Journal of pain and symptom management最新文献

{"title":"Quality indicators for home-based palliative care: A systematic review.","authors":"Yinshi Kan, Yao Xiao, Zhaoyu Li, Ziyue Chen, Peng Yue","doi":"10.1016/j.jpainsymman.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2025.06.011","url":null,"abstract":"<p><strong>Context: </strong>The advantages of home-based palliative care (HPC) are becoming increasingly acknowledged, resulting in a growing demand for this care model. The quality indicators (QIs) required for HPC may differ in scope and focus from those used in other care settings.</p><p><strong>Objectives: </strong>This review aimed to identify and integrate QIs for the provision of HPC.</p><p><strong>Methods: </strong>We searched PubMed, Medline, CINAHL, Cochrane Library, Web of Science and Embase databases to identify all articles on QIs for HPC. The QIs extracted from these articles were categorized by structure, process, or outcome, mapped to eight care domains, and their methodological characteristics were evaluated.</p><p><strong>Results: </strong>Fifteen articles were ultimately included, comprising 312 unique QIs. Among these, 45.5% were outcome indicators, 39.1% were process indicators. The most frequently addressed care domain were \"Structure and Process of Care\" (44.2%) and \"Physical Aspects of Care\" (28.8%), whereas the fewest QIs pertained to \"Spiritual, Religious and Existential Aspects of Care\" (2.2%) and \"Cultural Aspects of Care\" (1.6%). Methodological quality assessment varied considerably across the studies, with seven articles rated as high quality.</p><p><strong>Conclusions: </strong>This study integrated QIs for HPC. The majority of identified QIs were outcome or process indicators. However, fewer addressed social, cultural, and spiritual care domains. Validation was also limited, as only a small proportion of these QIs met sufficient criteria for warrant further testing. Future research could consider expanding QIs related to cultural sensitivity, home telehealth regulations, and subjective experiences and preferences to facilitate a more thorough and reliable assessment to improve the quality assessment of HPC services.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553799","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":"Minimal Clinically Important Difference in the Integrated Palliative Care Outcome Scale for Cancer Dyspnea.","authors":"Yoshinobu Matsuda, Masanori Mori, Akihiro Tokoro, Yoshihiko Taniguchi, Sayo Aiki, Yusuke Takagi, Daisuke Kiuchi, Kozue Suzuki, Madoka Ito, Shunsuke Oyamada, Keisuke Ariyoshi, Takashi Yamaguchi","doi":"10.1016/j.jpainsymman.2025.06.010","DOIUrl":"10.1016/j.jpainsymman.2025.06.010","url":null,"abstract":"<p><strong>Context: </strong>Dyspnea is a common and distressing symptom in patients with cancer. The Integrated Palliative care Outcome Scale (IPOS) provides health care providers with a proxy tool for assessing dyspnea; however, the minimal clinically important difference (MCID) in the IPOS for dyspnea is unknown.</p><p><strong>Objectives: </strong>To determine the MCID in the IPOS improvement for dyspnea.</p><p><strong>Methods: </strong>This secondary analysis used data from a multicenter prospective observational study initially designed to evaluate the effectiveness and safety of opioids for dyspnea in patients with cancer. We included patients with available IPOS scores and Patient's Global Impression (PGI) at baseline and 24, 48, and 72 h after starting opioid therapy, comprising cohorts 1, 2, and 3, respectively. The MCID for IPOS improvement in dyspnea was determined using a sensitivity-specificity approach, specifically Youden's J statistic and the top-left approach.</p><p><strong>Results: </strong>A total of 354, 308, and 272 patients were included in cohorts 1, 2, and 3, respectively. Based on Youden's J statistic, the optimal MCID cutoff for improvement in the IPOS score for dyspnea was ≥+1 in all cohorts. The sensitivities of these cutoffs were 0.86, 0.885, and 0.909 and the specificities were 0.770, 0.593, and 0.560 for cohorts 1, 2, and 3, respectively. The top-left approach confirmed this MCID cutoff of ≥+1 in all cohorts.</p><p><strong>Conclusion: </strong>The MCID for IPOS improvement in dyspnea was determined to be ≥+1 across all time points. This can facilitate the design and interpretation of future studies using IPOS scores as study outcomes.</p><p><strong>Clinical trial registration: </strong>UMINCTR: UMIN 000038918.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475731","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":"Profoundly Depleted: Qualitative Study of Persistent Fatigue Following Hematopoietic Cell Transplant.","authors":"Ashley M Nelson, Katherine G Cronin, Ally M Wood, Lara Traeger, Anna Barata, Richard Newcomb, Hermioni L Amonoo, Heather S L Jim, Hans Knoop, Areej El-Jawahri, Joseph A Greer","doi":"10.1016/j.jpainsymman.2025.06.009","DOIUrl":"10.1016/j.jpainsymman.2025.06.009","url":null,"abstract":"<p><strong>Context: </strong>Fatigue is the most commonly-reported symptom during long-term survivorship after hematopoietic cell transplant (HCT).</p><p><strong>Objectives: </strong>We sought to describe how HCT recipients experience and manage persistent post-transplant fatigue and to identify patient perceptions of and preferences for fatigue support.