Journal of palliative medicine最新文献

{"title":"Effects of a Video and Audio Support Tool on Family Members' Preferences and Understanding Regarding Life-Sustaining Treatments: Before-and-After Study.","authors":"Hyo Jin Lee, Kwonhyung Hyung, Heemoon Park, Hyun Woo Lee, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Tae Yun Park","doi":"10.1177/10966218261464664","DOIUrl":"10.1177/10966218261464664","url":null,"abstract":"<p><strong>Background: </strong>Audio- and video-based educational tools may improve family members' knowledge of and preferences for end-of-life care in intensive care units.</p><p><strong>Objectives: </strong>To determine and compare the effects of video and audio educational materials on knowledge of and preferences for life-sustaining treatment (LST) among family members of ICU patients in South Korea.</p><p><strong>Design: </strong>Pre-post study design.</p><p><strong>Setting/subjects: </strong>Family members of ICU patients aged >18 years received audio or video educational materials.</p><p><strong>Measurements: </strong>Preferences for LSTs, knowledge regarding LSTs.</p><p><strong>Results: </strong>A total of 168 were enrolled and randomly divided equally into the verbal (<i>n</i> = 84) and video (<i>n</i> = 84) interventions. Preferences for most LSTs remained unchanged after the intervention, except for tracheostomy (10.7% (18/168) changed from \"no\" to \"yes\" versus 3.6% (6/168) from \"yes\" to \"no\"; <i>p</i> = 0.023). No significant changes in treatment preferences were observed when analyzing the video and audio groups separately. Knowledge scores significantly improved after the intervention for all participants (7.44 ± 1.57 to 8.49 ± 1.79, <i>p</i> < 0.005), with the video (7.48 ± 1.56 to 8.64 ± 1.52) and audio groups (7.40 ± 1.58 to 8.34 ± 2.03) showing similar improvements (<i>p</i> < 0.005).</p><p><strong>Conclusion: </strong>Preferences for most LSTs remained unchanged, likely due to high baseline knowledge, whereas knowledge improved significantly regardless of education type. Notably, a significant shift in preference was observed for tracheostomy, where baseline knowledge was lower, suggesting an educational effect.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1542-1548"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405140","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 Impact of Clinical Experience on Medical Careers: How Two Psychotraumatic Events Shaped My Professional Identity.","authors":"Amandine Mathe, Etienne Riviere","doi":"10.1177/10966218251409919","DOIUrl":"10.1177/10966218251409919","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1635-1636"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645654","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":"Mandatory Mortality Surprise Question Screening in the ED: Identification and Associations with End-of-Life Care Outcomes.","authors":"Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder","doi":"10.1177/10966218261467467","DOIUrl":"10.1177/10966218261467467","url":null,"abstract":"<p><strong>Background: </strong>Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Its impact when implemented as mandatory clinical decision support with ED admission workflows has not been well characterized.</p><p><strong>Objective: </strong>The study evaluates the associations between MSQ responses within a mandatory ED admission workflow with serious illness processes such as palliative care consults, hospice-related outcomes, mortality, and readmission.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults admitted from the ED within a large academic health system 1 year following implementation of the mandatory MSQ. A \"No\" response (\"I would not be surprised if this patient died in the next 6 months\") linked directly to a care pathway prompting goals-of-care conversations with scripting, advance care planning (ACP) review, and optional orders for palliative care or hospice consultation. Outcomes included consultation rates (primary outcome), timing of palliative care, ACP documentation, mortality, readmissions, and provider-level differences in responses. Outcomes were measured from the electronic health record during the index hospitalization unless otherwise specified.</p><p><strong>Results: </strong>Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a \"No\" response. These patients were older, had greater comorbidity, and higher prior utilization. A \"No\" response was strongly associated with increased palliative care consultation (adjusted odds ratio [aOR]: 7.14), ACP documentation (aOR: 2.70), hospice referral (aOR: 3.89), comfort-measures-only orders (aOR: 3.97), hospice disposition (aOR: 3.84), higher inpatient mortality (aOR: 2.53), and increased 30-day readmission (aOR: 1.51). Palliative care consultation occurred earlier among MSQ \"No\" than MSQ \"Yes\" encounters. Length of stay (LOS) was modestly longer. Attendings were more likely than trainees or advanced practice providers to respond \"No.\"</p><p><strong>Conclusions: </strong>Within mandatory MSQ screening at the ED-admission interface, the MSQ \"No\" response identified a subgroup with substantial complexity, end-of-life care needs, and heightened vulnerability to readmissions. These patients may benefit from both earlier serious illness conversations and enhanced transitional support.