Journal of palliative medicine最新文献

{"title":"Managing Pain in Patients Receiving Palliative Cancer Care During the Opiophobia Epidemic.","authors":"Eduardo Bruera, Joseph A Arthur","doi":"10.1177/10966218261474932","DOIUrl":"10.1177/10966218261474932","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1356-1358"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664114","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":"One Glorious Day.","authors":"Robert Macauley","doi":"10.1177/10966218251403290","DOIUrl":"10.1177/10966218251403290","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1479-1480"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856919","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":"Pediatric Palliative Care for Patients Who Undergo Tracheostomy Placement: A Descriptive Study.","authors":"Emilee Flynn, Vrushali Thakkar, Daniel T Flanagan, Advaita Krishnan, Enid Swatson, Cynthia Sinha, Scott Gillespie","doi":"10.1177/10966218261493190","DOIUrl":"https://doi.org/10.1177/10966218261493190","url":null,"abstract":"<p><strong>Background: </strong>Pediatric palliative care (PPC) is specialized medical care for chronically critically ill children (CCIC), which focuses on improving quality of life, defining goals of care, and supporting decision-making. With advancements in management and technologies, including tracheostomy placement, CCIC are living longer. Access to PPC services remains essential.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for patients who underwent tracheostomy placement at a single institution between January 2017 and December 2019. Demographic and baseline medical characteristics were recorded. Attention was given to psychosocial determinants of health and PPC involvement. Based on the timing of PPC consultation, patients were classified into three mutually exclusive groups: PPC prior to tracheostomy, PPC after tracheostomy, and no PPC. Differences between groups were tested using omnibus Kruskal-Wallis, chi-square, and Fisher's exact tests.</p><p><strong>Results: </strong>PPC was provided for 40 of 99 patients (40%) who underwent tracheostomy placement. Patients who self-identified as Black comprised the largest racial group (55 of 99; 55%). Black patients also represented the largest proportion of those receiving PPC after tracheostomy placement and those who received no PPC (11 of 18; 61% and 36 of 59; 61%, respectively). Patients with neurologic indications for tracheostomy (15 of 29; 52%), complex congenital heart disease (12 of 14; 85%), who were older at time of tracheostomy placement (median 67 months, IQR 12-177; <i>p</i> = 0.004), and who had prior hospitalizations (median of two prior hospitalizations [IQR 0-6] <i>p</i> = 0.008) had higher portions of PPC. Not all patients who died within five years of tracheostomy placement received PPC; patients who died had higher proportions of PPC (20 of 30; 66%).</p><p><strong>Conclusions: </strong>Initial trends suggest that patients with comorbidities in several organ systems, who were older at time of tracheostomy placement, and those who had multiple encounters with the healthcare system prior to tracheostomy placement had higher proportions of PPC.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261493190"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111204","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 Architecture of Silence: A Reflection on Presence and the Death of a Father.","authors":"Amilton Dos Santos Júnior","doi":"10.1177/10966218261493725","DOIUrl":"https://doi.org/10.1177/10966218261493725","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261493725"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111145","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 When Caring for Unhoused Seriously Ill Patients.","authors":"Rebekka DePew, Sarah Cross, Abhi Kole, Emily Pinto Taylor, Anna White, Ashima Lal, Maura George, Avik Chatterjee, Erica Roberson, Blossom Tewelde, Elizabeth McCord, Heather Mikes, Gregg A Robbins-Welty","doi":"10.1177/10966218261494268","DOIUrl":"https://doi.org/10.1177/10966218261494268","url":null,"abstract":"<p><p>Unhoused individuals are at high risk for chronic illness and early mortality. For those who have serious or life-limiting illness, being unhoused can negatively impact symptom management, access to disease-modifying therapies, and ability to receive goal-concordant care at the end of life (EOL). Palliative care (PC) clinicians should be prepared to take a thorough housing history, identify barriers to care, and work with patients and teams to devise care plans that are realistic and in line with the patient's preference and values. In this article, an interdisciplinary group of PC, internal medicine, psychiatry, and addiction medicine clinicians and researchers with expertise in caring for unhoused patients present an overview of the assessment and management of patients with serious illness who are unhoused. We outline key considerations for addressing symptoms associated with serious illness, engaging in Advance Care Planning, evaluating for comorbidities and mental health concerns, and coordinating medical therapies for the patient's underlying serious illness.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261494268"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111194","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":"Palliative Care Support for Pediatric Cancer Patients Enrolled in Phase I Clinical Trials.","authors":"Andrea Cuviello, Mariela Trejo, Emily Zeng, Deena Levine, Holly Spraker-Perlman","doi":"10.1177/10966218261493731","DOIUrl":"https://doi.org/10.1177/10966218261493731","url":null,"abstract":"<p><strong>Background: </strong>Children diagnosed with cancer who enroll in phase I clinical trials may be exposed to greater risks beyond drug-related toxicity, such as delays in advance care planning and suboptimal end-of-life (EOL) care. Pediatric palliative care (PPC) can provide a specialized layer of support for patients enrolling in phase I trials; however, little is known about PPC utilization for pediatric phase I participants.