Journal of palliative medicine最新文献_第5页

High Flow Nasal Cannula Oxygen Withdrawal at the End of Life #503.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-03 DOI: 10.1089/jpm.2025.0085

Elizabeth Albert, Timothy Fuller, Cari Low, Casey Murphy

引用次数: 0

Health Care Professionals' Perceptions of Extubation During Withdrawal of Therapy in the Intensive Care Unit.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-03 DOI: 10.1089/jpm.2024.0195

Aurélie Perret, Hannah Wozniak, Sara Cereghetti, Alexandre Jeleff, Bara Ricou

{"title":"Health Care Professionals' Perceptions of Extubation During Withdrawal of Therapy in the Intensive Care Unit.","authors":"Aurélie Perret, Hannah Wozniak, Sara Cereghetti, Alexandre Jeleff, Bara Ricou","doi":"10.1089/jpm.2024.0195","DOIUrl":"10.1089/jpm.2024.0195","url":null,"abstract":"Background: Withdrawal of life-sustaining therapy can include the decision to extubate as part of end-of-life practices in the intensive care unit (ICU). Objectives: The purpose of this study was to explore ICU health care professionals (HCPs) perceptions regarding this procedure. Design: An online questionnaire was used to gather data on ICU HCPs' experiences and views regarding extubation. Setting/Subjects: This single-centered study was conducted in Switzerland from January 15 to March 15, 2019, and included physicians, nurses, and nurse assistants. Measurements: The survey assessed HCPs' emotional and ethical responses to extubation, perceptions of patient suffering, and the management of death rattles (DR). Results: A total of 150 out of 227 invited (66%) ICU HCPs participated in the study. Extubation was negatively experienced by 65 (44%) professionals. Twenty-two HCPs (15%) perceived the procedure as violent, while 12 (8%) considered it to be equivalent to suffocation. Eleven respondents (7%) considered it as active euthanasia. Five nurses (21%) and 14 nurse assistants (14%) perceived DR as an indication of patient suffering. Eighty-nine HCPs (95%) wished to treat DR for family's comfort, while 60 (64%) desired to care for it to alleviate their discomfort. The primary source of discomfort arose from the lack of know-how (n = 122, 82%), patient comfort (n = 114, 79%), and symbols of life's impermanence (n = 76, 51%). Beliefs about family distress and patient suffering positively influenced the decision to treat DR. Conclusions: While extubation in the context of end-of-life practices might be ethically sound, HCPs differed in their views on the potential suffering and DR that might be induced by this practice. HCPs discomfort was associated with difficulties in assessing patient comfort, family distress, and lack of know-how.","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":"143537322","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

A Call to Action.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-03 DOI: 10.1089/jpm.2025.0029

W David Clark

引用次数: 0

Quality of Life in Patients with Locally Advanced Pancreatic Cancer During Stereotactic Radiotherapy Combined with Heat-Killed Mycobacterium Obuense Vaccination.

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-01-31 DOI: 10.1089/jpm.2024.0160

Laura Schafthuizen, Freek R van 't Land, Monique van Dijk, Miranda Moskie, Joost van Rosmalen, Casper H J van Eijck

{"title":"Quality of Life in Patients with Locally Advanced Pancreatic Cancer During Stereotactic Radiotherapy Combined with Heat-Killed Mycobacterium Obuense Vaccination.","authors":"Laura Schafthuizen, Freek R van 't Land, Monique van Dijk, Miranda Moskie, Joost van Rosmalen, Casper H J van Eijck","doi":"10.1089/jpm.2024.0160","DOIUrl":"10.1089/jpm.2024.0160","url":null,"abstract":"Background: New treatment options for patients with locally advanced pancreatic cancer (LAPC) have proven to be safe but, in addition, may have an effect on the patient's quality of life. Objectives: To evaluate the effect of stereotactic body radiotherapy (SBRT) combined with intradermal heat-killed mycobacterium obuense (IMM-101) vaccination on health-related quality of life (HRQoL), pain, and sleep, in patients with LAPC. Design: Prospective cohort study. Setting/Participants: In total, 42 Dutch patients with LAPC were included after completion of at least four cycles of (m) leucovorin calcium (folinic acid), fluorouracil, irinotecan hydrochloride, and oxaliplatin (FOLFIRINOX). Measurements: Quality of life was assessed with the EORTC QLQ-C30. Patients completed the Richard Campbell Sleep Questionnaire (RCSQ) for five consecutive nights and wore simultaneously a GENEActiv tri-axial accelerometer, which registered sleep duration and sleep efficiency. The Numeric Rating Scale was used to assess pain intensity during treatment. Data were collected at the baseline visit [i.e., at inclusion in the study after (m)FOLFIRINOX treatment] and at week 8 (i.e., 6 weeks after start date of SBRT and after four IMM-101 vaccinations). Results: Univariable linear mixed model analysis revealed significant improvement for EORTC QLQ-C30 items \"cognitive functioning\" and \"emotional functioning.\" Outcomes on RCSQ subscales and \"RCSQ total score\" did not significantly change. In the multivariable model, with \"Global HRQoL scale\" and \"RCSQ total score\" as outcomes, we did not find a significant change during treatment. Conclusion: In this prospective cohort study, we found that SBRT combined with IMM-101, in patients with LAPC, is well tolerated and does not negatively affect HRQoL, sleep quality, and pain.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"351-357"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070959","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

