Journal of palliative medicine最新文献

{"title":"Immune Checkpoint Inhibitor Mediated Keratitis: A Case Study.","authors":"Ryan Baldeo, William E Rosa, Jamie Ellis-Wittenhagen, Sara E Wordingham","doi":"10.1177/10966218251392777","DOIUrl":"10.1177/10966218251392777","url":null,"abstract":"<p><p>This case study highlights the need for palliative care (PC) clinicians to expand their knowledge of rare complications associated with Immune Checkpoint Inhibitors (ICIs) in cancer treatment. We describe a 73-year-old male with metastatic squamous cell carcinoma of the tongue who developed ICI-mediated keratitis as a side effect of pembrolizumab. The patient's preexisting opioid regimen for chronic pain complicated the management of acute ocular pain, necessitating a multidisciplinary approach. This case demonstrates how a thorough understanding of novel cancer therapies and their adverse effects is critical for PC teams to facilitate timely diagnosis, initiate effective treatment, and enhance patient outcomes.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1637-1639"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous Levetiracetam Use in Adult Palliative Care in Australia: A Cross-Sectional Survey.","authors":"Fern Beschi, Begashaw Melaku Gebresillassie, Jennifer Schneider, Sarah Moberley, Rachel Hughes, Lisa Mackenzie","doi":"10.1177/10966218261463858","DOIUrl":"10.1177/10966218261463858","url":null,"abstract":"<p><strong>Background: </strong>Levetiracetam (LEV) continuous subcutaneous (SC) infusion (CSCI) is increasingly used in Australian patients receiving palliative care; however, evidence is limited for the stability and compatibility of LEV administered alone or with other medications. Understanding current prescribing practices and clinicians' research priorities is essential for guiding clinically relevant laboratory testing to support best practice.</p><p><strong>Aims: </strong>To examine current LEV infusion practices in Australian adult palliative care settings and identify clinician-prioritized drug combinations for future stability and compatibility testing.</p><p><strong>Methods: </strong>A cross-sectional online survey was distributed to palliative care clinicians across Australia. LEV administration practices, including doses, infusion volumes, diluents, devices, infusion durations, and drug combinations, were assessed. Clinician-reported rankings of priority medications for binary stability and compatibility testing with LEV were summarized.</p><p><strong>Results: </strong>Among 62 respondents representing each Australian state and territory (primarily doctors, nurses, and pharmacists), LEV was predominantly administered as a continuous 24-hour SC infusion. Reported total daily doses ranged from 250 to 4000 mg, with infusion volumes between 10 and 120 mL. 0.9% sodium chloride and water for injection were the only diluents used. Morphine and hydromorphone were the most frequently reported coadministered medications and ranked as the highest priorities for future stability and compatibility testing with LEV.</p><p><strong>Conclusion: </strong>LEV was administered via CSCI over a wide range of doses. Clinician-identified priorities for binary stability and compatibility testing were hydromorphone or morphine combinations with LEV. These findings provide a practice-informed foundation for targeted laboratory studies to support safe, efficient, and evidence-based clinical practice both in Australia and internationally.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1535-1541"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Religious Coping, Practices, and Community Involvement in Patients with Head and Neck Cancer.","authors":"Monica H Bodd, Rebecca A Zasloff, Jeehye Rose Lee, Maia Kotelanski, Steve P Wolf, Madeline Garcia, Alexandra Bennion, Buddy Marterre, Daniel J Rocke, Alan H Potter, Fred M Baik, Erika Juhlin, Revital Benvenisti, Walter T Lee, Nosayaba Osazuwa-Peters","doi":"10.1177/10966218261465479","DOIUrl":"10.1177/10966218261465479","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial well-being remains a significant unmet need among head and neck cancer (HNC) survivors in the United States, with limited understanding of the role of faith-based communities and religious coping in addressing social isolation.</p><p><strong>Methods: </strong>HNC patients not actively undergoing treatment were recruited to complete validated surveys assessing physical and psychological symptoms, religious participation, and coping.</p><p><strong>Results: </strong>52 patients completed surveys, of which most had early-stage cancer (61.5%). The majority of participants reported clinically significant pain (52.0%) or fatigue (53.1%). Nearly half of participants reported regular religious or spiritual involvement, with 60.5% attending services at least a few times per year and 48.9% engaging in private practices like prayer or meditation weekly. Negative religious coping was not significantly associated with distress (odds ratio: 1.17, 95% confidence interval: 1.00-1.37, <i>p</i> = 0.06), though this association approached significance.