Journal of palliative medicine最新文献

{"title":"Distress Intolerance: Dialectical Behavior Therapy Informed Communication for Serious Illness Care.","authors":"Neha Goyal, Margaret A Cramer, Emily Kantoff, Keri O Brenner, Danielle Chammas","doi":"10.1177/10966218261478411","DOIUrl":"10.1177/10966218261478411","url":null,"abstract":"<p><p>Patients with serious illness coupled with a history of difficulty coping with challenging situations often exhibit behaviors consistent with emotion dysregulation and low distress tolerance. Dialectical behavior therapy (DBT), an evidence-based psychological treatment originally developed for patients with borderline personality disorder and now widely applied across clinical settings, offers skills-based tools to support patients navigating the intense and understandable distress that arises with illness. This article explores the care of a patient with advanced cancer who presents with significant emotion dysregulation and low distress tolerance, which negatively affects their interactions with the medical team and generates secondary distress among clinicians. Drawing on foundational DBT principles, including distress tolerance skills, emotional validation, dialectical thinking, and clinician self-regulation, we demonstrate how DBT-informed communication strategies can help patients manage distress more effectively. We also explore how clinicians can use these skills to manage their own distress while interacting with patients experiencing high distress.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1448-1452"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764996","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 Do We Know About Hospice Enrollment for Nursing Home Residents with Cognitive Disabilities? A Systematic Review.","authors":"Victoria M Winogora, Patricia W Stone, Kimberlee Grier, Lara K Dhingra, Christine E DeForge","doi":"10.1177/10966218251388227","DOIUrl":"10.1177/10966218251388227","url":null,"abstract":"<p><strong>Background: </strong>At least 42% of nursing home (NH) residents live with cognitive disability, commonly associated with neurocognitive disorders (e.g., dementia), defined as difficulty concentrating, learning new things, remembering, or making decisions. The population of individuals with cognitive disabilities who qualify for hospice (end-of-life [EOL] care that reduces symptoms and promotes quality of life) in NHs is increasing. However, little is known about hospice enrollment for this population. This information is essential to clarify disparities in hospice access and guide efforts to improve EOL care for this population.</p><p><strong>Objective: </strong>To systematically review available evidence on hospice enrollment among US NH residents with cognitive disabilities.</p><p><strong>Methods: </strong>This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, CINHAL, Web of Science, and Google Scholar was conducted to identify studies. Peer-reviewed, English-language articles published before February 28, 2025, were included. The Joanna Briggs Institute Analytical Cross-Sectional Studies Appraisal Tool was used to assess study quality.</p><p><strong>Results: </strong>We screened 479 titles and abstracts and reviewed 36 full-text articles. Twelve studies met the inclusion criteria. In seven of the 12 studies, a substantial proportion of NH decedents with cognitive disabilities were not enrolled in hospice. Factors associated with increased likelihood of hospice enrollment at the time of death included female sex (<i>n</i> = 2), White race (<i>n</i> = 2), terminal diagnosis other than cognitive disability (<i>n</i> = 1), and increased prevalence of dementia in NH regardless of the individual's dementia status (<i>n</i> = 1).</p><p><strong>Discussion: </strong>This review is the first to systematically examine hospice enrollment among NH residents with cognitive disabilities. Hospice enrollment varied across studies but was consistently lower for NH decedents with cognitive disabilities compared to those without. Future research should include the broader cognitive disability community to assess hospice enrollment and other EOL outcomes, clarify targets for intervention, and address barriers to care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1461-1472"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top Ten Tips Palliative Care Clinicians Should Know About Symptom Assessment in People with Cancer.","authors":"Dori Beeler, Mellar P Davis, Spencer Strobel, Susan LeGrand, Lawrence Aung, Aynur Atkas, Wael Lasheen, Meredith O'Connor","doi":"10.1177/10966218251401793","DOIUrl":"10.1177/10966218251401793","url":null,"abstract":"<p><p>Symptom assessment is crucial in caring for people with cancer and should be a cornerstone in their care. Symptoms precede imaging modalities in diagnosing cancer and in evaluating efficacy of treatment, as well as being an integral part of the patient's experience with their illness. A comprehensive literature review was conducted when selecting these principles. This article presents ten important principles in symptom assessment chosen for their relevance in optimizing cancer care for patients, increasing the efficacy of shared decision making, and improving patient outcomes. These ten principles should provide a framework for symptom assessment that will optimize cancer care delivery and drive further research in the area.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1453-1460"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834076","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 the Life-Sustaining Treatment Decisions Act on End-of-Life Care in the Emergency Department.","authors":"Young Woo Um, Hee Eun Kim, Ji Eun Hwang, Seung Hyun Kang, Jae Hyuk Lee, You Hwan Jo","doi":"10.1177/10966218261457778","DOIUrl":"10.1177/10966218261457778","url":null,"abstract":"<p><strong>Background: </strong>The Life-Sustaining Treatment (LST) Decisions Act in South Korea was implemented to promote patient-centered end-of-life (EoL) care.