Journal of pain and symptom management最新文献

{"title":"Caring Outside the Box: A Painful Journey for Hindus at the End-of-Life.","authors":"Sujatha Shanmugasundaram","doi":"10.1016/j.jpainsymman.2026.05.001","DOIUrl":"10.1016/j.jpainsymman.2026.05.001","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864255","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 February 3, 2026.","authors":"","doi":"10.1016/j.jpainsymman.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.02.001","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 5","pages":"728-733"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690808","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":"Caring for Muslim Children at the End of Life: Faith-Informed Guidance for Pediatric Clinicians.","authors":"Mashal Z Naqvi, Fadumo Warsame, Zach W Lovig, Megan Thorvilson","doi":"10.1016/j.jpainsymman.2026.04.610","DOIUrl":"10.1016/j.jpainsymman.2026.04.610","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816465","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 Detachment.","authors":"Henry Bair","doi":"10.1016/j.jpainsymman.2026.03.007","DOIUrl":"10.1016/j.jpainsymman.2026.03.007","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458221","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":"Redesigning a Serious Illness Conversation Guide: A Mixed-Methods Community-Engaged Revision Process","authors":"Joanna Paladino MD ,&nbsp;Catherine Schofield BS ,&nbsp;Rebekah Angove PhD ,&nbsp;Amanda Murphy RN ,&nbsp;Justin J. Sanders MD, MSc ,&nbsp;Marisette Hasan RN, BSN ,&nbsp;Carine Davila MD, MPH ,&nbsp;Nora Downey BA ,&nbsp;Brett Auger BS ,&nbsp;Stacey Downey MA ,&nbsp;Suzanne E. Mitchell MD, MSc ,&nbsp;Erik K. Fromme MD, MCR, FAAHPM","doi":"10.1016/j.jpainsymman.2025.09.004","DOIUrl":"10.1016/j.jpainsymman.2025.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>Ariadne Labs’ Serious Illness Conversation Guide provides a structured, person-centered framework for conversations about patients’ values, goals, and prognosis in serious illness. The Guide has been implemented, adapted, and studied across clinical settings and patient populations. We refined the Guide to be more inclusive and accessible for diverse populations.</div></div><div><h3>Methods</h3><div>We employed a community-engaged iterative revision process. National experts in health equity and inter-professional clinicians across diverse clinical contexts affiliated with the Serious Illness Care Program Community of Practice (<em>n</em> = 59) provided feedback based on their clinical and professional experience. A group of patient and caregiver advisors affected by serious illness (<em>n</em> = 11 total) who identify as Black (<em>n</em> = 7), Latino/a (<em>n</em> = 1), Asian (<em>n</em> = 2) or mixed race (<em>n</em> = 1) refined and evaluated the final changes through focus groups, interviews, and a survey. A multistep rapid analysis process identified key themes and revisions to the Guide.</div></div><div><h3>Results</h3><div>70 participants contributed. Major revisions were made to specific Guide sections, including the introduction, prognosis, illness understanding, and critical abilities. Other additions included a question to align around patient hopes and a prompt for clinicians to respond to emotion. Four themes that informed final modifications included: (1) The introduction should build a sense of trust and togetherness and ensure the patient has a voice and choice; (2) Sharing prognosis is a high-stakes process influenced by the therapeutic relationship, the patient’s prior experience, and the language used; (3) Balancing the conversation toward positivity and hope is important to patients and caregivers; (4) Empathic communication skills build authentic connection and personalize a structured conversation. Nine of 11 patients/caregivers completed the closing acceptability survey: 8/9 strongly agreed or agreed that the revised Guide feels sensitive to their culture and identity; and 9/9 strongly disagreed or disagreed that the revised Guide was more emotionally upsetting than worthwhile.</div></div><div><h3>Conclusion</h3><div>Revisions of the Serious Illness Conversation Guide emphasizing hope and supporting partnership and alignment were perceived to be inclusive, emotionally safe, and acceptable for a diverse group of patient and caregiver advisors.