</p><p><strong>Conclusions: </strong>These findings suggest a need for further research on integrating spiritual support into HNC survivorship care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1583-1590"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relational Trauma: Psychodynamically Informed Communication for Serious Illness Care.","authors":"Indrany Datta-Barua, Keri O Brenner, Danielle Chammas, Margaret A Cramer","doi":"10.1177/10966218261484865","DOIUrl":"10.1177/10966218261484865","url":null,"abstract":"<p><p>Patients with <i>relational trauma</i>, including histories of maltreatment, abandonment, exploitation, or profound misattunement in caregiving relationships, may face unique psychological and interpersonal stressors when diagnosed with a serious illness. Because serious illness requires dependence on others, patients' past traumatic experiences with caregivers may be reactivated in medical relationships, manifesting in behaviors that can be confusing, contradictory, inconsistent, or difficult to understand. These dynamics may evoke intense <i>countertransference</i> responses in clinicians, at times making it difficult to offer therapeutically attuned care. By understanding relational trauma through the lens of psychodynamic and neuropsychological principles, palliative care clinicians can develop more empathic and clinically useful approaches to managing complex interpersonal dynamics. This article illustrates how these principles can be adapted to inform serious illness communication strategies for patients with relational trauma, including calibrating the treatment frame, validating emotions while maintaining boundaries, enhancing empathy to promote the therapeutic relationship, and repairing ruptures in the treatment relationship.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1598-1605"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Not to Say: Language Traps in Palliative Care Communication.","authors":"Natalie Lanocha, Cameron Price, Zack Wheat, Robert Macauley, Sara Taub","doi":"10.1177/10966218261473686","DOIUrl":"10.1177/10966218261473686","url":null,"abstract":"<p><p>As experts in communication, palliative care clinicians know to avoid not only well-recognized verbal pitfalls (such as describing a patient as \"non-compliant\" or a \"poor historian\") but also more subtle ones that colleagues in other specialties might still use (such as \"withdrawing care\"). Yet despite our training and experience, we, too, are prone to mis-speaking. This Special Report identifies some less obvious verbal missteps that can interfere with the provision of holistic, goal-concordant care. While they may initially seem innocuous, we have repeatedly witnessed the unintended detrimental effects on patients and families. Words, indeed, are a primary instrument in palliative care; we have the responsibility to wield them prudently.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1503-1507"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Intensive Care Syndrome #537.","authors":"Noah Mathis, Bojana Milekic, Joshua Lasseigne, Amy Newman, Ankita Mehta","doi":"10.1177/10966218261472559","DOIUrl":"10.1177/10966218261472559","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1631-1632"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges of Caregiving-Isn't It Time We Stopped Just Admiring the Problem?","authors":"Leah E Walsh, R Sean Morrison, Allison J Applebaum","doi":"10.1177/10966218261474590","DOIUrl":"10.1177/10966218261474590","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1496-1498"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pitt. Season 2, Episode 8: 2:00 pm. HBO Max. Written by Joe Sachs, Original Air Date: February 26, 2026<b>The Pitt. Season 2, Episode 8: 2:00 pm</b>. HBO Max. Written by Joe Sachs. Original air date: February 26, 2026.","authors":"Jessica Chin, Zikran Choudhury","doi":"10.1177/10966218261464241","DOIUrl":"https://doi.org/10.1177/10966218261464241","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":"29 11","pages":"1640-1641"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining and Managing End-of-Life Respiratory Changes in Adult Home Hospice Patients: A Systematic Review.","authors":"Allison K Donehower, Michelle Doering, Keisha White Makinde, Archanna Bharadwaj, Justin D Daniels, Yodahe Gebreegziabher, Mary Lynn McPherson, Patrick White, Masako Mayahara, Debra Parker Oliver","doi":"10.1177/10966218251388783","DOIUrl":"10.1177/10966218251388783","url":null,"abstract":"<p><strong>Background: </strong>End-of-life respiratory changes-agonal breathing, Cheyne-Stokes breathing, and death rattle/noisy breathing-are common in home hospice settings, impacting patient comfort, caregiver distress, and quality of care.