</p><p><strong>Objectives: </strong>To evaluate the impact of this legislation on LST practices for patients dying in the emergency department (ED).</p><p><strong>Design: </strong>A single-center retrospective study using interrupted time series (ITS) analysis.</p><p><strong>Setting/subjects: </strong>Adult nontraumatic deaths in the South Korean ED between 2014 and 2024.</p><p><strong>Measurements: </strong>Changes in LST practices were assessed between pre- and post-Act groups (implemented February 4, 2018). Subgroup analyses by advanced cancer status were conducted, and interaction terms between ITS variables and advanced cancer status were evaluated using analysis of variance.</p><p><strong>Results: </strong>Among 1,058 patients (median age 77.0), rates of cardiopulmonary resuscitation (CPR) (26.8% vs. 15.1%, <i>p</i> < 0.001) and intubation (31.6% vs. 22.1%, <i>p</i> = 0.002) decreased after the Act, whereas antibiotic administration (60.6% vs. 69.3%, <i>p =</i> 0.009) and LST withdrawal (0.7% vs. 5.2%, <i>p</i> = 0.002) increased. The Act was associated with a decreasing postimplementation trend in intubation (<i>p</i> = 0.046). In patients with advanced cancer, CPR and intubation rates were similar before and after the Act, while a significant interaction between the Act and advanced cancer status was observed for CPR (<i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>Following the legislation, the provision of invasive LST, such as CPR and intubation, at the EoL phase in the ED decreased. These shifts, primarily observed in patients without advanced cancer, indicate that the Act successfully catalyzed EoL discussions and promoted goal-concordant care for this population.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1394-1401"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199350","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</i>: Preliminary Ethical Considerations Regarding the Use of Empathic Artificial Intelligence in Individuals Desiring to Die Alone.","authors":"Akira Akabayashi","doi":"10.1177/10966218261445554","DOIUrl":"10.1177/10966218261445554","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1360"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729075","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 Narrative Review of Attitudes and Beliefs Toward Hospice and Palliative Care in South Asian Muslim Communities.","authors":"Adeela Mushtaq, Mona Tareen, Renato V Samala, Susan B LeGrand","doi":"10.1177/10966218251392462","DOIUrl":"10.1177/10966218251392462","url":null,"abstract":"<p><p>As hospice and palliative care (HPC) expands, it faces the challenge of serving patients from diverse cultural and religious backgrounds. Understanding these communities' unique values during critical life transitions is essential. This article presents two case narratives illustrating reservations toward HPC in South Asian Muslim (SAM) communities, highlighting challenges and proposing strategies for culturally sensitive care. The first case demonstrates that, even with evidence-based and empathetic approaches, hesitancy toward HPC may persist. This underscores the need for (1) community-level initiatives leveraging religious and cultural platforms to educate and engage communities, and (2) greater awareness among healthcare professionals of these values to minimize conflict and reduce provider distress. In the second case, Islamic scholars were consulted regarding the use of sedative medicines at the end of life. They agreed such use is permissible under the principle of medical necessity, emphasized deference to medical expertise, and stressed preserving the patient's ability to recite the Shahadah (testimony of faith) in their final moments.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1481-1485"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142784","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":"Outcomes for Hospitalized Patients with Comfort Measures Only Orders.","authors":"Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell","doi":"10.1177/10966218261452339","DOIUrl":"10.1177/10966218261452339","url":null,"abstract":"<p><strong>Background: </strong>Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur.</p><p><strong>Objectives: </strong>Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders.</p><p><strong>Design: </strong>We completed a retrospective cross-sectional study of data from the electronic medical record.</p><p><strong>Setting/participants: </strong>We assessed all adult patients with CMO orders admitted to four hospitals in the United States between 2022 and 2024.</p><p><strong>Measurements: </strong>We used descriptive statistics and multivariable logistic regression and linear regression models to identify the association of SPC and documented GOCC with patient outcomes.</p><p><strong>Results: </strong>Of 6789 hospitalized patients with CMO orders, 48% were female, and these patients had median age 71 years. Seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality (aOR 0.4, 95% CI 0.3-0.6, <i>p</i> < 0.0001) and higher discharge with hospice (aOR 2.4, 95% CI 1.8-3.2, <i>p</i> < 0.0001). In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality (aOR 1.8, 95% CI 1.3-2.4, <i>p</i> = 0.0004) and lower discharge with hospice (aOR 0.5, 95% CI 0.4-0.7, <i>p</i> = 0.0003).</p><p><strong>Conclusions: </strong>For patients with CMO orders, SPC, rather than documented GOCC, were associated with lower in-hospital mortality and higher receipt of hospice. Future research should explore reasons why only SPC, and not documented GOCC, were associated with these findings.