</p><p><strong>Methods: </strong>HCT recipients who were at least six months after autologous or allogeneic HCT and experiencing moderate to severe fatigue based on the fatiue symptom inventory (severity rating ≥4 / 0-10 scale) participated in this qualitative study conducted at a tertiary care transplant center. Participants completed in-depth individual interviews using semi-structured guides that probed their experiences with persistent fatigue. We simultaneously interviewed a small sample of five HCT clinicians. We used thematic analysis to code verbatim transcripts for a priori and identified themes.</p><p><strong>Results: </strong>Participants (N = 20; median (range) age = 55 (31-78) years; n = 9 female) were a median of 3.88 years (6 months-13 years) post-transplant and reported moderate fatigue severity (median = 5 (4-9)/0-10 scale). Final themes included: 1) challenges describing the multidimensional symptom of persistent fatigue, 2) fatigue as an impairing ongoing symptom, 3) identification of a variety of factors modulating persistent fatigue, 4) use of action- and emotion-oriented strategies to manage fatigue, and 5) desire for additional information and fatigue support.</p><p><strong>Conclusion: </strong>Study findings highlight the numerous and ongoing disruptions to everyday life experienced by patients living with persistent fatigue following HCT, variety of management strategies, and their desire for supportive programs to aid in the management of this symptom. Results support the need for future research into evidence-based interventions to alleviate HCT survivors' fatigue.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475732","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 Network of Pediatric Palliative Care Educators: Cultivating Community in Interprofessional Education.","authors":"Katharine E Brock, Amy Trowbridge, Gitanjli Arora, Arika Moore Patneaude, Camara Van Breemen, Naomi Goloff","doi":"10.1016/j.jpainsymman.2025.06.008","DOIUrl":"10.1016/j.jpainsymman.2025.06.008","url":null,"abstract":"<p><strong>Context: </strong>Interprofessional education is essential to pediatric palliative care (PPC), however, to date the PPC community has no dedicated organization of educators.</p><p><strong>Objectives: </strong>To conceptualize and create a PPC educational community of practice (CoP): the Network of Pediatric Palliative Care Educators (NPPCE).</p><p><strong>Methods: </strong>We describe NPPCE's conceptualization, preparation, advisory board formation, curriculum planning and marketing. A baseline needs assessment survey, and one-year follow-up survey were sent to members. Survey data were analyzed descriptively.</p><p><strong>Results: </strong>In 2021, 436 members completed a NPPCE needs assessment survey. Members were from 135 cities in 17 countries, reported a variety of educator training and educational roles, and identified as attending physicians (58.0%), resident/fellow trainees (9.4%), advance practice providers (APPs) (9.2%), social workers, (5.7%), nurses (5.0%), psychologists (4.1%), or other professions (4.1%). Despite participating in education in numerous ways, only 53.1% of members felt connected to an educational community. After one year of bimonthly NPPCE content (6 virtual sessions), 59 members (14%) reported attending or watching a mean of 3/6 sessions (range 1-5); the primary reasons for attendance were to connect with peers and learn about a particular topic. Sessions were rated as highly pertinent to members' practice (mean = 4, SD 3-5). All respondents planned to attend future NPPCE sessions.</p><p><strong>Conclusion: </strong>NPPCE was formed with the intent to advance access to, and quality of, interprofessional PPC education through a community for collaboration and dissemination of educational best practices, research, and resources. This can serve as a model for various healthcare fields to connect and educate their members.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368919","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":"Breakthrough Pain: More to Learn.","authors":"Rachel Mack, Mellar Davis","doi":"10.1016/j.jpainsymman.2025.06.007","DOIUrl":"10.1016/j.jpainsymman.2025.06.007","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484772","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":"Community engagement in Palliative Care: a lesson from the Lakshadweep Islands.","authors":"Azher Ali, K Abdul Hameed Moulana, Broderick Ann","doi":"10.1016/j.jpainsymman.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2025.06.006","url":null,"abstract":"<p><p>A palliative care organization on the remote Lakshadweep Islands on the coast of India disrupts the Global North paradigm for palliative care by a thoughtful response to the needs of the community. In this community effort to bring those who need dialysis back to their home islands, the palliative care organization, Thanal, illustrates how palliative care can reduce health-related suffering in innovative ways and enhance the lives and health of the community that they serve. The Global South provides lessons for global palliative care, including the Global North, in its focus on community needs and social networks.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484773","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 Night Belongs to Gerasim.","authors":"Juan Luis Torres-Tenor","doi":"10.1016/j.jpainsymman.2025.06.004","DOIUrl":"10.1016/j.jpainsymman.2025.06.004","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":"144326004","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":"\"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}