</p><p><strong>Methods: </strong>A retrospective chart review of pediatric oncology patients enrolled in phase I trials over a 9-year period was completed at an academic cancer hospital. Data collection included sociodemographic, clinical, PPC, and EOL-related variables. Descriptive analyses were performed.</p><p><strong>Results: </strong>Of the 539 included participants, central nervous system tumors were the most common diagnosis (44%, <i>n</i> = 237), followed by leukemias (33%, <i>n</i> = 179), solid tumors (20%, <i>n</i> = 108), and lymphomas (3%, <i>n</i> = 15). Two thirds of patients (68%, <i>n</i> = 368) had PPC support; however, only 21% (<i>n</i> = 76) had PPC involvement prior to trial enrollment. Patients with PPC involvement were more likely to die in their preferred location (<i>p</i> < 0.001), have do not resuscitate documentation (<i>p</i> < 0.001) and enroll in hospice (<i>p</i> < 0.001). More frequent PPC visits (>20 visits) increased the likelihood of death outside of the ICU (i.e., home or general inpatient floor; <i>p</i> < 0.001) and hospice enrollment (<i>p</i> = 0.0015).</p><p><strong>Conclusions: </strong>Although most patients enrolled in phase I studies in this review utilized PPC, referrals were typically late in their course. Earlier and systematic PPC integration in this high-risk patient population may offer potential benefits of shared medical decision-making support and optimize EOL care through advanced planning.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261493731"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111134","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>When a Composer Dies</i>.","authors":"Madeline Cheshire","doi":"10.1177/10966218261493719","DOIUrl":"https://doi.org/10.1177/10966218261493719","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261493719"},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111165","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":"Admission Surprise Question Response and Its Association with Advance Care Planning Documentation and Palliative Care Consultation: A Multisite Propensity-Matched Cohort Study.","authors":"Ankita Agarwal, Kolby Johnson, Benjamin Verplanke, Lauren Messing, Heather Menzer, Veerawat Phongtankuel, Jesse Burk-Rafel","doi":"10.1177/10966218261488922","DOIUrl":"https://doi.org/10.1177/10966218261488922","url":null,"abstract":"<p><strong>Background: </strong>The Surprise Question (SQ) asks providers, \"Would you be surprised if this patient died in the next year?\". It is a tool that was developed to help providers identify patients who would benefit from palliative care (PC) interventions. There is limited research on whether the provider's response to the SQ at the time of hospital admission influences the quality of care and clinical outcomes in the inpatient setting.</p><p><strong>Aim: </strong>To evaluate the impact of the SQ response at the time of hospital admission on the initiation and timing of PC interventions during hospitalization.</p><p><strong>Design: </strong>This was a retrospective, propensity-matched cohort study assessing the association between the SQ response and the presence and timing of advance care planning (ACP) documentation and PC consultation.</p><p><strong>Setting/participants: </strong>The study included hospitalized patients admitted to the Hospital Medicine service across three New York University Langone Health sites in New York City over a five-year period (2020-2025) with a discharge disposition of \"expired\" or discharged to hospice care (inpatient or outpatient).</p><p><strong>Results: </strong>After propensity matching, 8,970 encounters were analyzed. Patients with an SQ response of \"No\" on admission had higher odds of having ACP documentation or PC consultation (odds ratio 1.28, 95% confidence interval [CI]: 1.11-1.49) compared to those with a response of \"Yes.\" In addition, patients with a \"No\" response had ACP documentation or PC consultation an average of 2.7 days earlier than those with a \"Yes\" response (CI -2.9 to -2.5, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>An SQ response of \"No\" at the time of admission was associated with an increased likelihood and earlier timing of PC interventions.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261488922"},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075078","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> Patients Are Not \"Palliative\": Rethinking Patient Labels in Modern Palliative Care.","authors":"Andrew Jeong","doi":"10.1177/10966218261492791","DOIUrl":"https://doi.org/10.1177/10966218261492791","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261492791"},"PeriodicalIF":1.8,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061903","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> When Feasibility Data Are Mistaken for Evidence of Efficacy.","authors":"Queenne Kimverlee C Landingin, Maria Diwata Cadiente, Lilia D Antonio, Jonathan M Beltran, Cherry Amor V Ariola","doi":"10.1177/10966218261492790","DOIUrl":"https://doi.org/10.1177/10966218261492790","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"10966218261492790"},"PeriodicalIF":1.8,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061913","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}