Journal of palliative medicine最新文献

"Screening" for End of Life Using Artificial Intelligence: A Qualitative Study of Palliative Care Team Members' Perspectives on Ethical Use. 使用人工智能“筛选”生命终结：姑息治疗团队成员对伦理使用观点的定性研究

IF 2.1 3区医学

Journal of palliative medicine Pub Date : 2025-07-30 DOI: 10.1177/10966218251363753

Mika K Hamer, Ahmed Y Alasmar, Kathryn Huber, Stacy M Fischer, Regina M Fink, Matthew DeCamp

{"title":"\"Screening\" for End of Life Using Artificial Intelligence: A Qualitative Study of Palliative Care Team Members' Perspectives on Ethical Use.","authors":"Mika K Hamer, Ahmed Y Alasmar, Kathryn Huber, Stacy M Fischer, Regina M Fink, Matthew DeCamp","doi":"10.1177/10966218251363753","DOIUrl":"https://doi.org/10.1177/10966218251363753","url":null,"abstract":"Background: Artificial intelligence (AI) tools for health care applications are rapidly emerging. Some AI-based prognostic tools can predict patient mortality automatically and with accuracy that outperforms clinicians and other available tools. In palliative care (PC), these tools may change practice in ways we do not fully understand and raise important ethical and implementation questions. Objective: Identify the ethical challenges that could shape the implementation of AI-based prognostication in PC. Design: We conducted a qualitative study using semistructured interviews and a modified grounded theory approach. Setting/Subjects: We interviewed 45 PC team members (physicians, nurses, social workers, spiritual care providers, psychologists) from four U.S. academic medical centers. Results: PC team members viewed AI-based prognostication as a form of \"screening\" for end of life (EOL) and believed it could help identify patients with PC or other EOL needs. By drawing on an established model of screening ethics as a framework for our analysis, we identified four principles to guide the implementation of AI-based prognostication as screening: (i) screening for EOL should be evidence-based, (ii) screening for EOL should take opportunity cost into account, (iii) screening for EOL should distribute costs and benefits fairly, and (iv) screening for EOL should offer respect for persons. Conclusions: Our findings help us understand how PC team members view AI-based prognostic tools and offer guidance for their implementation. In the future, it will be important to define more precisely the role of screening in this context and understand how it affects decision making for patients, families, and care teams.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753611","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}

引用次数: 0

Mariah: Lessons in Motherly Love and Perseverance. 玛丽亚：母爱和毅力的课程。

IF 2.1 3区医学

Journal of palliative medicine Pub Date : 2025-07-30 DOI: 10.1177/10966218251364702

Ira Byock

引用次数: 0

Why Is Community-Based Palliative Care Declined? Older Adult, Caregiver, and Provider Perspectives. 为什么以社区为基础的姑息治疗减少了？老年人，照顾者和提供者的观点。

IF 2.1 3区医学

Journal of palliative medicine Pub Date : 2025-07-30 DOI: 10.1177/10966218251363804

Kira G Sheldon, Kathryn H Bowles, Lori King, Elizabeth A Luth

{"title":"Why Is Community-Based Palliative Care Declined? Older Adult, Caregiver, and Provider Perspectives.","authors":"Kira G Sheldon, Kathryn H Bowles, Lori King, Elizabeth A Luth","doi":"10.1177/10966218251363804","DOIUrl":"https://doi.org/10.1177/10966218251363804","url":null,"abstract":"Background: Palliative care can help manage health challenges of seriously ill individuals, including persons living with dementia (PLWD), but is often declined. Objective: Explore why seriously ill individuals and caregivers decline palliative care. Methods: A pilot study using semi-structured interviews with three Medicare Advantage plan members and 15 caregivers, including 13 caregivers of PLWD, who declined palliative care (PC) within the previous year and focus groups with five PC staff. Results: Reasons for declining included mis-association with hospice, not seeing additional benefit to current care, and reluctance to change current care. PC staff provided additional reasons: challenges engaging with the outreach team, need for family-based decision-making, and reluctance to engage with unfamiliar persons. Conclusions: Incremental adjustments in PC communication may facilitate uptake, including providing explanations that are distinct from hospice, tailored to care needs, focused on reducing illness burden, and introduced by the current care team.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753613","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}

引用次数: 0

End-of-Life Dreams and Visions and Self-Transcendence: A Comparison Study. 临终梦、幻象与自我超越：比较研究。

IF 2.1 3区医学

Journal of palliative medicine Pub Date : 2025-07-30 DOI: 10.1177/10966218251363395

Kathryn Levy, Gina Schuster, Sheila Conboy, Hannah Maciejewski, Pei C Grant, Christopher W Kerr