Palliative Care Consults in the Southeast: Lower Readmissions Despite Increased Length of Stay. 东南地区的姑息治疗咨询：尽管住院时间延长，但再入院率较低。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-01-10 DOI: 10.1089/jpm.2024.0298

Hillary E Davis, Heather Reed-Day, Erin W Jackson, R Eric Heidel, Justin Wolfe, Adam J Tyson

{"title":"Palliative Care Consults in the Southeast: Lower Readmissions Despite Increased Length of Stay.","authors":"Hillary E Davis, Heather Reed-Day, Erin W Jackson, R Eric Heidel, Justin Wolfe, Adam J Tyson","doi":"10.1089/jpm.2024.0298","DOIUrl":"10.1089/jpm.2024.0298","url":null,"abstract":"Background: Inpatient palliative care (PC) consultations are increasingly used to address operational challenges. We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. Methods: This is a retrospective analysis of a tertiary system's adult patients who received PC consultations from December 2021 to August 2022. A Medicare Severity Diagnosis Related Groups (MS-DRG) code was identified for each PC encounter, and a comparison cohort was created from non-PC encounters. Outcomes: There were 1906 patients who received a PC consultation and 7730 patients in the matched cohort. Patients receiving a PC consultation were older (mean age 68.55 years) compared with the matched cohort (mean age 62.75 years). Despite a significantly longer length of stay (LOS) (12.46 days vs. 6.99 days, p < 0.001), the PC group experienced a lower readmission rate (adjusted odds ratio 0.54, 95% confidence interval 0.44-0.65, p < 0.001). Conclusions: Our cohort study using MS-DRG matching indicates that despite increased LOS, PC consultations were associated with significantly lower readmission rates. This suggests their potential to improve resource utilization, especially in regions affected by pandemic-deferred care.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"382-388"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950476","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

Development and Implementation of the Palliative Care Assessment Toolkit for Rural Aged Care Facilities in Australia. 澳大利亚农村老年护理机构姑息治疗评估工具包的开发和实施。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-01-02 DOI: 10.1089/jpm.2024.0368

H Khalil, R Hardman, M Livens, P Poon, E Spelten, I Blackberry, S O'Neill

{"title":"Development and Implementation of the Palliative Care Assessment Toolkit for Rural Aged Care Facilities in Australia.","authors":"H Khalil, R Hardman, M Livens, P Poon, E Spelten, I Blackberry, S O'Neill","doi":"10.1089/jpm.2024.0368","DOIUrl":"10.1089/jpm.2024.0368","url":null,"abstract":"Background: Palliative care (PC) in rural aged care facilities faces significant challenges, including late referrals and insufficient staff training, leading to a risk of suboptimal end-of-life care. Objectives: The aim of the project was to develop and implement an evidence-based Palliative Care Assessment Toolkit (PCAT) to improve PC in rural aged care facilities and evaluate its impact on care delivery and staff practices. Design: The study employed a mixed-methods design across three phases: codesign of the toolkit, implementation, and evaluation (using pre- and post-data). Baseline data were collected through an audit of decedents records and interviews with clinical staff. The toolkit was developed based on these findings and included resources in four domains: anticipatory care; advanced care planning, end-of-life care management, and staff training. Post-implementation, the toolkit's impact was assessed through repeat audit of resident records. Results: The baseline audit revealed issues around advanced care directives, regular reviews, and end-of-life care management. Five to seven months post-implementation of the PCAT toolkit, there were improvements in key areas, the commencement of end-of-life care planning (54% vs. 88%, p = 0.03), availability of medications (55% vs. 100%, p = 0.0016), provision of psychological (59% vs. 82%, p = 0.17), and spiritual support (14% vs. 44%, p = 0.05). Staff feedback indicated increased confidence in delivering PC. Conclusions: The PCAT improved the delivery of PC in rural aged care settings, enhancing both resident outcomes and staff practices. Further research is recommended to validate these findings across various settings and to explore the long-term sustainability and cost-effectiveness of such interventions.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"302-309"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915216","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

Letter to the Editor: Encouraging Nursing Students to Volunteer for Palliative Care. 致编辑的信：鼓励护理学生自愿接受姑息治疗。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-01-13 DOI: 10.1089/jpm.2024.0477

