Journal of pain and symptom management最新文献

{"title":"A Qualitative Study of Team-Based Serious Illness Communication in ALS.","authors":"Jaclyn Shameklis, Alexis Drutchas, Tamra Keeney, Michaela Rowland, Lindsay Dow, Darlene Sawicki, Doreen Ho, Joanna Paladino, Elizabeth Lindenberger","doi":"10.1016/j.jpainsymman.2026.09.025","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.09.025","url":null,"abstract":"<p><strong>Context: </strong>Amyotrophic lateral sclerosis (ALS) is a terminal neurodegenerative disease with an illness trajectory requiring repeated, high-stakes decisions and ongoing serious illness communication (SIC). While multidisciplinary team care is best practice in ALS, how interprofessional teams operationalize SIC, and how team culture shapes this work, remain poorly understood.</p><p><strong>Objective: </strong>To examine how team culture influences SIC delivery within an interprofessional ALS clinic.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews and a focus group with interprofessional clinicians from a multidisciplinary ALS clinic at an academic medical center. Data explored clinicians' perceptions of interprofessional roles, team culture, facilitators, and barriers related to SIC. Transcripts were analyzed using thematic analysis with a combined deductive-inductive approach.</p><p><strong>Results: </strong>Analysis identified interpersonal facilitators, systems-level facilitators, and structural barriers shaping team-based SIC. Clinicians described shared responsibility for SIC, with conversations unfolding cumulatively over time across roles and clinical encounters. Interpersonal facilitators included mutual respect, psychological safety, role flexibility, and a shared commitment to reducing patient harm. Systems-level facilitators included frequent multimodal communication, structured documentation, leadership support, and use of adverse outcomes as opportunities for practice improvement. Structural barriers included time constraints, care transitions, regulatory limitations, and variability in comfort with SIC language.</p><p><strong>Conclusions: </strong>In this multidisciplinary ALS clinic, strong team culture enabled SIC to function as a longitudinal, interprofessional process rather than a single clinician-led event. Findings highlight the importance of psychological safety, teamwork, and supportive systems in delivering high-quality SIC and inform future clinical practice, training, and research.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039446","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":"Bereaved Parents' Experiences of Virtual Storytelling Through Music: A Qualitative Analysis.","authors":"Carolyn S Phillips, Sue E Morris, Erin Rodriguez, Megan Thomas-Hebdon, Jason Morris, Rev Brandon Morgan, Meera Sinha, Amanda Maestro-Scherer, Claudia Gruber","doi":"10.1016/j.jpainsymman.2026.09.014","DOIUrl":"10.1016/j.jpainsymman.2026.09.014","url":null,"abstract":"<p><strong>Context: </strong>Bereaved parents whose child died from cancer are at risk for prolonged and complicated grief, yet accessible, engaging bereavement interventions remain limited. Storytelling Through Music (STM) is a virtual, group-delivered expressive arts intervention that integrates reflective writing, psychoeducation, and therapeutic songwriting.</p><p><strong>Objectives: </strong>To explore parents' emotional experiences and perceived impacts of participating in STM one month after completing the intervention.</p><p><strong>Methods: </strong>This qualitative study was embedded within a randomized controlled feasibility trial (ClinicalTrials.gov NCT06047808). Following the six-week STM intervention, bereaved parents in the intervention arm completed semi-structured, one-on-one interviews approximately one-month postintervention. Interviews were audio-recorded, transcribed, and analyzed using conventional content analysis with multiple coders and iterative consensus to develop themes.</p><p><strong>Results: </strong>Twelve bereaved parents participated in postintervention interviews. Five interrelated themes characterized the STM experience: 1) connecting with peers and music, 2) benefits of coping through sharing, 3) expansive emotional experience (coexistence of grief and positive emotion), 4) graded exposure through the sequenced writing-storytelling-songwriting process, and 5) enduring legacy, with the final song functioning as a lasting keepsake and ongoing coping resource.