Journal of pain and symptom management最新文献

{"title":"'Autonomy' Without Assessment Is Abandonment: A Response to \"Voluntarily Stopping Eating and Drinking (VSED) With Hospice Support: A Case Series\".","authors":"Gregg A Robbins-Welty, Joshua Briscoe, Cynthia Geppert, Ann C Schwartz, Jane Gagliardi","doi":"10.1016/j.jpainsymman.2026.09.002","DOIUrl":"10.1016/j.jpainsymman.2026.09.002","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906580","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-FACSSeptember 1, 2026.","authors":"","doi":"10.1016/j.jpainsymman.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.09.001","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891807","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":"Beyond Direct Observation: Leveraging Ambient Listening AI for Scalable Communication Coaching.","authors":"Rhianon R Liu, Rebecca N Hutchinson","doi":"10.1016/j.jpainsymman.2026.08.015","DOIUrl":"10.1016/j.jpainsymman.2026.08.015","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891779","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":"Educating the Hospice Workforce on Pediatric Concurrent Care: A National Workshop Approach.","authors":"Rakhshanda Ramzan, Lisa C Lindley, Logan Hoover, Jia Liang, Markeya Martin, Salina Temesghen, Meaghann S Weaver","doi":"10.1016/j.jpainsymman.2026.08.019","DOIUrl":"10.1016/j.jpainsymman.2026.08.019","url":null,"abstract":"<p><strong>Context: </strong>Medicaid insures most children at the end of life and mandates concurrent hospice and curative care coverage. Uptake remains inconsistent, partly due to hospice workforce unfamiliarity with the benefit and concerns about compliance.</p><p><strong>Objectives: </strong>To evaluate whether a brief virtual workshop can shift hospice workforce self-perceived knowledge, attitudes, and behavior (KAB) regarding pediatric concurrent care, and to identify workforce-informed priorities for a Concurrent Care Toolkit.</p><p><strong>Methods: </strong>Two national one-hour virtual workshops (clinical and administrative audiences) were conducted in April 2026 (n = 264 attendees). A seven-item retrospective pre/post-KAB survey was distributed postsession. McNemar's and Fisher's exact tests assessed changes and subgroup differences. Real-time chat input was analyzed to identify desired toolkit content.</p><p><strong>Results: </strong>Thirty respondents completed the survey (11.4%). Perceived ability to contribute effectively increased (from 76.7% to 86.7%) and was higher among respondents from frequently enrolling hospices (100% vs. 62.5%, P = 0.0205). Scores significantly decreased pre- to postsurvey across five of seven KAB items: understanding, resource awareness, perceived value, outcome improvement, and adaptability (P < 0.05). Confidence explaining concurrent care to families declined nonsignificantly (from 86.7% to 63.3%). Attendee toolkit suggestions (n = 26) emphasized needs in policy guidance, role clarity, best practices, and templates, including family-facing materials.</p><p><strong>Conclusion: </strong>A brief virtual workshop shifted hospice workforce perceptions of pediatric concurrent care, revealing gaps in baseline understanding and increasing awareness of implementation challenges. Findings informed development of a Pediatric Concurrent Care Toolkit and suggest that practical implementation resources, policy guidance, and family-centered communication tools may be needed to improve uptake and access to concurrent care.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880776","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":"Determinants of Family Caregiver Well-Being in Home-Based End-of-Life Care: A Qualitative Synthesis.","authors":"Ravi Shankar, Yu Xuan Ng, Rui Fang Teo, Jingrong Yu, Fiona Devi, Toon Hao Foo, Qian Xu","doi":"10.1016/j.jpainsymman.2026.08.016","DOIUrl":"10.1016/j.jpainsymman.2026.08.016","url":null,"abstract":"<p><strong>Context: </strong>Family caregivers are fundamental to enabling home-based end-of-life care, yet their well-being remains inadequately understood. While previous research has documented caregiver burden, a comprehensive understanding of the multidimensional factors shaping caregiver well-being across diverse contexts remains lacking.</p><p><strong>Objectives: </strong>To synthesize qualitative evidence on the determinants of family caregiver well-being in home and community end-of-life care settings, developing an integrated conceptual understanding of facilitators and barriers across physical, psychological, social, and spiritual domains.