Journal of palliative medicine最新文献

{"title":"Exploring the Definitions of Physician-Delivered Palliative Care in Canada: A Narrative Review.","authors":"John M Lapp, Media Mokhtarnia, Kieran L Quinn","doi":"10.1177/10966218251386947","DOIUrl":"https://doi.org/10.1177/10966218251386947","url":null,"abstract":"<p><p><b><i>Background:</i></b> Palliative care is essential yet underutilized in Canada. Inconsistent definitions and fee codes across provinces/territories hinder effective comparative analysis. <b><i>Aim:</i></b> Explore palliative care definitions and fee codes in Canada by examining the provincial/territorial schedules of benefits. <b><i>Design:</i></b> We conducted a narrative review of provincial/territorial schedules of benefits, focusing on palliative care definitions and fee codes. Qualitative comparative analysis was performed on the definitions, and descriptive statistical analysis was conducted on the fee codes. <b><i>Setting/Participants:</i></b> The study reviewed schedules of benefits from 11 Canadian provinces and territories, excluding Quebec and Nunavut. <b><i>Results:</i></b> About 7/11 (64%) provinces/territories published definitions for palliative care, typically characterizing it as terminal, focusing on comfort, and providing a time-based prognosis. The number of specific palliative care fee codes varied from 4 to 32. <b><i>Conclusions:</i></b> There is substantial variability in the definition and fee codes used for physician-delivered palliative care across Canada. A standardized national framework for palliative care definitions and fee codes could improve access and care delivery.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251646","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":"Introducing the Descriptive Framework for Assessing Epidemiological Cross-National Transferability: Application to Extrapolating Pediatric Life-Limiting Condition Prevalence Between Two European Countries.","authors":"Larissa Kubek, Julia Wager, Patrick Brzoska, Lorna Fraser, Boris Zernikow","doi":"10.1177/10966218251376899","DOIUrl":"https://doi.org/10.1177/10966218251376899","url":null,"abstract":"<p><p><b><i>Background:</i></b> The transfer of epidemiological parameters, such as prevalence, between nations with limited data is a common but unstructured process. Determining how pediatric life-limiting condition (LLC) prevalence rates from one country can be applied to another country is unclear. <b><i>Objectives:</i></b> This study introduces the Descriptive Framework for Assessing Epidemiological Cross-National Transferability (FACT), a five-step approach to systematically validate and execute the transfer of epidemiological prevalence estimates. <b><i>Design:</i></b> Using the established epidemiological work by Fraser et al., the framework was applied to determine LLC prevalences in Germany (the use case). <b><i>Measurements:</i></b> Official population statistics from England and Germany were adjusted for gender and age. Results revealed that many comparative indicators were similar, deviating <2.5/5 percentage (points), supporting the transfer of English pediatric LLC prevalences to Germany. <b><i>Results:</i></b> The transfer resulted in an estimated number of 103,566 (65.30 per 10,000) German children and adolescents affected by life-shortening diseases in 2022, with projections between 107,934 and 138,817 by 2030. <b><i>Conclusions:</i></b> FACT demonstrates significant utility in transferring prevalence figures and is likely applicable to other epidemiological measures, such as incidence.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251669","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":"Tracheostomy Outcomes in Muslim Intensive Care Unit Patients with Acute Respiratory Failure: Highlighting a Critical Palliative Care Gap.","authors":"Imran Khalid, Manahil Imran, Raafey Imran, Muhammad Ali Akhtar, Tabindeh Jabeen Khalid, Maryam Imran, Anam Salman, Ibrahim Imran, Ibrahim Salman, Muhammad Usman Shirazi, Faisal Khateeb, Syed Saqib Ali","doi":"10.1177/10966218251386524","DOIUrl":"https://doi.org/10.1177/10966218251386524","url":null,"abstract":"<p><p><b><i>Background:</i></b> Tracheostomy often marks the onset of prolonged critical illness with high mortality, yet outcome data from Muslim-majority settings are unavailable. <b><i>Methods:</i></b> We conducted a retrospective cohort study (2019-2023) of Muslim intensive care unit (ICU) patients undergoing tracheostomy for acute respiratory failure. The primary outcome was in-hospital mortality; secondary outcomes included ICU mortality, code-status transitions, and one-year survival. <b><i>Results:</i></b> Among 411 patients (median age 68 years; 55% male), 68% were hospice-eligible at admission, while 38% were bedridden. In-hospital mortality was 53%; one-year mortality, 68%. Although 90% were full code pre-tracheostomy, 77% transitioned to Do Not Attempt Resuscitation afterward. Palliative care consultation occurred in only 12%. Key mortality predictors included age, comorbidity burden, bedridden status, and receipt of cardiopulmonary resuscitation. <b><i>Conclusions:</i></b> This study highlights three critical gaps in Muslim patients undergoing tracheostomy: high mortality, delayed code transitions, and inadequate palliative care before and during hospitalization. Future research should focus on strategies to bridge these palliative gaps.