</p><p><strong>Conclusion: </strong>STM appears to support multidimensional grief processing by combining social connection, narrative meaning-making, and music-based emotional engagement in a virtual format. Findings suggest STM may be a feasible, scalable approach to bereavement support and highlight potential mechanisms (connection, graded exposure, and legacy creation) to test in larger, more diverse trials.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025262","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":"Methylphenidate-Based Interventions for Depressive Symptoms in Palliative Care: A Systematic Review and Meta-analysis.","authors":"Yuhong Huang, Chunyan Tan, Panyun Huang, Daiping Li, Meiling Ge, Dongliang Guo, Hongyi Li, Yaqin Li","doi":"10.1016/j.jpainsymman.2026.09.015","DOIUrl":"10.1016/j.jpainsymman.2026.09.015","url":null,"abstract":"<p><strong>Background: </strong>Depressive symptoms are common in palliative care, but conventional antidepressants are limited by delayed onset and adverse effects. We evaluated randomized evidence on methylphenidate, a faster-acting intervention, for depressive symptoms in adults receiving palliative care.</p><p><strong>Methods: </strong>This PRISMA 2020-compliant systematic review and meta-analysis (PROSPERO: CRD420261277228) included randomized controlled trials of methylphenidate-based interventions vs. placebo, usual care, or background antidepressants in adults with advanced, life-limiting illness receiving palliative care. Depression-targeted trials provided direct evidence; fatigue-focused trials with depression outcomes provided indirect evidence. Continuous outcomes were pooled as standardized mean differences (SMD) with random-effects models and Hartung-Knapp sensitivity analysis. Risk of bias was assessed with RoB 2.</p><p><strong>Results: </strong>Five trials (342 participants) were included. Methylphenidate-based interventions were associated with greater improvement in depressive symptoms overall (SMD -0.47, 95% confidence intervals [CI] -0.81 to -0.13; P = 0.006; I² = 58.9%). Depression-targeted (three trials; SMD -0.62, 95% CI -1.18 to -0.05) and fatigue-focused subgroups (two trials; SMD -0.30, 95% CI -0.53 to -0.07) did not differ significantly (P = 0.307). Depression response was more frequent with methylphenidate (Risk Ratio 1.78, 95% CI 1.09-2.89; P = 0.021). Risk of bias was low in one, of some concern in three, and high in one.</p><p><strong>Conclusions: </strong>Methylphenidate-based interventions may improve depressive symptoms in selected palliative-care patients, but evidence certainty is very low to low due to small samples, heterogeneity, and indirectness. Findings support cautious, individualized use rather than rapid antidepressant efficacy. Adequately powered trials with depression as a primary endpoint are needed.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008515","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":"Perceptions and Attitudes on Psilocybin-Assisted Therapy Among Underrepresented People With Cancer.","authors":"Megan Miller, Molly Meyers, Candace Oglesby-Adepoju, Ronit Elk, Yvan Beaussaunt","doi":"10.1016/j.jpainsymman.2026.09.018","DOIUrl":"10.1016/j.jpainsymman.2026.09.018","url":null,"abstract":"<p><strong>Context: </strong>Psilocybin-assisted therapy (PAT) shows promise for alleviating psychological and existential distress among people with cancer; however, research is limited by homogeneous samples, raising concerns about generalizability and equity.</p><p><strong>Objectives: </strong>To explore perceptions and attitudes of PAT among a subset of people with cancer who have been underrepresented in research.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted. Nineteen participants were recruited from a comprehensive cancer center in the Midwestern U.S.. The sample included Black/African American participants without a completed postsecondary degree (n = 7), Black/African American participants with postsecondary degrees (n = 6), and White participants without a completed postsecondary degree (n = 6). Semi-structured interviews occurred September 2024-October 2025. Interviews were transcribed verbatim and analyzed using inductive critical content analysis.</p><p><strong>Results: </strong>Four categories were identified. 1) Perceptions of psychedelics shaped by comparisons to other substances, stigma, and mixed beliefs about benefits and risks. 2) Perceptions of PAT ranged from viewing it as a legitimate, structured intervention to uncertainty about usefulness, with benefit to others commonly endorsed. 3) Considering PAT participation involved trust in providers and systems, safety/comfort, interpersonal support, intersectional cultural considerations, and timing preferences, with some patterns differing across strata. 