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1563-1571"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421907","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 People with Postintensive Care Syndrome.","authors":"Alice Bottussi, Jacopo D'Andria Ursoleo, Donald R Sullivan, Rachel Kohn, Kimberley J Haines, Allison J Applebaum, Sarah Byrne-Martelli, Rachel Hadler, Stephanie Hiser, Jennifer M Maguire, Mallory McCall, Ankita Mehta, Dorothy W Tolchin, Eduardo Bruera, Sebastiano Mercadante, Benjamin Tolchin, Louis P Voigt, William E Rosa, Fabrizio Monaco","doi":"10.1177/10966218261419634","DOIUrl":"10.1177/10966218261419634","url":null,"abstract":"<p><p>Intensive care unit (ICU) mortality rates have substantially declined over the past few decades. Accordingly, there has been an increase in the number of ICU survivors, who are often burdened by long-term sequelae and high morbidity following their discharge. The term postintensive care syndrome (PICS) was first coined in 2012 to describe this constellation of physical, psychological, and cognitive sequelae, which may persist long after acute care hospitalization and may also affect family members. In this context, the timely integration and delivery of palliative care has the potential to alleviate the suffering experienced by both ICU survivors and their families. In this article, an interdisciplinary team presents ten tips to describe PICS and enhance the quality of care for palliative care clinicians caring for people with PICS.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1610-1618"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474068","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":"Poseidon's Potion.","authors":"Michael S Avidan, Jon Cohen, Jessica L Saleska","doi":"10.1177/10966218251397730","DOIUrl":"10.1177/10966218251397730","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1633-1634"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541121","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":"Hepatorenal Syndrome-Acute Kidney Injury in End-Stage Liver Disease #536.","authors":"Nivetha Saravanan, Daniel Ganger","doi":"10.1177/10966218261465475","DOIUrl":"10.1177/10966218261465475","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1629-1630"},"PeriodicalIF":1.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376058","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":"Heart Failure Medication Discontinuation Among Hospice Patients with Concomitant Heart Failure and Dementia.","authors":"Laura Tycon Moreines, Dena Schulman-Green, Stuart Katz, Komal Patel Murali, Chenjuan Ma, Michael G Nanna, Colleen K McIlvennan, Abraham A Brody","doi":"10.1177/10966218261498525","DOIUrl":"https://doi.org/10.1177/10966218261498525","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) and Alzheimer's disease and related dementias (AD/ADRD) frequently co-occur, complicating medication management at the end of life.</p><p><strong>Methods: </strong>This secondary analysis included 1338 patients with HF and AD/ADRD across 12 hospices. HF was classified as a primary (<i>n</i> = 210) or secondary (<i>n</i> = 1128). HF-related medication use and discontinuation at hospice admission were characterized and compared by diagnosis primacy.</p><p><strong>Results: </strong>Prehospice use was highest for beta-blockers (44.0%), loop diuretics (32.4%), and renin-angiotensin-aldosterone system (RAAS) inhibitors (17.7%). Among patients with documented use, discontinuation was 91.2%-100% across medication classes, including beta-blockers (97.5%), loop diuretics (97.0%), and RAAS inhibitors (94.1%). Discontinuation did not differ by HF diagnostic primacy.</p><p><strong>Conclusions: </strong>HF-related medication discontinuation was common at hospice admission among patients with HF and AD/ADRD, regardless of HF diagnostic primacy. Further research is needed to understand the clinical rationale and symptom outcomes associated with medication discontinuation in hospice.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261498525"},"PeriodicalIF":1.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224274","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":"Patients with Serious Illness and Opioid Use Disorder on Methadone #541.","authors":"Reed Nerness, Julie Kmiec, Julie Childers","doi":"10.1177/10966218261499456","DOIUrl":"https://doi.org/10.1177/10966218261499456","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261499456"},"PeriodicalIF":1.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224294","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":"Using Hospital Mortality Data to Inform Creation of an Acute Care Inpatient GIP Hospice Program Led by an Academic Palliative Care Team.","authors":"John Liantonio, Zachary Klock, Katie Mechler, Gillian Love, Margaret Kreher","doi":"10.1177/10966218261498536","DOIUrl":"https://doi.org/10.1177/10966218261498536","url":null,"abstract":"<p><strong>Background: </strong>Acute Care General Inpatient (GIP) Hospice within hospital systems is becoming more common nationally. Palliative care teams are often involved in programmatic planning.</p><p><strong>Methods: </strong>A retrospective chart review of 100 inpatient acute care deaths was conducted to review characteristics of patient deaths in an urban academic hospital.</p><p><strong>Results: </strong>The majority (79%) of patients died on comfort care, with 61% dying within minutes to hours of decision to transition to comfort care, often associated with terminal extubation, while 39% of patients lived greater than 12 hours with an average time from comfort care to death of 72 hours. Palliative care was consulted on 46% of patients prior to death. Hospice was consulted on 17% of all mortalities.</p><p><strong>Conclusions: </strong>Understanding patient volumes and demographics is essential for operational planning and to ensure high-quality care can be delivered. Hospital-based GIP programs provide an opportunity to improve end-of-life care for patients that are unable to be discharged.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261498536"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194671","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":"When Gratitude Outlasts Cure: A Reflection from a Chinese Neonatal Intensive Care Unit.","authors":"Shan Yang, Zhenai Jin","doi":"10.1177/10966218261497462","DOIUrl":"https://doi.org/10.1177/10966218261497462","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261497462"},"PeriodicalIF":1.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169669","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}