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages e245-e260"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146162136","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":"Discordance in Ratings of Symptoms Experienced by Nursing Home Residents With Cognitive Impairment","authors":"Kathleen T. Unroe MD, MHA, MS ,&nbsp;Mary Ersek PhD, RN ,&nbsp;Timothy E. Stump MA ,&nbsp;Alexander Floyd BS ,&nbsp;Matthew Nesvet PhD ,&nbsp;Lieve Van den Block MSc, PhD ,&nbsp;Wanzhu Tu PhD ,&nbsp;John G Cagle PhD, MSW","doi":"10.1016/j.jpainsymman.2025.11.022","DOIUrl":"10.1016/j.jpainsymman.2025.11.022","url":null,"abstract":"<div><h3>Context</h3><div>Evaluation of palliative care programs in nursing homes often includes symptom assessments. For residents with cognitive impairment, proxy symptom reports, such as those from family members or nursing home staff, may be used as outcome measures.</div></div><div><h3>Objectives</h3><div>This analysis compares differences between family and staff proxy reports of symptoms of nursing home residents with moderate to severe cognitive impairment.</div></div><div><h3>Methods</h3><div>Data were collected as part of a clinical trial, conducted in 16 nursing homes (NHs) in Indiana and Maryland (U.S.). We calculated the difference in total modified End-of-Life Dementia Comfort Assessment in Dying (EOLD-CAD) scores between family and staff respondents for 194 residents, and quantified characteristics associated with discordance.</div></div><div><h3>Results</h3><div>About half of responding staff were licensed nurses and 37% were certified nursing assistants. Adult children of residents were the most common (57%) family respondents. There was fair agreement between the respondent groups (kappa = 0.26) for the total modified EOLD-CAD scale. Overall, family members reported higher symptom burden than staff. Some symptoms, including discomfort, pain, restlessness and agitation, were reported as more burdensome by both groups of proxies vs. symptoms such as gurgling or choking. Proxy symptom reports on residents with more advanced cognitive impairment were less likely to be substantially discordant (OR = 0.50, 95% CI 0.26, 0.99, <em>P</em> = 0.047).</div></div><div><h3>Conclusion</h3><div>Proxies are often used to report symptom experiences for people living with cognitive impairment. Multiple perspectives may be needed to obtain a fuller picture of symptom burden in this population.</div></div><div><h3>Registration: ClinicalTrials.gov</h3><div>NCT04520698</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages 403-410.e4"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648852","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":"Validation of a Claims-Based Algorithm for Specialist Palliative Care Delivery in Metastatic Cancer","authors":"May Hua MD, MS ,&nbsp;Zhixin Yang MS ,&nbsp;Ling Guo MD, MS ,&nbsp;J. Brian Cassel PhD ,&nbsp;R. Sean Morrison MD ,&nbsp;Guohua Li MD, DrPH","doi":"10.1016/j.jpainsymman.2025.11.016","DOIUrl":"10.1016/j.jpainsymman.2025.11.016","url":null,"abstract":"<div><h3>Context</h3><div>The lack of valid methods to identify specialist palliative care (PC) delivery in population-level data impedes comprehensive understanding of its use.</div></div><div><h3>Objective</h3><div>To develop and validate a claims-based algorithm to identify receipt of specialist PC in Medicare beneficiaries with metastatic cancer.</div></div><div><h3>Methods</h3><div>We developed a claims-based algorithm to identify specialist PC, using a physician billing claim from a known PC clinician as the gold standard, retaining candidate variables with a positive predictive value (PPV) &gt;60%. We evaluated algorithm performance and conducted simulation to measure bias resulting from algorithm use when examining the association between specialist PC and outcomes.