4) Ongoing questions and needs included accessible, culturally responsive information, representation, and clearer understanding of PAT.</p><p><strong>Conclusion: </strong>Participants expressed nuanced views of PAT, shaped by structural, cultural, and informational factors. Findings highlight the importance of trust-building, culturally responsive information, and community engagement to support equitable access and translation of PAT in oncology and palliative care.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002026","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":"Expert Guidance on High-Quality Mentoring in Hospice and Palliative Medicine Research.","authors":"Karleen F Giannitrapani, Cati Brown-Johnson, Sarina R Isenberg, Laura Petrillo, Erica C Kaye","doi":"10.1016/j.jpainsymman.2026.09.020","DOIUrl":"10.1016/j.jpainsymman.2026.09.020","url":null,"abstract":"<p><strong>Background: </strong>Research in the field of hospice and palliative medicine (HPM) is necessarily interdisciplinary, requiring mentorship across diverse disciplines and methods to advance science. As the field grows, mentorship of the next generation of HPM researchers is of paramount importance. To advance HPM research, the American Academy of HPM Research Committee gathered and synthesized expert recommendations for provision of high-quality mentorship.</p><p><strong>Methods: </strong>Experts in codesign methodology led five sequential codesign focus groups with a purposeful sample of n = 14 senior HPM research mentors representing a variety of discipline backgrounds, methods foci, and geographical locations. Participants iteratively identified and refined the attributes of high-quality mentorship in HPM research using Stanford Inverted Codesign, a codesign approach focused on inverting participant expectations to promote engagement and elicit a broader range of feedback. We employed rapid analysis to identify themes, using previously established functions of mentor relationships as a starting framework to characterize, adapt, and expand definitions and examples of quality mentorship in HPM research.</p><p><strong>Results: </strong>In focus groups, senior HPM mentors identified that high-quality, interdisciplinary HPM research mentorship relies on purposeful implementation of various mentor-driven activities, including sponsorship, exposure, challenging assignments, coaching, protection, role modeling, and work-life balance. Synthesizing these activities, expert-driven recommendations specific to high-quality HPM research mentorship include: 1) holistic wellbeing support for mentees, including mentors acknowledging stressors and helping mentees reframe them, 2) promotion of bidirectional work-life balance for mentors and mentees, 3) institutional investment in interdisciplinary networking, and 4) field-wide resources for continuing mentor education and self-development.</p><p><strong>Discussion: </strong>HPM research mentorship experts described key activities to improve HPM mentorship and support mentees, spanning multiple levels of action from intrapersonal to broad system change. Launching an independent HPM research career in a climate of limited funding can be supported by mentors who emphasize the joys and challenges of research, model work-life balance, and foster an environment supportive of broad collaboration and continuous improvement, and support for mentor training and self-development.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008566","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":"Workforce Readiness for Advance Care Planning in Intellectual Disability Services.","authors":"Elisabeth Lucia Zeilinger, Gudrun Kreye, Tobias Fragner, Igor Grabovac, Ellen Sterz, Lena Simeoni, Eva Katharina Masel, Matthias Unseld","doi":"10.1016/j.jpainsymman.2026.09.016","DOIUrl":"10.1016/j.jpainsymman.2026.09.016","url":null,"abstract":"<p><strong>Context: </strong>Advance Care Planning (ACP) improves communication, goal-concordant care, and end-of-life outcomes for people with serious illness. For people with intellectual disabilities (ID), ACP is essential for promoting autonomy but remains inconsistently implemented. Professional caregivers in disability services often provide long-term support and may be key facilitators of ACP; however, their preparedness for this role remains unclear.</p><p><strong>Objectives: </strong>To evaluate workforce readiness for ACP in intellectual disability services by examining caregivers' conceptual knowledge, self-perceived competence, communication comfort, and role perceptions.