Jingjing Hu, Shuangqin Chen

引用次数: 0

"Who Has the Relationship?": Caring for a Shared Population of Children with Medical Complexity. “谁有关系？”：照顾具有医疗复杂性的共同儿童群体。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2024-12-24 DOI: 10.1089/jpm.2024.0315

P Galen DiDomizio, Madeleine Johnson, Annie Friedrich

{"title":"\"Who Has the Relationship?\": Caring for a Shared Population of Children with Medical Complexity.","authors":"P Galen DiDomizio, Madeleine Johnson, Annie Friedrich","doi":"10.1089/jpm.2024.0315","DOIUrl":"10.1089/jpm.2024.0315","url":null,"abstract":"Background: Many academic pediatric centers care for children with medical complexity (CMC) through established complex care and palliative care programs. There are little prior data investigating best practices for collaboration between these two subspecialties in caring for CMC. Objectives: The aim of this study is to explore the distinct and overlapping roles and responsibilities of pediatric complex care and palliative care teams as identified by providers when caring for a shared population of CMC and their families. Design: Qualitative analysis of semi-structured interviews. Settings/Subjects: Pediatric complex care and palliative care providers (physicians and nurse practitioners) actively caring for CMC at academic medical centers in the Midwestern United States. Measurements: Data obtained from semi-structured interviews were audio-recorded, transcribed, coded, and analyzed by two independent reviewers using thematic analysis. Results: Interviews revealed that both programs operate within a spectrum of clinical roles, thematically organized as complex-leaning, palliative-leaning, or blended. Responses highlighted that clinical roles are more likely defined by relationships established between specific providers and families, instead of by clear boundaries between the two programs. Conclusions: Pediatric complex care and palliative care teams provide both distinct and overlapping roles in caring for CMC. This overlap can vary between institutions and individual provider-caregiver dyads. Further studies are needed to explore collaborative practices on shared patients and caregiver perceptions on the benefits and challenges of utilizing both teams concurrently. Key Message: This qualitative study of providers of CMC highlights the overlapping roles and responsibilities between complex care and palliative care teams in caring for a shared population of patients and families.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"358-364"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882192","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

Is It in You?… (to be a Spiritual Care Champion). 它在你身上吗？（成为精神关怀冠军）。

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1089/jpm.2024.0558

Paul Galchutt, Betty R Ferrell

引用次数: 0

Aggressiveness of Care at the End of Life of Children Dying with Cancer in Public Hospitals-A Nationwide Retrospective Cohort Study. 公立医院癌症患儿临终关怀的积极性——一项全国性回顾性队列研究

IF 2.2 3区医学

Journal of palliative medicine Pub Date : 2025-03-01 Epub Date: 2024-12-05 DOI: 10.1089/jpm.2024.0179

Ana Lúcia Cardoso, Luis Guilherme Del Nero, Diogo Martins-Branco, Ana Lacerda, Barbara Gomes, Sílvia Lopes

{"title":"Aggressiveness of Care at the End of Life of Children Dying with Cancer in Public Hospitals-A Nationwide Retrospective Cohort Study.","authors":"Ana Lúcia Cardoso, Luis Guilherme Del Nero, Diogo Martins-Branco, Ana Lacerda, Barbara Gomes, Sílvia Lopes","doi":"10.1089/jpm.2024.0179","DOIUrl":"10.1089/jpm.2024.0179","url":null,"abstract":"Background: Little is known about the aggressiveness of cancer care at the end of life (ACCEoL) for children with cancer in countries where palliative care (PC) is scarce. Objective: The aim of this study was to determine the frequency and time trends of ACCEoL in the pediatric population in a Western European country. Setting/Subjects: We conducted a retrospective cohort study analyzing children between 0 and 17 years who died of cancer in public hospitals in Portugal, from January 2010 to December 2015. Measurements: Hospital admissions during the last month of life were identified and we analyzed the length of stay and procedures performed. The ACCEoL was measured with a composite indicator. Results: We identified 300 children, with a median age of 9 years. A total of 58.7% were male and 31.3% had central nervous system tumors. We found at least one indicator of ACCEoL in 87.8% of patients. \"More than 14 days spent in the hospital\" (51.0%) and \"more than one hospitalization\" (43.3%) were the most frequent individual indicators. Infants and children with hematological malignancies had a numerically higher percentage of ACCEoL. We found no statistically significant differences in the frequencies of the ACCEoL among the subgroups. The prevalence of ACCEoL remained stable over the period. Conclusions: In our cohort about 9 out of 10 children with cancer experienced at least one indicator of ACCEoL, a rate higher than in countries with well-developed PC services. There is a need to improve the care in the last months of life for children with cancer.","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"317-325"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785989","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