Journal of palliative medicine最新文献

{"title":"Best Interest.","authors":"J Rush Pierce","doi":"10.1089/jpm.2025.0048","DOIUrl":"https://doi.org/10.1089/jpm.2025.0048","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586046","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":"Enhancing Bereavement Experiences for Family Caregivers of Cancer Patients: A Pilot Intervention Study.","authors":"Yutaka Hatano, Isseki Maeda, Kaoru Nishijima, China Kamei, Keisuke Ariyoshi, Shunsuke Oyamada","doi":"10.1089/jpm.2024.0090","DOIUrl":"https://doi.org/10.1089/jpm.2024.0090","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although hospice care is associated with better bereavement outcomes, the duration of hospice care at the end of life remains very short. <b><i>Objective:</i></b> The aim was to assess the feasibility of the study methods and to measure the impact of a novel brief intervention on bereaved family caregivers' satisfaction and their psychological distress and psychological burden in nurses. <b><i>Method:</i></b> Family caregivers of patients with cancer in an inpatient hospice were recruited. Participants provided information about the patient's personality and photographs of the patient before the illness. Researchers used this information to create a self-introduction sheet and placed it in the patient's room. Family caregivers were asked to complete pre- and post-intervention measures of satisfaction, depression, and grief. Nurse satisfaction was also assessed. <b><i>Results:</i></b> Twenty-one participants received the intervention. Sixteen participants completed the postbereavement assessments. At three months postbereavement, 100% of bereaved caregivers \"absolutely agreed\" or \"agreed\" with the subdomain \"I was satisfied with the sheet.\" More than 76% of them \"absolutely agreed\" or \"agreed\" with other subdomains. The average score of the Patient Health Questionnaire-9 showed a significant decrease between pre- and post-intervention (7.2 vs. 4.4, <i>p</i> = 0.014). More than 80% of the nurses rated \"absolutely agree\" or \"agree\" with all subdomains of the satisfaction scale. <b><i>Conclusions:</i></b> The results suggest that our approach can be acceptable. Further research is needed to facilitate implementation and to compare the impact on caregiver psychological distress with a control group.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586054","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":"Feasibility Study of Using Electronic Patient-Reported Outcomes to Screen Patients with Advanced Solid Cancers for Palliative Care Needs.","authors":"Tara L Kaufmann, Matthew Kearney, Dagoberto Cortez, John W Saxton, Katie Goodfellow, Carolyn Smith, Patrick Chang, Katherine Sebastian, Aaron Galaznik, Julie Scott, Elizabeth Ann Kvale, Arif H Kamal, Antonia V Bennett, Angela M Stover, Ashley M Henneghan, Michael Pignone, Gabrielle Betty Rocque","doi":"10.1089/jpm.2024.0375","DOIUrl":"https://doi.org/10.1089/jpm.2024.0375","url":null,"abstract":"<p><p><b><i>Background:</i></b> Palliative care delivery in oncology is challenging and referral practices vary widely. Standardized, needs-based screening and triage systems are essential to more effectively address patients' palliative care needs. <b><i>Objective:</i></b> Assess the feasibility, acceptability, and appropriateness among patients with advanced solid cancers of using electronic patient-reported outcomes (ePROs) to screen for palliative care needs. <b><i>Design:</i></b> We developed a 13-item ePRO palliative care survey to assess multidimensional palliative care needs and conducted a pilot study (<i>n</i> = 25) of a palliative care screening intervention using ePRO monitoring and presentation of ePRO reports to a multidisciplinary care team. Feasibility was assessed through enrollment, retention, and ePRO adherence rates. Acceptability and appropriateness were evaluated through exit surveys of all participants and semistructured interviews of a subset of participants (<i>n</i> = 10). <b><i>Results:</i></b> From May 2022 to April 2023, 68% (25/37) of eligible patients consented and enrolled on the ePRO platform. Overall, 96% (22/23; 2 censored for death/hospice) of participants completed the study and 96% of participants met predefined ePRO adherence thresholds. Overall, 84% (21/25) of patients reported a severe response during the study period, of whom 95% (20/21) received supportive services during the study period. Patients found the ePRO palliative survey acceptable and appropriate. Qualitative interviews found patient-identified barriers to the intervention and areas for improvement. <b><i>Conclusions:</i></b> Screening patients for unmet palliative needs using ePRO monitoring is feasible, acceptable, and appropriate among patients, but more work is needed to understand the perspectives of diverse patients and how to integrate ePRO palliative care screening into clinical workflows.