</p><p><strong>Methods: </strong>Qualitative evidence synthesis using thematic synthesis methodology, following ENTREQ reporting guidelines. Seven databases (Embase, Scopus, CINAHL, PsycINFO, Web of Science, PubMed, Cochrane Library) were searched, yielding 7933 records. After removing 3319 duplicates and screening 4647 records, 669 studies were assessed for eligibility. Nineteen primary qualitative studies from 13 countries were included.</p><p><strong>Results: </strong>Determinants of caregiver well-being operated across four interconnected levels: personal factors (coping strategies, health literacy, prior experience), relational factors (relationship quality, family dynamics, social support), care-related factors (intensity, symptom management demands, night-time needs), and environmental or systemic factors (service access, healthcare provider interactions, financial resources, cultural norms). Key findings revealed that caregiver well-being was fundamentally shaped by the quality of professional relationships, the availability of comprehensive support services, and the cultural context of caregiving obligations.</p><p><strong>Conclusion: </strong>Caregiver well-being in home-based end-of-life care is determined by complex interactions between individual, relational, and systemic factors. Healthcare services must move beyond patient-focused models to genuinely partner with caregivers, recognizing their dual role as providers of care and individuals with their own support needs. In practice, this means offering a named point of contact, assessing caregivers across personal, relational, care-related, and systemic domains, and tailoring support to cultural context and disease trajectory.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874452","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":"End-of-Life Care Patterns by Transplant Eligibility Among Patients With End Stage Kidney Disease.","authors":"Annie Liu, Jennifer F N Kizza-Brown, Ayman Al Jurdi, Ayesha M Malik, Anushka Dalvi, Sharneet Sandhu, Lina Nurhussien, Nora K Horick, Onyenma E Obiejesie, Grace Bizup, Malia Armstrong, Kassem Safa, Sahir Kalim, Samantha Gelfand, Joshua Lakin, James A Tulsky, Areej El-Jawahri, Nneka N Ufere","doi":"10.1016/j.jpainsymman.2026.08.014","DOIUrl":"10.1016/j.jpainsymman.2026.08.014","url":null,"abstract":"<p><strong>Context: </strong>Adults with end stage kidney disease (ESKD) often spend years awaiting kidney transplantation, during which transplant listing status frequently changes from active to inactive-a phase marked by evolving expectations. The relationship of these changes to healthcare utilization and end-of-life care is poorly characterized.</p><p><strong>Objective: </strong>To compare healthcare utilization and end-of-life outcomes by transplant eligibility and transplant listing status (active vs. inactive) changes during the final year of life.</p><p><strong>Methods: </strong>We conducted an observational study of 394 adults with ESKD (active, n = 69; inactive, n = 325) who underwent kidney transplant evaluation in a large healthcare system between January 1, 2017 and June 30, 2023, and died without transplantation by June 30, 2024.</p><p><strong>Results: </strong>In the last year of life, patients had a median of two emergency department visits (interquartile range [IQR] 1-5), two hospitalizations (IQR 1-4), and 25 cumulative hospital days (IQR 1-51). Overall, 61% died in the hospital and 59% remained full code at death, and 18% were referred to hospice (median stay four days, IQR 1-8). Inactive status was associated with more emergency department visits (median 2 [IQR 1-5] vs. 2 [IQR 0-3]; P = 0.011) and hospitalizations (median 3 [IQR 1-5] vs. 2 [IQR 1-4]; P = 0.032) than active status, without differences in end-of-life outcomes. Periods of inactive status were associated with approximately two-fold higher hospitalization rates and greater time hospitalized than active periods.</p><p><strong>Conclusion: </strong>Adults with ESKD on dialysis experience intensive end-of-life care regardless of transplant eligibility. Switches to inactive status may represent a clinical inflection point to address prognostic understanding and transplant expectations.