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among 127 professional caregivers working in Austrian intellectual disability services. The instrument assessed familiarity with ACP-related concepts, declarative knowledge, and Likert-scale measures of perceived competence, discussion comfort, attitudes, and responsibility attribution. Descriptive statistics and exploratory nonparametric analyses were performed.</p><p><strong>Results: </strong>Although 67.7% of participants were familiar with advance directives, only 1.6% reported being able to explain ACP, indicating substantial conceptual gaps. Despite limited declarative knowledge, 68.5% reported feeling comfortable discussing ACP, and 85.8% endorsed its importance for people with ID. Declarative knowledge was not associated with perceived competence or discussion comfort, suggesting a mismatch between confidence and understanding. Most caregivers (77.2%) identified ACP as part of their professional responsibility.</p><p><strong>Conclusion: </strong>Professional caregivers demonstrate strong support for ACP but limited conceptual preparedness to implement it consistently. Insufficient workforce readiness may impede timely, person-centered ACP and personalized care for people with ID. Targeted training, interdisciplinary role clarification, and institutional support are required to enable inclusive, person-centered ACP for people with ID.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990313","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":"Clinicians vs. Artificial Intelligence in Predicting 28-day ICU Mortality: A Vignette Study.","authors":"Suppanut Siriseth, Veerapong Vattanavanit","doi":"10.1016/j.jpainsymman.2026.09.019","DOIUrl":"10.1016/j.jpainsymman.2026.09.019","url":null,"abstract":"<p><strong>Context: </strong>The surprise question (SQ) is an intuition-based tool for identifying patients who may benefit from palliative care, but its short-term prognostic performance in critical illness remains uncertain. Large language models may offer standardized prognostic judgments.</p><p><strong>Objectives: </strong>To compare healthcare professionals and ChatGPT in predicting 28-day mortality among critically ill patients using the binary 28-day surprise question (SQ-28d).</p><p><strong>Methods: </strong>We conducted a multi-rater, vignette-based cross-sectional study in a tertiary medical intensive care unit (ICU) in Thailand. Sixty de-identified clinical vignettes were derived from adult patients with known 28-day outcomes. Consultant intensivists, internal medicine residents, ICU nurses, and ChatGPT each answered the SQ-28d. Primary outcome was correct prognostic classification; secondary outcomes included sensitivity, specificity, predictive values, likelihood ratios, area under the receiver operating characteristic curve (AUROC), and inter-rater agreement.</p><p><strong>Results: </strong>Correct classification differed significantly across groups (P = 0.046): consultant intensivists, 69.4%; residents, 66.4%; nurses, 64.1%; and ChatGPT, 55.0%; however, no pairwise comparison remained significant after Bonferroni adjustment. AUROC was highest for consultant intensivists (0.734, 95% confidence interval [CI]: 0.670-0.798), followed by residents (0.713), nurses (0.657), and ChatGPT (0.657). Consultant intensivists had the highest positive likelihood ratio (2.25) and ChatGPT the lowest negative likelihood ratio (0.14). Inter-rater agreement was substantial between intensivists and residents and moderate between nurses and physicians.</p><p><strong>Conclusions: </strong>Healthcare professionals demonstrated higher 28-day mortality prediction accuracy than ChatGPT using the SQ. The SQ-28d may serve as a pragmatic trigger for prognostic awareness and palliative care discussions, but should not be used as a standalone prognostic tool.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002095","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 River on the Wall.","authors":"Vangipuram Sai Shreya","doi":"10.1016/j.jpainsymman.2026.09.021","DOIUrl":"10.1016/j.jpainsymman.2026.09.021","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002064","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 Reinfusion of Ascitic Fluid in Malignant Ascites: A Nationwide Claims-based Cohort Study.","authors":"Naosuke Yokomichi, Koji Okuhara, Takuhiro Yamaguchi, Tatsuya Morita, Kazuki Sato","doi":"10.1016/j.jpainsymman.2026.09.017","DOIUrl":"10.1016/j.jpainsymman.2026.09.017","url":null,"abstract":"<p><strong>Context: </strong>Malignant ascites causes substantial symptom burden in advanced cancer. Repeated drainage may accelerate protein loss and ascitic fluid re-accumulation. Cell-free and concentrated ascites reinfusion therapy (CART) returns concentrated proteins to patients, but comparative efficacy data remain scarce.