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586059","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":"Impact of Outpatient Palliative Care Services on Resource Utilization and Cost Management in a Capitated Medicare Population.","authors":"Parag Bharadwaj, Gagandeep Gill, Nathan Dyjack, Lindsay Fahnestock, Lorie D'Amore, Shuinn Chang, Nancy Hanna, Tanya Dansky, Gwyn Merz, Annamarie Jones, David Kim, Manjit Randhawa","doi":"10.1089/jpm.2024.0325","DOIUrl":"https://doi.org/10.1089/jpm.2024.0325","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The integration of palliative care into the U.S. health care system has grown significantly, with outpatient palliative care services (OPCSs) playing an increasingly vital role in managing patients with serious illnesses. This study evaluates the impact of OPCS on resource utilization and cost management within the MemorialCare Medical Group Medicare Advantage population from January 1, 2019, to December 31, 2023. <b><i>Design:</i></b> The analysis focuses on cost reduction, emergency department (ED) visits, inpatient (IP) admissions, and average length of stay. <b><i>Results:</i></b> Results demonstrate substantial growth in OPCS enrollment, with a 129% increase from 2019 to 2023. Per-member-per-month costs showed a sustained reduction, with a 23% decrease by 2023. In addition, there were consistent reductions in ED visits and IP admissions, indicating effective outpatient care management. Patients transitioning from OPCS to hospice exhibited longer hospice stays, further emphasizing the benefits of early palliative care interventions. <b><i>Conclusion:</i></b> These findings underscore the potential of OPCS to enhance patient outcomes, reduce high-intensity service utilization, and manage health care costs more effectively. Future research should expand to broader populations to validate these findings and refine early referral strategies for OPCS.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596959","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":"Consumer Contribution in Designing Medicinal Cannabis Clinical Trials in Palliative Medicine.","authors":"Valentina Razmovski-Naumovski, Beverly Noble, Linda Brown, Meera R Agar","doi":"10.1089/jpm.2024.0422","DOIUrl":"https://doi.org/10.1089/jpm.2024.0422","url":null,"abstract":"<p><p><b><i>Background:</i></b> Medicinal cannabis clinical trials in palliative medicine present unique and complex challenges encompassing ethical, legal, and feasibility obligations, making consumer input essential. However, little is known about the consumer contribution in the medicinal cannabis research space. <b><i>Objective:</i></b> We present a case report on consumer contribution in the design and conduct of a Phase I/IIb medicinal cannabis clinical trial for anorexia in people with advanced cancer. Our discussion highlights the various ways consumers contribute through (1) lived experience, (2) knowledge, (3) inclusion as investigators, (4) advocacy, and (5) outreach, considering approaches that can mitigate bias. <b><i>Conclusion:</i></b> Consumer contribution shaped the study design, ensured successful implementation and completion of the trial, and will guide future dissemination of the results. It is crucial that consumers are included at all stages of the research process to uphold research integrity and alignment with future clinical practice and policy. <b><i>Clinical Trial Registration:</i></b> ACTRN12616000516482.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596958","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>Letter to the Editor:</i> Click Here to Connect: Learning Palliative Care Skills During Ambulatory Telehealth Visits at a Rural Academic Medical Center.","authors":"Margot G Robinson, Alexander D Steele, Alexandra C Steinbaugh, Kathleen Broglio","doi":"10.1089/jpm.2025.0033","DOIUrl":"https://doi.org/10.1089/jpm.2025.0033","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557151","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>Letter to the Editor:</i> Limitations of the 1-10 Pain Scale in Rural Indian Settings.","authors":"Sunakshi Bhatia","doi":"10.1089/jpm.2025.0082","DOIUrl":"https://doi.org/10.1089/jpm.2025.0082","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557154","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":"Spiritual Well-Being and Phenoconversion in Huntington's Disease: Analysis from the Prospective Huntington at Risk Observational Study.","authors":"Leonard L Sokol, Marissa C Ashner, Danny Bega, Benzi M Kluger, Alexander K Smith, Karen S Marder, Tanya P