shorter sentences and inclusive pronouns. It was considered important that clinicians keep the conversation hopeful, individualize the conversation content according to the patient's journey, and use prompts where necessary to support the patient's elaboration.</p><p><strong>Conclusion: </strong>This study outlined a patient-centric approach to localizing the SICG in the English language to a new cultural context, marking the first such effort in an Asian setting. Further study is under way to evaluate the SICG in more disease populations and non-English languages used in Singapore.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"122-126"},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are We Consulting, Sharing Care, or Taking Over? A Conceptual Framework.","authors":"José Pereira, Christopher Klinger, Hsien Seow, Denise Marshall, Leonie Herx","doi":"10.1089/pmr.2023.0079","DOIUrl":"10.1089/pmr.2023.0079","url":null,"abstract":"<p><strong>Background: </strong>Primary- and specialist-level palliative care services are needed. They should work collaboratively and synergistically. Although several service models have been described, these remain open to different interpretations and deployment.</p><p><strong>Aim: </strong>This article describes a conceptual framework, the Consultation-Shared Care-Takeover (C-S-T) Framework, its evolution and its applications.</p><p><strong>Design: </strong>An iterative process informed the development of the Framework. This included a symposium, literature searches, results from three studies, and real-life applications.</p><p><strong>Results: </strong>The C-S-T Framework represents a spectrum anchored by the <i>Consultation</i> model at one end, the <i>Takeover</i> model at the other end, and the <i>Shared Care</i> model in the center. Indicators, divided into five domains, help differentiate one model from the other. The domains are (1) Scope (What aspects of care are addressed by the palliative care clinician?); (2) Prescriber (Who prescribes the treatments?); (3) Communication (What communication occurs between the palliative care clinician and the patient's attending clinician?); (4) Follow-up (Who provides the follow-up visits and what is their frequency?); and (5) Most responsible practitioner (MRP) (Who is identified as MRP?). Each model demonstrates strengths, limitations, uses, and roles.</p><p><strong>Conclusions: </strong>The C-S-T Framework can be used to better describe, understand, assess, and monitor models being used by specialist palliative care teams in their interactions with primary care providers and other specialist services. Large studies are needed to test the application of the Framework on a broader scale in health care systems.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"104-115"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioids and Immunosuppression: Clinical Evidence, Mechanisms of Action, and Potential Therapies.","authors":"Jeffrey J Bettinger, Bruce C Friedman","doi":"10.1089/pmr.2023.0049","DOIUrl":"10.1089/pmr.2023.0049","url":null,"abstract":"<p><strong>Background: </strong>In addition to the more well-known adverse effects of opioids, such as constipation, mounting evidence supports underlying immunosuppressive effects as well.</p><p><strong>Methods: </strong>In this study, we provide a narrative review of preclinical and clinical evidence of opioid suppression of the immune system as well as possible considerations for therapies.</p><p><strong>Results: </strong><i>In vitro</i> and animal studies have shown clear effects of opioids on inflammatory cytokine expression, immune cell activity, and pathogen susceptibility. Observational data in humans have so far supported preclinical findings, with multiple reports of increased rates of infections in various settings of opioid use. However, the extent to which this risk is due to the impact of opioids on the immune system compared with other risk factors associated with opioid use remains uncertain. Considering the data showing immunosuppression and increased risk of infection with opioid use, measures are needed to mitigate this risk in patients who require ongoing treatment with opioids. In preclinical studies, administration of opioid receptor antagonists blocked the immunomodulatory effects of opioids.</p><p><strong>Conclusions: </strong>As selective antagonists of peripheral opioid receptors, peripherally acting mu-opioid receptor (MOR) antagonists may be able to protect against immune impairment while still allowing for opioid analgesia. Future research is warranted to further investigate the relationship between opioids and infection risk as well as the potential application of peripherally acting MOR antagonists to counteract these risks.