</p><p><strong>Objectives: </strong>To compare CART with paracentesis alone for overall survival and repeat ascites drainage in patients with malignant ascites.</p><p><strong>Methods: </strong>This nationwide retrospective cohort study used the Japanese National Database of Health Insurance Claims and Specific Health Checkups. We identified adults with cancer who underwent CART or paracentesis within the last year of life between April 2013 and March 2016. Patients receiving CART as the first drainage procedure were compared with those receiving paracentesis alone. Outcomes were overall survival and repeat drainage, with prespecified subgroup analyses by tumor site and liver metastases.</p><p><strong>Results: </strong>Of 638,626 cancer decedents, 52,625 underwent ascites drainage within the last year of life. Of these, 10,654 received CART initially, and 37,272 received paracentesis alone. Median overall survival was 31 vs. 28 days (adjusted hazard ratio, 0.97; 95% confidence interval [CI], 0.95-0.99), indicating no clinically meaningful survival benefit with CART. CART was associated with a lower repeat drainage rate (adjusted hazard ratio, 0.73; 95% CI, 0.72-0.74), consistent with longer observed intervals between drainage procedures (median, 15 vs. 8.3 days). The reduction appeared greater in patients with hepatocellular carcinoma or liver metastases.</p><p><strong>Conclusion: </strong>CART was associated with lower rate of repeat drainage but no meaningful survival prolongation compared with paracentesis alone. CART may reduce repeat drainage, particularly in patients with liver-dominant diseases.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002024","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":"Breathlessness Discussions in Oncology Consultations: An Exploratory Quantitative Analysis.","authors":"Slavica Kochovska, Zac Vandersman, Jane Hunt, Maja Garcia, Tim Luckett, Michelle DiGiacomo, Sungwon Chang, Jessica Macdonald, Stephen Clarke, Steven Z Pantilat, Patricia M Davidson, Marie T Williams, David C Currow","doi":"10.1016/j.jpainsymman.2026.09.008","DOIUrl":"10.1016/j.jpainsymman.2026.09.008","url":null,"abstract":"<p><strong>Context: </strong>Chronic breathlessness is a prevalent, distressing and debilitating symptom in people with life-limiting conditions, including cancer. Despite this, patients report that breathlessness is often ignored in routine clinical consultations.</p><p><strong>Objectives: </strong>To explore whether breathlessness is discussed in oncology consultations and, if so, how it is assessed and managed.</p><p><strong>Methods: </strong>An exploratory sub-analysis of a mixed-methods study combining audio-recorded oncology consultations and postconsultation interviews with patients self-identifying breathlessness as concern (or not). Adults (≥18 years; any cancer/stage; able to provide informed consent and converse in English or with the help of an interpreter) in two hospitals' oncology outpatient clinics. Routine consultations (audio-recorded; transcribed; coded) and participant data (demographics; cancer type/stage; breathlessness; functional status; quality of life) are described.</p><p><strong>Results: </strong>In 54 consultations with individual patients, seven (13%) patients (median age 74 [IQR 63-78]; male 71%; advanced cancer 100%) were concerned by breathlessness, a topic raised in 22/54 (41%) of consultations. In patients concerned about breathlessness, the symptom was raised in 5/7 (71%) consultations, mostly by patients (3/5;60%); however, it was not raised in the two patients with the most severe breathlessness (2/7;29%). In patients not concerned about breathlessness, the symptom was raised in 17/47 (36%) consultations, primarily by clinicians (14/17;82%). Breathlessness discussions focused on symptom history (5/5; 8/17), leading to no further action (3/5) nor specific outcomes (12/17).</p><p><strong>Conclusion: </strong>Chronic breathlessness was raised in less than half of the people with advanced cancers and not identified for those with the most severe breathlessness. Discussions offered no breathlessness-control advice.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982824","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}