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874472","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 12, 2026.","authors":"","doi":"10.1016/j.jpainsymman.2026.06.015","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.06.015","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"72 3","pages":"384-390"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604304","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":"Time Is of the Essence: Evaluating Short-Term Prognosis Tools in Cancer and Noncancer Patients.","authors":"Kayla Sheehan, Navasuja Kumar, Julia Pudar, Susan Duong, Megan Bricely, Mohamman Alhameed, Mohammed Kabeto, Donglin Zeng, Adam Marks","doi":"10.1016/j.jpainsymman.2026.08.005","DOIUrl":"10.1016/j.jpainsymman.2026.08.005","url":null,"abstract":"<p><strong>Context: </strong>Accurate end-of-life prognostication supports patient, family, clinician, and health system decision-making. The Palliative Prognostic Index (PPI), Palliative Performance Scale (PPS), and Short-Term Prognosis Signs (SPS) have been used in palliative care populations, particularly advanced cancer, but their utility for short-term prognostication in noncancer patients is less established.</p><p><strong>Objectives: </strong>To compare PPI, PPS, and SPS, alone and in combination, for predicting death within three days among cancer patients, then evaluate the best-performing tools in noncancer patients.</p><p><strong>Methods: </strong>This retrospective study reviewed records of 290 in-unit decedents admitted to palliative care beds at a tertiary referral center and categorized by terminal diagnosis as cancer or noncancer. Admission PPI, PPS, SPS, and combined models were evaluated using logistic regression in the cancer training dataset. Model performance was assessed using area under the curve (AUC) and Akaike Information Criterion (AIC). Fitted model parameters were applied to the noncancer validation dataset.</p><p><strong>Results: </strong>In 166 cancer patients, PPI + SPS performed best, with AUC 0.72 (95% CI, 0.64-0.80) and AIC 207.56. Among individual predictors, SPS performed best, with AUC 0.70 (95% CI, 0.62-0.77) and AIC 208.18. Among 124 noncancer patients, PPI + SPS and SPS had similar AUCs of 0.69 (95% CI, 0.59-0.79) and 0.69 (95% CI, 0.59-0.78), respectively.</p><p><strong>Conclusion: </strong>PPI + SPS performed best in cancer patients, although improvement over SPS alone was modest. In noncancer patients, SPS and PPI + SPS demonstrated similar, modest discrimination, supporting prospective validation in broader palliative care populations.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840440","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":"Impact of Satisfactory Family Coping on the Mental Health of Parents Whose Children Died of Cancer.","authors":"Adam René P Rosenbaum, Gabriela Pearson, Li Chen, Molly Ream, Grace Chandler, Abby R Rosenberg, Sarah McCarthy, Jennifer Snaman","doi":"10.1016/j.jpainsymman.2026.08.013","DOIUrl":"10.1016/j.jpainsymman.2026.08.013","url":null,"abstract":"<p><strong>Context: </strong>Bereaved parents experience significant psychosocial distress following the death of a child. Effective family coping may help to mitigate mental health symptoms.</p><p><strong>Objective: </strong>To evaluate the association between parent-reported satisfaction with family coping and anxiety, depression, and prolonged grief among parents whose children died from cancer.</p><p><strong>Methods: </strong>We conducted a secondary analysis of surveys from bereaved parents at two timepoints: 6 months-2 years (timepoint 1, TP1) and 3-6 years (TP2) following the child's death. Surveys included an item from the Family Satisfaction Scale measuring parent satisfaction with their family's ability to cope with stress, which we dichotomized as satisfied versus dissatisfied. Validated measures of depression (PHQ-8), anxiety (GAD-7), and prolonged grief (PG-13) were included. Linear regression assessed the association between satisfaction with family coping and mental health symptoms.</p><p><strong>Results: </strong>Parents (N = 47) were mean aged 47.2 years (SD 9.1), predominantly white (85%) and female (70%). Parents had elevated rates of at least moderate depression (TP1 40%, TP2 32%), anxiety (TP1 21%, TP2 28%), and prolonged grief (TP1 46%, TP2 26%). At TP1, family coping satisfaction was associated with less depression (β = -4.63, 95% confidence interval [CI]: -8.5, -0.8, P = 0.020), anxiety (β = -4.86, 95% CI: -8.7, -1.1, P = 0.013), and prolonged grief (β = -8.21, 95% CI: -14.9, -1.5, P = 0.017). When controlling TP1 mental health, TP1 family coping satisfaction was not associated with TP2 mental health.</p><p><strong>Conclusion: </strong>Parents' satisfaction with family coping was associated with fewer negative mental health symptoms in early, but not later, bereavement among bereaved oncology parents.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813215","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":"Gold-Leaf Turkeys and Cynicism in Health Care.","authors":"David Casarett","doi":"10.1016/j.jpainsymman.2026.08.012","DOIUrl":"10.1016/j.jpainsymman.2026.08.012","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794459","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}