{"title":"End-of-Life Dreams and Visions and Self-Transcendence: A Comparison Study.","authors":"Kathryn Levy, Gina Schuster, Sheila Conboy, Hannah Maciejewski, Pei C Grant, Christopher W Kerr","doi":"10.1177/10966218251363395","DOIUrl":"https://doi.org/10.1177/10966218251363395","url":null,"abstract":"Background: End-of-life dreams and visions (ELDVs) are common and meaningful experiences for individuals trending toward death. While research has shown the positive impact of ELDVs on some psychological processes, there is more to learn. Objective: This study aimed to explore the differences in perceived self-transcendence between hospice patients who experience ELDVs and hospice patients who do not have this experience. Design: This is a cross-sectional comparison study. Settings/Subjects: Seventy-two hospice patients (35 with ELDV experiences and 37 without ELDV experiences) were recruited after being admitted into hospice. Study procedures were completed at the participant's current place of residence, all within the United States. Measurements: Self-transcendence was assessed using the Self-Transcendence Scale. Demographic information and a measure of confusion were also collected. Results: No significant differences were discovered between groups in terms of self-transcendence based on the measure used (p = 0.310). Patients with ELDVs did not experience greater levels of self-transcendence compared with nondreaming patients. Further, no significant differences were found on any of the items within the survey. Conclusions: The presence of ELDVs did not impact the experience of self-transcendence for hospice patients. Findings may be, in part, explained by (1) the consideration of self-transcendence as a natural stage of development, (2) the intrinsic relationship between self-transcendence, religiosity, and end of life, or (3) the holistic nature of hospice care and its impact on self-transcendence. Future research may explore if and how the presence of ELDVs impacts spiritual wellness for the dying.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742303","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}

引用次数: 0

Health, Heartache, and Humor: A Practical Framework for Approaching Humor in Serious Illness. 健康、心痛与幽默：大病中幽默的实用框架。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-07-23 DOI: 10.1177/10966218251361487

Melissa Rizzolo, Nathan A Gray

引用次数: 0

Tell Us More: Episode 1-Dr. Betty Ferrell. 告诉我们更多：第一集。贝蒂·法瑞尔。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-07-22 DOI: 10.1177/10966218251360871

Betty Ferrell, Yilong Peng, William E Rosa, Richard E Leiter

引用次数: 0

Sex and Racial/Ethnic Differences in End-of-Life Care in Decedents with Lung Cancer in Texas. 德克萨斯州肺癌患者临终关怀的性别和种族差异。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-07-22 DOI: 10.1177/10966218251361485

Myrna Katalina Serna, Efstathia Polychronopoulou, Aimee Rodriguez, Anjali Ramachandran, Margaret Goodrich, Sean O'Mahoney, Mukaila Raji, Yong-Fang Kuo

{"title":"Sex and Racial/Ethnic Differences in End-of-Life Care in Decedents with Lung Cancer in Texas.","authors":"Myrna Katalina Serna, Efstathia Polychronopoulou, Aimee Rodriguez, Anjali Ramachandran, Margaret Goodrich, Sean O'Mahoney, Mukaila Raji, Yong-Fang Kuo","doi":"10.1177/10966218251361485","DOIUrl":"https://doi.org/10.1177/10966218251361485","url":null,"abstract":"Background: The lung cancer five-year survival rate is lower for Texans compared with the national average. We assessed sex and racial/ethnic differences in end-of-life care among decedents with lung cancer in Texas. Methods: We used the Texas Cancer Registry with Medicare data for decedents ≥66 years who died six months to five years after diagnosis of lung cancer between 2010 and 2018 and assessed differences in health care utilization, billed advance care planning (ACP), and hospice in the last 30 days of life. Multivariable logistic regression models were used to assess differences in odds of inpatient admission and hospice. Results: Males had more health care utilization and less hospice enrollment. Multivariable logistic regression models confirmed that males had lower odds of hospice enrollment. Non-Hispanic Blacks and Hispanics had more health care utilization and less hospice enrollment, confirmed by multivariable logistic regression models. Billed ACP was low across all groups. Conclusion: Texan males, non-Hispanic Blacks, and Hispanics had greater health care utilization and less hospice enrollment.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715092","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}

引用次数: 0

The Family that Never Shows Up. 从未出现的家庭。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-07-21 DOI: 10.1177/10966218251361498

Mohammed Ayyad

引用次数: 0

Because I Knew You: How Some Remarkable Sick Kids Healed a Doctor's Soul. 《因为我认识你：几个了不起的病童如何治愈了一位医生的灵魂》

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-07-21 DOI: 10.1177/10966218251362666

Elisha Waldman

引用次数: 0

Grim Reaper's Gambit. 死神的开局。