Journal of palliative medicine最新文献

{"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":"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":"345-350"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","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":"Top Ten Tips Palliative Care Clinicians Should Know About Diagnosing, Categorizing, and Addressing Fatigue.","authors":"Gregg A Robbins-Welty, Danielle Chammas, Ethan J Silverman, Maria Felton Lowry, Elizabeth Hale, Corina Martinez, Morgan M Nakatani, Daniel Shalev, Paul Noufi, Paul A Riordan, Keri O Brenner, William E Rosa, Christopher A Jones","doi":"10.1089/jpm.2024.0232","DOIUrl":"10.1089/jpm.2024.0232","url":null,"abstract":"<p><p>Fatigue is a multifactorial symptom that is commonly faced by patients with cancer, chronic disease, and other serious illnesses. Fatigue causes suffering across biopsychosocial domains and affects patients and their loved ones. In this article, a consortium of professionals across cancer care, physical therapy, exercise, pharmacy, psychiatry, and palliative medicine offers tips and insights on evaluating, categorizing, and addressing fatigue in the setting of serious illness. The comprehensive approach to managing fatigue underscores the importance of collaborative efforts characteristic of interdisciplinary palliative care. Prioritizing screening, diagnosing, and treating fatigue is crucial for enhancing patients' and families' overall quality of life.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"389-396"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759387","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":"A Good Day to Die for Deb.","authors":"Judith Redwing Keyssar","doi":"10.1089/jpm.2024.0476","DOIUrl":"10.1089/jpm.2024.0476","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"415"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877213","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":"In this Issue.","authors":"","doi":"10.1089/jpm.2025.0012","DOIUrl":"https://doi.org/10.1089/jpm.2025.0012","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":"28 3","pages":"293"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630574","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":"No One Dies Alone: Developing A Comfort Care Home for Unhoused, Isolated, and Vulnerable Individuals.","authors":"Holly Klein, Steven Radwany, Barbara Palmisano, Cole Thompson","doi":"10.1089/jpm.2024.0192","DOIUrl":"10.1089/jpm.2024.0192","url":null,"abstract":"<p><p>This report highlights the development of Grace House Akron, Inc. (GHA) a comfort care home focused on caring for terminally ill individuals who are unhoused, isolated, without caregivers, economically disadvantaged and face end of life alone. GHA is a free-standing home that provides safe housing, a nurturing environment, and round-the-clock personal care while local hospice agencies provide medical management. Successful strategies and lessons learned from creation of the GHA organization in 2016 to the opening in 2022 and operating of the home for 24 months, are discussed. These strategies include: (1) Build strong executive leadership in partnership with a broadly skilled and connected board; (2) Develop a comprehensive and flexible business plan; (3) Identify state licensure regulations and physical facility requirements; (4) Engage foundations, donors, and the local community early and often; (5) Utilize volunteers as an essential part of the team; and (6) Listen to and learn from each resident while identifying their unique needs. We also share four lessons learned from our journey. By sharing these strategies and lessons, we hope to inform others interested in filling gaps in hospice services to vulnerable individuals in their own communities.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"298-301"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794829","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":"What Would You Do if It Were Your Child? #497.","authors":"Katherine F Guttmann, Renee D Boss, Cardinale B Smith, Robert M Arnold","doi":"10.1089/jpm.2024.0538","DOIUrl":"10.1089/jpm.2024.0538","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"411-412"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977757","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 Assessment of a Basic Palliative Care Training Course in Uganda.","authors":"Angella Namatovu, Barnabas Atwiine, Antonia Kamate Tukundane, Annet Kembabazi, Allen W Wong, Khadidjatou Kane, Mark Stoltenberg, Bethany-Rose Daubman","doi":"10.1089/jpm.2024.0219","DOIUrl":"10.1089/jpm.2024.0219","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Palliative care (PC) is essential for improving the quality of life for individuals with serious illnesses, yet access to PC services remains limited, particularly in low- and middle-income countries (LMICs). This study aimed to assess the impact of a one-day PC training initiative for health care professionals in Uganda. <b><i>Methods:</i></b> Participants' pre- and post-course self-assessments, qualitative feedback, and satisfaction surveys were analyzed. <b><i>Results:</i></b> Significant improvements were observed in participants' self-assessed abilities across various PC competencies. Course satisfaction was high. <b><i>Conclusion:</i></b> This study underscores the importance of investing in PC education to address the growing demand for PC in LMICs. The positive impact observed highlights the potential of such initiatives to bridge the gap in access to PC services and improve outcomes for patients facing life-threatening illnesses.