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251598","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":"Gefapixant Citrate, a Selective P2X3 Receptor Antagonist, May Improve Cancer-Related Hypergeusia: A Case Report.","authors":"Satoshi Murakami, Kazutaka Yamagishi, Akira Kitani, Toru Ueta, Yasuaki Matsuura, Toru Kubota, Yasuhito Uezono","doi":"10.1177/10966218251385732","DOIUrl":"https://doi.org/10.1177/10966218251385732","url":null,"abstract":"<p><p>Patients with cancer frequently experience taste disorders that substantially affect their quality of life. Gefapixant citrate, a P2X purinoceptor 3 receptor antagonist, is an antitussive agent known to cause taste-related adverse effects. In this study, we report the clinical course of a patient with cancer who was administered gefapixant citrate for refractory cough, which improved preexisting hypergeusia. The patient was an 85-year-old woman with lung cancer and malignant pleurisy who experienced hypergeusia and hypergeusia-induced loss of appetite. After aggressive cancer treatments were discontinued, gefapixant citrate was administered to treat her refractory cough. The patient reported improvement in hypergeusia and oral intake, which was maintained for 3 weeks. Gefapixant citrate may improve hypergeusia and sustain oral intake in patients with refractory cough, suggesting its potential use in the management of hypergeusia. However, caution is required owing to its limited efficacy in treating cancer cachexia and possible taste-related adverse effects.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244728","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":"Improving Access to Inpatient Hospice: Implementation and Impact of a Dedicated Comfort Care Service in a Tertiary Care Hospital.","authors":"Neha Kayastha, Eric Pollak, Yvonne Acker, David Fisher, Noppon Setji, David Casarett","doi":"10.1177/10966218251386955","DOIUrl":"https://doi.org/10.1177/10966218251386955","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hospice is the gold standard for end-of-life care. Many hospitalized patients on comfort care (CC) have a high symptom burden and qualify for General Inpatient Hospice (GIP) care. <b><i>Local Problem:</i></b> At our institution, many hospitalized patients who qualified for GIP were unable to discharge to stand-alone hospice facilities due to clinical instability or lack of beds. Prior attempts at providing GIP hospice in the hospital were unsuccessful. <b><i>Interventions:</i></b> In July 2022, we created the General Medicine 24 (GM24) Comfort Care and Hospice Team to improve access to high-quality hospice services for hospitalized CC patients. <b><i>Methods:</i></b> We compared the number of patients receiving GIP care in the hospital and the number of CC patients discharged with hospice services before and after GM24 was created. <b><i>Results:</i></b> In the three years since the creation of GM24, GIP admissions have increased annually, now 107% higher compared to the year before GM24 was created. Discharges to stand-alone inpatient hospice facilities have increased by 65% in the three years since GM24 was created compared to the year before GM24 was created. <b><i>Conclusions:</i></b> GM24 is a model that can be replicated to improve access to hospice care for hospitalized patients.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238923","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":"Assessing Quality of Life in Patients with Pancreatic Cancer in a Prospective Single-Center Observational Study.","authors":"Sofia Miinalainen, Eliisa Löyttyniemi, Sirkku Jyrkkiö, Outi Akrén","doi":"10.1177/10966218251383708","DOIUrl":"https://doi.org/10.1177/10966218251383708","url":null,"abstract":"<p><p><b><i>Background and Purpose:</i></b> Patients with pancreatic cancer have an extensive symptom burden and a modest quality of life (QoL). Our aim was to evaluate three QoL questionnaires in clinical practice and monitor patients' symptoms over a 4-month follow-up period. <b><i>Materials and Methods:</i></b> The study included 54 patients with pancreatic cancer in a single-center University Hospital in Finland. The QoL questionnaires involved were the European Organization for Research and Treatment of Cancer QLQ-C15-PAL, QLQ-C30, and QLQ-PAN26. Patients completed the questionnaires at baseline and at 2 and 4 months. <b><i>Results:</i></b> All three questionnaires served as a tool for facilitating dialogue between patient and physician. No relevant changes were observed in reported symptoms, concerns, or QoL during the follow-up period. However, the amount of missing data increased over time due to patients' declining health or death. The main reported concern was worry about future health. <b><i>Conclusion:</i></b> The shorter 15-question survey seemed to capture an adequate picture of patient well-being. The QLQ-PAN26 added valuable insight, as it focuses on pancreatic cancer-related symptoms. The information gathered from these QoL questionnaires can be used both to emphasize patients' concerns and to support decision making.