</div></div><div><h3>Results</h3><div>We identified 1,384,750 claims from 68,121 patients. The prevalence of specialist PC was 3.8% on the claim-level and 26.8% on the patient-level. The provider specialty code for “hospice and palliative care” (PPV 80.4%) and the diagnosis code Z51.5 for “encounter for palliative care\" (PPV 67.5%) were included, where claims were counted as specialist PC if they had either variable. PPV and sensitivity of the algorithm were 68.0% and 83.0% respectively on a claim-level, and 78.4% and 88.3% respectively on a patient-level. Percent bias differed by outcome (hospice 4.2%, hospice enrollment ≥3 days 5.3%, intensive care unit use in the last 30 days of life −1.7%, chemotherapy use in the last 14 days of life −1.3%).</div></div><div><h3>Conclusions</h3><div>A simple algorithm can identify receipt of specialist PC care in Medicare claims for patients with metastatic cancer with reasonable accuracy. Algorithm use results in potentially acceptable amounts of bias, depending on study aims.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages 385-393.e2"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604387","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":"Patient Access to Opioids for Pain Management in SEA with a Focus on Timor-Leste: A Scoping Review","authors":"Julia M. Da Costa BPharm, MSc ,&nbsp;Alexandra Martiniuk BA, BScH, MSc, PhD ,&nbsp;Deborah Bateson MBBS, MSc, MA ,&nbsp;Clive Stevens BSc ,&nbsp;Betty B. Chaar BPharm, MHL, PhD, MPS, FFIP","doi":"10.1016/j.jpainsymman.2025.11.006","DOIUrl":"10.1016/j.jpainsymman.2025.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The majority of the world's population, including the Southeast Asia region, needs legitimate access to opioids, for the treatment of moderate to severe pain. The escalating incidence of cancer in Timor-Leste, the newest nation in the region, presents a significant challenge to healthcare systems particularly in pain management.</div></div><div><h3>Objectives</h3><div>To examine the literature on patients’ access to effective pain management in Southeast Asian countries with a focus on Timor-Leste.</div></div><div><h3>Methods</h3><div>Four databases and records were searched on January 1, 1999 to May 15, 2025, including Scopus, MEDLINE via Ovid, Embase via Ovid, and CINAHL via EBSCO.</div></div><div><h3>Results</h3><div>Fifty studies were analyzed using the World Health Organization’s (WHO) health system framework and the Levesque conceptual framework for healthcare access. Over one-third of the studies included were carried out in Thailand, and only two studies, including a report, were conducted in Timor-Leste. Approximately 70% of the studies were categorized under service delivery, workforce, and availability of medicines, financing and affordability aspects of opioids access were the least category explored.</div></div><div><h3>Discussion</h3><div>The literature revealed significant barriers impeding adequate access to pain management, including regulatory obstacles, a lack of trained healthcare workers, medications’ availability, deficiencies in pain assessment, affordability, and resistance to opioid treatment among both patients and healthcare providers due to stigma and cultural beliefs.</div></div><div><h3>Conclusion</h3><div>As a country that is in the process of strengthening its healthcare sector, it is crucial for Timor-Leste to understand regional research for effective intervention to improve access to pain management policies and practices.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages e322-e335"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513142","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":"Development and Testing of a Tool to Measure Clinician Bias Related to End-of-Life Care","authors":"Elizabeth Chuang MD, MPH ,&nbsp;Amber E. Barnato MD, MPH, MS ,&nbsp;Ronit Elk PhD ,&nbsp;Michelle N. Gong MD, MS","doi":"10.1016/j.jpainsymman.2025.08.023","DOIUrl":"10.1016/j.jpainsymman.2025.08.023","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages e217-e219"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146161728","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":"Reply to Letter to the Editor by Gaetner et al.","authors":"Benjamin Thomas MMed, FRACP, FAChPM ,&nbsp;Greg Barclay MBBS, FRACGP, FAChPM","doi":"10.1016/j.jpainsymman.2025.11.012","DOIUrl":"10.1016/j.jpainsymman.2025.11.012","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 3","pages":"Pages e398-e399"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146161679","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}