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"377-381"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877383","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":"High Dyspnea Score, a Trigger for Specialist Palliative Care Utilization-Results from a Cohort Study on the Predictors of High Opioid and Benzodiazepine Use in COVID-19 Patients.","authors":"Lionel Kee Yon See, Mahrley Tanagon Provido, Sheryl Ng, Fionna Chunru Yow, Xin Lun Ho, Khar Suan Lee, Han Yee Neo, Oon Tek Ng, Kalisvar Marimuthu, Allyn Yin Mei Hum, Wen Yang Goh","doi":"10.1089/jpm.2024.0128","DOIUrl":"10.1089/jpm.2024.0128","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients with severe coronavirus disease 2019 (COVID-19) often rapidly deteriorate with severe dyspnea and should receive early specialist palliative care (SPC) as intensive symptom management may be required at the end of life. Currently, there is a paucity of data identifying triggers for early SPC involvement. <b><i>Objective</i>:</b> To identify risk factors among nonventilated patients with severe COVID-19 who required high opioid and/or benzodiazepines (BZD) use for the control of dyspnea. <b><i>Methods:</i></b> This is a retrospective cohort study of nonventilated patients with COVID-19 admitted to the National Centre for Infectious Diseases in Singapore and seen by SPC between January 2021 and July 2022. We collected baseline demographics, comorbidities, 4C mortality score (International Severe Acute Respiratory Infection Consortium-Comprehensive Clinical Characterization Collaboration [ISARIC-4C]), and COVID-19 vaccination status. Clinical and laboratory results, dyspnea by numerical rating scale, and palliative-related treatments were recorded at the first SPC review, when symptoms peaked, and the last SPC review. Patients with morphine equivalent daily dose (MEDD) of ≥45mg and/or BZD use for dyspnea control were grouped as high users, while patients with MEDD <45mg and no BZD use were low users. <b><i>Results:</i></b> Among 234 patients, 119 (50.9%) were high users. Multivariate analysis showed that subjects with higher dyspnea (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.45-2.08) and lower ISARIC-4C scores (OR 0.77, 95% CI 0.67-0.88) at first SPC review were predictive of high users. High users also required higher supplemental oxygen and had higher inpatient mortality rates. <b><i>Conclusions:</i></b> High dyspnea score is predictive of high opioid and/or BZD use for symptom control in nonventilated patients with severe COVID-19. Such patients with high mortality rates should be seen early by SPC.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"310-316"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716544","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 Catalan Institute of Oncology (ICO) Presents the ICO Toolkit-2: An Updated, Spanish National Assessment Kit for Patients with Malignant Neoplasm in Palliative Care.","authors":"Deborah Moreno-Alonso, Joaquim Julià-Torras, Josep Majó Llopart, Gala Serrano-Bermúdez, Anna Duran Adán, Denise Pergolizzi, Sílvia Llorens-Torromé, Jordi Trelis-Navarro","doi":"10.1089/jpm.2024.0109","DOIUrl":"10.1089/jpm.2024.0109","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The needs of patients living with malignant neoplasm, and those of their families and care partners, require a multidimensional and interdisciplinary approach. By systematically assessing these needs with validated tools, healthcare professionals can identify and monitor therapeutic objectives, interventions, and results. <b><i>Objective:</i></b> At the Catalan Institute of Oncology (ICO), we set out to update the ICO Toolkit-a set of instruments for assessing the physical, emotional, and social needs of palliative care patients. <b><i>Methods:</i></b> We conducted a non-systematic review of the most common instruments currently used for multidimensional assessment of cancer patients nearing the end of life and then applied the Delphi method to achieve consensus on the instruments to be included in the updated ICO Toolkit-2. Initial consensus was obtained via interobserver agreement within a discussion group of experts, drawing on their daily clinical practice, and the published evidence. The Delphi method was then used to survey a representative sample of 22 experts from the ICO's three interdisciplinary palliative care teams. <b><i>Results:</i></b> The final 19 instruments selected for the ICO Toolkit-2 achieved a degree of consensus of 90%-100%. <b><i>Conclusions:</i></b> The updated ICO Toolkit-2 facilitates a multidimensional, systematic, objective, and measurable assessment of the needs of malignant neoplasm patients throughout their cancer journey. Uptake of the new toolkit could improve the care and support provided to patients and their families and care partners.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"397-407"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895517","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":"Orexin Receptor Antagonists for Insomnia in Patients with Serious Illness #496.","authors":"Hana Yu, Brooke Cline","doi":"10.1089/jpm.2024.0521","DOIUrl":"10.1089/jpm.2024.0521","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"408-410"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059402","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}