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225139","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":"Why Black, Hispanic, and Asian Patients Hesitate to Opt for Palliative Care: Deep Metaphors from Patients, Community Leaders, and Clinicians with Shared Cultural Identities to Shape More Effective Outreach.","authors":"Anthony L Back, MaryGrace S King, Kathy C Shaw, Kelly Willis, Malcolm Brooks, Arigun Bayaraa, Leon He, Vanessa Herman, Ivan Sanchez, Lindsay Zaltman, Marian S Grant","doi":"10.1177/10966218251383713","DOIUrl":"https://doi.org/10.1177/10966218251383713","url":null,"abstract":"<p><p><b><i>Background:</i></b> In the United States, national data show that Black, Hispanic, and Asian patients are less likely than White patients to receive palliative care (PC) despite comparable or greater symptom burden. Multiple factors contribute to this inequity, but one familiar to clinicians is that a significant proportion of Black, Hispanic, and Asian patients and families hesitate to choose PC when it is offered. <b><i>Objectives:</i></b> As part of a larger project to develop public messaging for advance care planning, PC, and hospice, we conducted a qualitative study aimed at identifying the \"deep metaphors\" evoked when Black, Hispanic, and Asian patients consider PC. <b><i>Methods:</i></b> We sampled Black, Asian, and Hispanic patients receiving PC, community leaders, and PC clinicians, and interviewed them using a qualitative method designed to elicit emotional meanings and unconscious mental orientations, the Zaltman Metaphor Elicitation Technique. The interviews were video-recorded, transcribed, and analyzed using a variation of the constant comparative method. <b><i>Results:</i></b> We enrolled 15 patients (5 Black, 5 Hispanic, 5 Asian), 8 community leaders (5 Black, 3 Hispanic, 1 Asian), and 6 palliative care clinicians (2 Black, 2 Hispanic, 2 Asian). Patients' images about their experiences of being offered PC revealed the metaphor of \"inside/outside\"-a sense of simultaneous inclusion and exclusion with regard to their community and also the medical system. The patients' sense of belonging and protection felt from their communities was demonstrated in images that evoked the metaphor of \"home,\" as a physical and emotional place with a sense of belonging. The metaphor of home as a place of belonging was mirrored in community leader and PC clinician interviews. <b><i>Conclusion:</i></b> Designing public messaging and outreach for PC that invokes the deep metaphor of \"home,\" especially in the sense of belonging, is a strategy supported by qualitative evidence that should be tested further.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199778","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":"<i>Psychedelics in Palliative Care</i>.","authors":"Megan Miller","doi":"10.1177/10966218251383706","DOIUrl":"https://doi.org/10.1177/10966218251383706","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199676","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":"I Hear Your Laugh.","authors":"Danielle Chammas","doi":"10.1177/10966218251385354","DOIUrl":"https://doi.org/10.1177/10966218251385354","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199741","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":"Experiences of Distress Among Mothers of Children with Single-Ventricle Hearts: A Qualitative Study.","authors":"Melissa J Uehling, Dio Kavalieratos, Jeffrey C Klick, Jane Lowers","doi":"10.1177/10966218251382706","DOIUrl":"https://doi.org/10.1177/10966218251382706","url":null,"abstract":"<p><p><b><i>Background:</i></b> Caregivers of children with single-ventricle hearts (SVHs) experience high levels of distress associated with the illness. The treatment course for SVH often places a significant burden on family caregivers due to the complex nature of the disease, and the stress of this experience is moderated by the family's available emotional, social, and material resources to cope. <b><i>Objective:</i></b> Given the high level of involvement of the family in the treatment course, viewing the entire family as the unit of care is likely an important component of effective care provision. Accordingly, the objective of this work is to explore experiences of distress of family caregivers of children with SVH. <b><i>Design:</i></b> This study involved in-depth interviews with 14 parent caregivers of children with SVH. <b><i>Setting and Subjects:</i></b> Caregivers were drawn from a sample of children who received treatment for SVH at a major pediatric care center in the southeastern United States. <b><i>Results:</i></b> Results indicated four major types of stressors related to caring for a child with SVH: facing major upheavals, adjusting to a new normal, anticipating negative events, and experiencing challenges to role and identity. Additionally, results revealed three factors that functioned as resources which moderated the impact of these stressors: practical support, interaction with clinicians, and personal preparedness. <b><i>Conclusions:</i></b> Our findings highlight the complexity of experiences of caregivers of children with SVH and underscore the need for comprehensive family-centered care during the treatment course.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186162","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}