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"70-80"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of Patients With Relapsed and Refractory Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome on Patient-Clinician Communication About Prognosis and the Future.","authors":"Vinay Rao, Sarah Linsky, M Tish Knobf","doi":"10.1089/pmr.2023.0064","DOIUrl":"10.1089/pmr.2023.0064","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) experience unpredictable disease trajectories and high prognostic uncertainty, which serve as barriers to patient-clinician communication about prognosis and their values and preferences for the future in the event of worsening health. Little is known about patients' day-to-day lived experiences and how this shapes their willingness to engage in such conversations.</p><p><strong>Objectives: </strong>To explore participant perspectives on living with their illness and patient-clinician communication about prognosis and the future.</p><p><strong>Design: </strong>This is a qualitative study using semi-structured interviews.</p><p><strong>Setting/subjects: </strong>Patients with relapsed and refractory (R/R) AML and high-risk MDS from a northeastern U.S. cancer center.</p><p><strong>Data collection: </strong>Interviews were transcribed verbatim and thematic analysis was used to generate findings.</p><p><strong>Results: </strong>Of the 14 participants, the mean age was 66 years, 79% were men, 93% were White, married, and had AML. The overarching theme that describes the experience was <i>\"Taking One Day at a Time\" in a Fog of Uncertainty.</i> Uncertainty was a universal perception related to the challenges for clinicians to predict prognosis. To cope with uncertainty, most participants tried to focus on the present and maintain normality in everyday life. Participants valued encouragement and positivity in patient-clinician communication, however, the majority were not ready to discuss prognosis and the future in the event of worsening health. Of note, 7 of 14 participants died within three months after the interview.</p><p><strong>Conclusions: </strong>These data describe a unique perspective of patients with R/R AML and high-risk MDS that clinicians could use to enhance communication strategies.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10797310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study.","authors":"Takehiko Tsuno, Takashi Kawaguchi, Ryota Yanaizumi, Junichi Kondo, Keiko Kojima, Takashi Igarashi, Masaki Inoue, Tomofumi Miura, Akime Miyasato, Kanako Azuma, Hiroshi Hamada, Tomoya Saeki, Hironori Mawatari, Hiroyuki Ogura, Akira Kotani, Takuhiro Yamaguchi, Hideki Hakamata","doi":"10.1089/pmr.2023.0068","DOIUrl":"10.1089/pmr.2023.0068","url":null,"abstract":"<p><strong>Background: </strong>We aimed to gain insight into psychological barriers toward initiation of strong opioid analgesic use in patients with advanced recurrent cancer.</p><p><strong>Methods: </strong>This study included 46 patients who were prescribed with opioid analgesics for advanced recurrent cancer. The primary outcome was psychological barriers assessed using the Japanese version of the Barriers Questionnaire-II (JBQ-II). The secondary outcomes were psychological changes and pain relief one week after the induction of strong opioid analgesics.</p><p><strong>Results: </strong>The mean age of participants was 63.6 years. Furthermore, 26.1% had an Eastern Cooperative Oncology Group (ECOG) performance status of ≥3. The mean JBQ-II total score was 1.97 (95% confidence interval: 1.75-2.19). At the initiation of opioid therapy, there was no difference in the total scores between the baseline and one week later. Nevertheless, there was a significant difference in the subscale \"disease progression\" score (mean 2.97 vs. 2.59, difference in means 0.38, standard error 0.16, <i>p</i> = 0.026). Personalized Pain Goal (PPG) was achieved in about half of the participants, and a trend toward a higher score in the subscale \"harmful effects\" (concern about adverse events) was observed in those who did not achieve PPG.</p><p><strong>Conclusion: </strong>This study showed that patients with advanced recurrent cancer have psychological barriers to opioid induction. The relationship between the presence of psychological barriers before and after induction of opioid analgesics and the speed of pain improvement was determined. The results may provide fundamental information for prospective intervention studies to develop individualized education programs for patients with psychological barriers to opioids.Clinical Trial Registration Number UMIN000042443.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10797307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}