Journal of palliative medicine最新文献

{"title":"Barriers to Research in Palliative Care: A National Survey of Nonphysician Interprofessional Team Members.","authors":"Rabia S Atayee, Kyle P Edmonds, Allison Kestenbaum, Jennifer Kim, Karolina Soriano, Kelly C Lee","doi":"10.1089/jpm.2024.0333","DOIUrl":"https://doi.org/10.1089/jpm.2024.0333","url":null,"abstract":"<p><p><b><i>Context:</i></b> The growing field of palliative care emphasizes the need for high-quality research, yet the contributions of nonphysician palliative care specialists to studying patient outcomes remain underexplored. <b><i>Methods:</i></b> This national observational study aims to identify barriers to conducting research among chaplains, nurses, pharmacists, and social workers in palliative care settings. An anonymous online survey was conducted across various disciplines. <b><i>Results:</i></b> A total of 173 participants reveal significant differences in research engagement and perceived barriers, with chaplains and pharmacists more likely to have research requirements and training, respectively, but face obstacles including insufficient time and article preparation. Nurse practitioners and social workers reported lower research involvement and higher perceived barriers in study design and mentorship. <b><i>Conclusion:</i></b> The study highlights the need for tailored interventions, including targeted training, mentorship, and financial support to enhance research engagement among nonphysician palliative care specialists. Addressing these barriers through institutional support and interprofessional collaboration is crucial for advancing palliative care research and practice.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390862","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":"If a Tree Falls?: Using the Electronic Medical Record to Understand How Patients Self-Advocate for Their Health and Quality of Life.","authors":"Sneha Padamati, Teresa Hagan Thomas","doi":"10.1089/jpm.2024.0548","DOIUrl":"https://doi.org/10.1089/jpm.2024.0548","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390899","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":"Prediction of Next-Day Survival in Imminently Dying Cancer Patients: A Multicenter Cohort Study.","authors":"Masanori Mori, Takuhiro Yamaguchi, Isseki Maeda, Yutaka Hatano, Shih-Wei Chiu, Takashi Yamaguchi, Kengo Imai, Naosuke Yokomichi, Hiroyuki Otani, Jun Hamano, Satoru Tsuneto, David Hui, Tatsuya Morita","doi":"10.1089/jpm.2024.0334","DOIUrl":"https://doi.org/10.1089/jpm.2024.0334","url":null,"abstract":"<p><p><b><i>Background:</i></b> Accurate prediction of next-day survival in imminently dying patients is crucial for facilitating timely end-of-life decisions. <b><i>Objectives:</i></b> To develop diagnostic models for predicting next-day survival in cancer patients with a Palliative Performance Scale (PPS) score of ≤20. <b><i>Design:</i></b> A multicenter, prospective, observational study. <b><i>Setting/subjects:</i></b> We enrolled advanced cancer patients at 23 palliative care units across Japan. <b><i>Measurements:</i></b> Clinical signs of impending death were recorded daily after patients' PPS scores decreased to ≤20, continuing until death or for up to 14 days. The developed models included the prediction of one-day survival-decision tree (P1d-Survival-DT), based on recursive partitioning analysis, the P1d-Survival-organ system score, which utilized a scoring system across four clinical systems (nervous/cardiovascular/respiratory/musculoskeletal), and the early signs model that focused on the absence of two early signs (altered consciousness and liquid dysphagia). <b><i>Results:</i></b> Of the 1896 patients included in the study, 1396 (74%) reached PPS ≤20. The average age was 73 ± 12 years, with 49% being female. The P1d-Survival-DT model showed next-day survival rates of 91.6% for patients with a response to verbal stimuli and no peripheral cyanosis, and 37.1% for those with no response to verbal stimuli and respiration with mandibular movement. The P1d-Survival-organ system score model revealed a 95.9% survival rate for score = 0, decreasing progressively to 46.7% for score = 4. The early signs model predicted a 95.2% survival rate in patients with normal consciousness and no liquid dysphagia. <b><i>Conclusions:</i></b> This study successfully developed three distinct models to predict next-day survival in cancer patients with PPS ≤20, offering vital tools for informed decision making in palliative care settings.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391156","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":"Aftermath.","authors":"Danielle Ní Chróinín","doi":"10.1089/jpm.2024.0495","DOIUrl":"https://doi.org/10.1089/jpm.2024.0495","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382607","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":"Development and Validation of Integrated Palliative Care Outcome Scale Short Form for Efficient Specialist Palliative Care Screening in Oncology (ScreeningPALL): A Cross-Sectional Study.","authors":"Evelyn Müller, Michael J Müller, Paul Sölder, Beate Rautenberg, Maryam En-Nosse, Gerhild Becker","doi":"10.1089/jpm.2024.0343","DOIUrl":"https://doi.org/10.1089/jpm.2024.0343","url":null,"abstract":"<p><p><b><i>Background:</i></b> Widespread implementation of specialist palliative care screening in oncology can be facilitated by efficient screening tools. It has been shown that patient-reported outcome measures are useful as screening tools and might reduce staff effort. Short forms could further improve feasibility. <b><i>Objective:</i></b> Development and validation of a short form of the Integrated Palliative Care Outcome Scale (IPOS) for use as a screening tool for specialist palliative care need in patients with incurable cancer. <b><i>Design:</i></b> In a cross-sectional study, patients completed the IPOS. In an independent process, the palliative care consultation service assessed specialist palliative care need in each patient through multiprofessional case review (reference standard). Statistical analysis included bootstrapping and binary logistic regression to select suitable items for an IPOS short form and receiver operating characteristics analyses for validation. <b><i>Setting/Subjects:</i></b> The analysis included 205 hospital episodes of 194 inpatients and outpatients with incurable cancer (prognosis <2 years) at a German Comprehensive Cancer Center. <b><i>Results:</i></b> Possible IPOS short forms of two to eight items showed acceptable or excellent accuracy in predicting specialist palliative care need. A six-item IPOS short form that included the most predictive items of each of the three IPOS dimensions identified specialist palliative care need with 87.5% sensitivity (specificity = 56.4%; area under the curve = 0.786). <b><i>Conclusions:</i></b> IPOS short forms can facilitate efficient screening for specialist palliative care need, and the validation results are comparable to the full version of IPOS. Results also indicate which symptoms and problems might be most relevant as red flags in routine data or staff-based screening approaches.