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1367-1374"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199320","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":"\"It Is Within the Gift of Filmmakers and TV Producers to Educate Society on the Living that Happens for People with Life-Limiting Conditions\": A Mixed-Method Study of Health Care Staff About the Portrayal of Children and Young People with Life-Limiting Conditions in the Media.","authors":"Doireann Pereira, Mirella Longo, Fiona McElligott","doi":"10.1177/10966218261460946","DOIUrl":"10.1177/10966218261460946","url":null,"abstract":"<p><strong>Background: </strong>Given the increasing prevalence of children and young people with life-limiting conditions (CYP LLC), media plays a pivotal role in shaping public understanding, highlighting both the challenges and realities faced by these children and their families.</p><p><strong>Objectives: </strong>This study explores health care staff perceptions of the portrayal of CYP LLC in media, focusing on the roles of media, accuracy of portrayals, and their impact on society.</p><p><strong>Design: </strong>The study employed a mixed-methods approach, combining quantitative data from the modified Palliative Care Knowledge Scale and thematic analysis of qualitative responses to open-ended questions.</p><p><strong>Setting: </strong>Participants were health care workers in a tertiary pediatric hospital in the Republic of Ireland.</p><p><strong>Results: </strong>While many health care professionals viewed media as a valuable tool for education, there were concerns about misrepresentation and the emotional impact of dramatized content. Respondents highlighted the difficulty in balancing accurate, sensitive depictions with the entertainment-driven nature of television and film. They stressed the need for collaboration with families and professionals to improve media portrayals, ensuring they reflect the complexities of CYP LLC. The study identified three major themes: (1) The media's role in information transmission about CYP LLC, (2) The current status and future vision for media portrayals, and (3) The impact of these portrayals on public perceptions and health care practices.</p><p><strong>Conclusion: </strong>The findings underscore the need for improved media guidelines, increased collaboration between health care and media professionals, and more thoughtful representation of CYP LLC in popular media to support better societal awareness and inclusion.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1410-1418"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829522","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":"Sexual Health and Relationship Quality in Advanced Cancer: A Cross-Sectional Dyadic Analysis of Heterosexual Couples in Malaysia.","authors":"Julia Fee Voon Ho, Pei Hwa Goh, Hasrina Mustafa, Mark Wing Loong Cheong, Qian Yi Lee, Puy Lyng Wong, Hayati Yaakup","doi":"10.1177/10966218261452779","DOIUrl":"10.1177/10966218261452779","url":null,"abstract":"<p><strong>Background: </strong>Sexual health is an important component of quality of life and relationship quality in advanced cancer patients, yet research on this domain remains limited in the Asian context.</p><p><strong>Objectives: </strong>To examine how evaluations of sexual satisfaction and frequency of intimacy behaviors are associated with relationship satisfaction and emotional closeness in advanced cancer dyads.</p><p><strong>Design: </strong>Cross-sectional survey study involving patient-partner dyads.</p><p><strong>Setting/subjects: </strong>Adult patients with advanced cancer and their partners in an oncology clinic in Malaysia.</p><p><strong>Measurements: </strong>Measures of sexual health (sexual satisfaction, frequency of sexual activity, and frequency of nonsexual physical affection) and relationship quality (relationship satisfaction and emotional closeness) were analyzed using descriptive and correlational analyses and dyadic analysis.</p><p><strong>Results: </strong>Responses from 49 patients (mean age 44.7 ± 11.0 years) and their 49 partners (mean age: 45.1 ± 11.4 years) were analyzed. Both patients and partners reported high sexual satisfaction, relationship satisfaction, and emotional closeness. Only patients' evaluation of sexual satisfaction was positively correlated with their relationship satisfaction (<i>b</i> = 0.54, <i>p</i> < 0.001, partial <i>r</i> = 0.70). Patients' evaluations of sexual and nonsexual physical affection behavior frequencies were not associated with relationship quality. Partners' evaluations of sexual satisfaction and intimacy behavior frequencies were not correlated with patients' evaluations of emotional closeness and relationship satisfaction.</p><p><strong>Conclusion: </strong>Relationship satisfaction is linked to subjective sexual satisfaction more than frequency of sexual behaviors among advanced cancer patients. Interventions should prioritize individual perceptions and dyadic communication over behavioral targets. Future research with more diverse cohorts is needed to generalize these findings across varying cultural and relationship contexts.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1379-1386"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031618","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>In Memoriam:</i> June L. Dahl, PhD.","authors":"David E Weissman","doi":"10.1177/10966218261469664","DOIUrl":"https://doi.org/10.1177/10966218261469664","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":"29 10","pages":"1359"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990089","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}