Garcia","doi":"10.1089/jpm.2024.0227","DOIUrl":"10.1089/jpm.2024.0227","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Spiritual well-being (SWB) has been shown to delay the onset of cognitive decline among older adults predisposed to Alzheimer's disease and related neurodegenerative dementias. It was, however, unknown if SWB is also associated with delay in disease manifestation (\"phenoconversion\") in rare, genetic neurodegenerative dementias, such as Huntington's disease (HD). Thus, we sought to evaluate the association between SWB and phenocovnersion in people at-risk for HD. <b><i>Methods:</i></b> The \"Prospective Huntington At Risk Observation Study\" (PHAROS), a large-scale national prospective research study, recruited a substantial cohort of 1001 participants. These participants, who were first-degree relatives of individuals diagnosed with HD and had a 50% chance of carrying the HD genetic mutation, were blinded to their genetic status and underwent repeated clinical assessments every 12 months. The study used Cox proportional models to examine the relationship between SWB and time to phenoconversion while also considering subcomponents of SWB and adjusting for age, sex, and CAG repeat length. <b><i>Results:</i></b> The study found no significant association between SWB and time to phenoconversion in individuals with the HD gene mutation. <b><i>Conclusion:</i></b> While existing data suggest that SWB may be an actionable target to improve health-related quality of life in HD and other serious illnesses, there is a lack of evidence supporting the role of SWB in attenuating phenoconversion in people with the HD genetic mutation. Unlike Alzheimer's, HD may be less responsive to analogous factors in delaying disease onset.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"0"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557117","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 Preference for Acute Rehospitalization Scale: Evaluating Preference for Acute Rehospitalization in Pediatric Hospice Patients.","authors":"Kelley Newcomer, Katherine Maddox","doi":"10.1089/jpm.2024.0308","DOIUrl":"https://doi.org/10.1089/jpm.2024.0308","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Since the passage of the Affordable Care Act, children are able to access pediatric hospice while still pursuing life-prolonging care. This can create confusion between hospice and palliative care staff and families about current goals of care (GOC), which evolve over time. <b><i>Methods:</i></b> Hospice and palliative care teams created, implemented, and evaluated a five-point scale to summarize the Preference for Acute Rehospitalization (PAR) Scale for children on concurrent care hospice. After 3 months, users were surveyed about the PAR Scale. <b><i>Results:</i></b> Most users reported they agreed or strongly agreed the PAR Scale helped them to understand families' GOC and feel more confident giving advice with urgent questions. <b><i>Conclusions:</i></b> The PAR Scale is a useful tool to help hospice and palliative workers quickly identify GOC for families accessing the concurrent care for children hospice benefit. Further validation in a larger study is needed to confirm these results.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537325","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":"Referrals in Focus: A Retrospective Study of Palliative Care Referrals from Rheumatology Providers at an Academic Medical Center.","authors":"Shannon Herndon, Jack Kimball, Christopher Jones, David Leverenz","doi":"10.1089/jpm.2024.0403","DOIUrl":"https://doi.org/10.1089/jpm.2024.0403","url":null,"abstract":"<p><p><b><i>Background:</i></b> People with rheumatic diseases suffer from serious complications of their illness, though little research is available on the utilization of palliative care (PC) for this population. <b><i>Methods:</i></b> We performed a retrospective chart review of patients referred to outpatient PC from a single academic rheumatology practice over five years and reviewed patients seen concurrently by rheumatology and PC in the inpatient setting over one year. <b><i>Results:</i></b> Of 18,441 patients seen in the outpatient rheumatology practice over five years, 11 (0.06%) patients were referred to PC by rheumatology providers. Of the 527 patients seen by inpatient rheumatology over a year period, 14 (3%) had rheumatic disease and were also seen by inpatient PC. Average time to death was 190 days among outpatients and 139 days among inpatients. <b><i>Conclusion:</i></b> Patients with rheumatic disease are rarely referred to PC despite high morbidity and mortality. Interventions are needed to improve this gap in care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537324","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}