</p><p><strong>Purpose: </strong>To identify and critically evaluate literature on definitions, characteristics, and management for end-of-life respiratory changes in home hospice patients.</p><p><strong>Data sources: </strong>English-language articles in Ovid Medline, Scopus, CINAHL, APA PsycINFO, and Web of Science published before April 18, 2024.</p><p><strong>Study selection: </strong>9 peer-reviewed articles (comprising two nonrandomized experimental studies, two case reports, a cohort study, a cross-sectional study, a review, a text and opinion article, and a combined case report with personal reflection) involving adults in home hospice or palliative care and included definitions, characteristics, or treatments of agonal breathing, Cheyne-Stokes breathing, or death rattle/noisy breathing.</p><p><strong>Data extraction: </strong>Two independent reviewers extracted data on study characteristics, respiratory change definitions/characteristics, distress to patients and care providers, and treatments.</p><p><strong>Data synthesis: </strong>Most studies were recent (2014 or later) and conducted in the United States. Agonal breathing was defined as reflexive gasping and sighing respirations. Cheyne-Stoke's breathing was mentioned without detailed descriptions. Death rattle/noisy breathing was characterized by loud secretions. Distress was evident for care providers, not patients. Treatment included anticholinergics for death rattle/noisy breathing, showing limited efficacy, and nonpharmacological approaches such as caregiver education and patient positioning.</p><p><strong>Limitations: </strong>Few studies included, encompassing various report types.</p><p><strong>Conclusions: </strong>There is a dearth of evidence on respiratory changes, particularly agonal breathing and Cheyne-Stokes breathing, in home hospice patients. Definitions and treatment guidelines vary, emphasizing the need for clear, evidence-based protocols. Improved caregiver education and future research are crucial to enhancing end-of-life care in home hospice settings.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1619-1628"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing the Prevalence and Correlates of Spiritual Concerns Using the PC-6 Spiritual Assessment with Palliative Care Patients Near the End of Life.","authors":"Sarah Byrne-Martelli, Patricia K Palmer, Burl Cole, Ian Cullen, Steven B Drennan, Melissa L Harry, Dirk Labuschagne, Edward Peñate, Kathryn A Ulrich, George Fitchett","doi":"10.1177/10966218261467136","DOIUrl":"10.1177/10966218261467136","url":null,"abstract":"<p><strong>Background: </strong>Religious and spiritual (R/S) concerns are common among patients with serious illness. Attending to the R/S concerns of patients is a core component of quality palliative care.</p><p><strong>Objectives: </strong>Our aim was to describe the prevalence and demographic, medical, and religious correlates of R/S concerns in patients receiving palliative care.</p><p><strong>Design: </strong>Multisite, cross-sectional study.</p><p><strong>Setting/subjects: </strong>Adult patients in the United States receiving inpatient or outpatient palliative care.</p><p><strong>Methods: </strong>Chaplains completed the PC-6, an interview-based spiritual assessment, as part of routine palliative care practice. The PC-6 evaluates six domains of R/S concern: relationships, meaning, legacy, dying, religious/spiritual struggle, and treatment decision-related concerns. Demographic, clinical, and religious affiliation data were obtained from the medical record.</p><p><strong>Results: </strong>A total of 172 palliative care patients were included. Fifty percent were assessed to have moderate or severe concerns in at least one of six spiritual domains, and 17% had concerns in two or more domains. The most prevalent concerns involved relationships (19.2%), dying (14.5%), meaning (14.0%), and legacy (11.0%). In multivariable analyses, patients with no religious affiliation were more than three times more likely to have moderate or severe spiritual concerns compared to those with a Protestant affiliation. Demographic characteristics and primary diagnosis were not associated with the presence of spiritual concerns.</p><p><strong>Conclusions: </strong>Moderate to severe spiritual concerns are prevalent among patients receiving palliative care, including among those without a religious affiliation. Integrating spiritual assessment into palliative care workflows may facilitate specialty spiritual care and comprehensive attention to patients' multidimensional suffering.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1555-1562"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}