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390870","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":"Fast Facts and Concepts #501: Antidepressant Pharmacogenomics.","authors":"Cari Low","doi":"10.1089/jpm.2025.0038","DOIUrl":"https://doi.org/10.1089/jpm.2025.0038","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255973","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":"My Dad-the Hospice Graduate….","authors":"Michael J Zoosman","doi":"10.1089/jpm.2025.0011","DOIUrl":"https://doi.org/10.1089/jpm.2025.0011","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079897","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":"Top Ten Tips Palliative Care Clinicians Should Know About Caring for Patients with Myeloproliferative Neoplasms.","authors":"Jill Brennan-Cook, Lindsay Rein, Andrew Kuykendall, Natasha Johnson, Amie Koch, Allison O Taylor, Christopher A Jones, Thomas W Leblanc","doi":"10.1089/jpm.2024.0221","DOIUrl":"10.1089/jpm.2024.0221","url":null,"abstract":"<p><p>Myeloproliferative neoplasms (MPNs) are a group of rare chronic progressive blood cancers that vary widely in clinical presentation, yet all patients have a risk of disease progression and thrombotic complications. Diseases include primary myelofibrosis, polycythemia vera, and essential thrombocythemia. With current treatment approaches, most patients live a prolonged life, but many experience a complex of symptoms that negatively influence their functional status and quality of life. Although significant advances have been made in preventing arterial and venous complications while mitigating inflammatory processes, comprehensive palliative care can help address unmet complex physical and psychosocial needs on a long-term basis. This article, created by a multidisciplinary group of providers, offers an overview of MPNs so palliative care clinicians can better support patients with these hematologic cancers.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"257-264"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004403","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":"Palliative Care and End-of-Life Care in Metastatic Pancreatic Cancer.","authors":"Jenny O'Brien, Brenton Halsey, Meghan Connors, Mengying Deng, Elizabeth Handorf, Giuliana Berardi, Shannon Lynch, Kristen Sorice, Sanjay Reddy, Joshua Meyer, Jessica Bauman, Efrat Dotan","doi":"10.1089/jpm.2024.0313","DOIUrl":"10.1089/jpm.2024.0313","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients with metastatic pancreatic cancer (mPC) have a five-year survival of 2.7%. Studies have shown that patients with mPC receive aggressive care at the end of life (EOL), which has been associated with worse quality of life for patients and high use of health care resources when they are least likely to benefit patients. Multiple studies suggest that integration of palliative care (PC) teams often leads to less aggressive EOL care. <b><i>Methods:</i></b> A retrospective database of patients with mPC treated at a tertiary cancer center between 2010 and 2021 was analyzed for utilization of PC consultation and EOL care. <b><i>Results:</i></b> We identified 610 patients with mPC, of whom 39% were seen by PC, 56% were referred to hospice, and 91.8% are deceased. The average time from mPC diagnosis to PC consult was 232 days, the average time from PC consult to death was 121 days. Patients who had PC consultations were less likely to receive chemotherapy within 14 days of death (7.7% vs. 13.3%, <i>p</i> = 0.05), more likely to have a do not resuscitate (DNR) code status (83.3% vs. 44.5%, <i>p</i> < 0.0001), and more likely to be referred to hospice (83.9% vs. 35.9%, <i>p</i> < 0.0001). The average length of time on hospice was 24 days with no difference between those who saw PC and those who did not. Patients who were referred to hospice were also less likely to receive chemotherapy within 14 days of death (6.7% vs. 19.8%, <i>p</i> < 0.0001). Lastly, no significant difference was observed in mean overall survival from time of diagnosis in patient referred to PC and those who were not (349.4 vs. 349.6 days, <i>p</i> = 0.992). <b><i>Conclusions:</i></b> Patients with mPC who had a PC team involved in their care were significantly less likely to receive aggressive EOL care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"217-223"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786065","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":"Our Unrealized Imperative: Integrating Mental Health Care into Hospice and Palliative Care.","authors":"Susan Block","doi":"10.1089/jpm.2024.0366","DOIUrl":"10.1089/jpm.2024.0366","url":null,"abstract":"<p><p>The field of Hospice and Palliative Medicine (HPM) has its roots in the principles, promulgated by Dame Cicely Saunders, that patient and family are the unit of care and that comprehensive integration of physical, psychological, social, and spiritual care is necessary to address suffering in all its dimensions. Although we aspire to provide comprehensive care for our patients, most hospice and palliative care (HPM) physicians lack basic competencies for identifying and managing patients with psychological distress and mental health distress and disorders, a growing segment of our clinical population. In this article, I argue that we are not living up to the founding values of our field in how we practice, how we educate our trainees, our research, and in how we pursue our own professional development as faculty. The history of our field, the nature of our clinical workforce, the culture of PC, and our educational programs all contribute to our current practice model, which is not adequate to meet the mental health needs of our patients. I propose strategies to address these challenges focused on enhancing integration between psychiatry/psychology and HPM, changes in fellowship education and faculty development, addressing the stigma against people with mental health diagnoses, and addressing system and cultural challenges that limit our ability to provide the kind of comprehensive, integrative care that our field aspires to.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"151-161"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800984","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}