Journal of palliative medicine最新文献

{"title":"\"Telehealth Allows for Flexibility and More Equity\": Provider Perspectives on Telehealth for Outpatient Palliative Care for Underserved Patients.","authors":"Julia I Bandini, Jeannette Tsuei, Dio Kavalieratos, Sangeeta C Ahluwalia, Enrique Vazquez, Kimberly Curseen, Jordan M Harrison","doi":"10.1089/jpm.2024.0525","DOIUrl":"10.1089/jpm.2024.0525","url":null,"abstract":"<p><p><b><i>Background:</i></b> Telehealth for outpatient palliative care has grown rapidly since the COVID-19 pandemic, yet there remain important questions about the use of telehealth for underserved patient populations in a \"postpandemic\" society. <b><i>Objective:</i></b> To examine current perspectives from interdisciplinary providers on the use of telehealth and in-person care for outpatient palliative care among underserved patients. <b><i>Methods:</i></b> We conducted semi-structured interviews with outpatient palliative care providers and clinic staff (<i>n</i> = 17) from one health system in the United States. <b><i>Results:</i></b> Providers endorsed tele-palliative care for underserved patients because it enhanced patient-centered care and increased equity. However, providers noted two main challenges to the use of telehealth: technological issues on the part of patients and policies around prescribing controlled substances. <b><i>Conclusions:</i></b> Future efforts to improve tele-palliative care for underserved patients may focus on technological and institutional infrastructure to support telehealth and consider policies around prescribing controlled substances for palliative care patients.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501895","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 Single-Center Experience of the Same-Day Palliative Radiotherapy for Patients Referred to the Radiotherapy Department.","authors":"Norio Mitsuhashi, Fumiya Shiina, Daichi Tominaga, Hajime Ikeda, Atsushi Motegi, Keiko Fukaya, Yoshitaka Nemoto","doi":"10.1089/jpm.2024.0356","DOIUrl":"10.1089/jpm.2024.0356","url":null,"abstract":"<p><p><b><i>Background:</i></b> Rapid initiation of radiotherapy plays an increasingly important role in palliation of advanced cancer. <b><i>Objective:</i></b> We performed a retrospective analysis to determine the current status of same-day palliative radiotherapy in patients referred to the Radiotherapy Department of a medium-sized institution in Japan. <b><i>Materials and Methods:</i></b> The incidence by year, sex, age, primary cancer site, indication for radiotherapy, radiotherapy regimens, response rates to radiotherapy, and treatment waiting times were studied in 96 patients who received same-day palliative radiotherapy between 2016 and 2023. <b><i>Results:</i></b> The annual incidence of same-day palliative radiotherapy was 5.9%. The study included 61 males (aged 42-96) and 35 females (aged 42-97). The most common tumor was non-Hodgkin's lymphoma, followed by lung cancer. The main indications were malignant spinal cord compression and symptomatic brain metastases. Prostate cancer is the leading cause of malignant spinal cord compressions. Of the 96 patients, 84 received same-day palliative radiotherapy for oncological emergencies. Various radiotherapy regimens have been used, ranging from conventional 40 Gy in 20 fractions to hypofractionated 8 Gy in a single fraction. The response rates were 69.0% for spinal cord compression, 91.7% for symptomatic brain metastases, 100% for hollow organ compression and/or obstruction, and 100% for uncontrolled tumor bleeding. The mean time from the end of the consultation to the end of treatment was 262 ± 90 minutes. <b><i>Conclusion:</i></b> Same-day palliative radiotherapy is indispensable, especially in oncologic emergencies. Therefore, criteria for its appropriateness should be established.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516055","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":"Grief and Bereavement in Pediatric Palliative Care #502.","authors":"Lori Wiener, Meaghann S Weaver","doi":"10.1089/jpm.2025.0079","DOIUrl":"https://doi.org/10.1089/jpm.2025.0079","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483482","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":"Pancreatic Enzyme Supplementation for Patients with Pancreatic Cancer #500.","authors":"Mary Acelle Garcia, Ursula K Braun, Syed Imam, Ivy Poon, Leanne Jackson","doi":"10.1089/jpm.2025.0037","DOIUrl":"https://doi.org/10.1089/jpm.2025.0037","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472228","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 Systematic Review of Grief Experiences of Children Who Have Lost a Sibling.","authors":"Ayaka Fujita, Shingo Ueki, Harumi Moriguchi, Yuko Hamada, Momoko Sasazuki","doi":"10.1089/jpm.2024.0418","DOIUrl":"https://doi.org/10.1089/jpm.2024.0418","url":null,"abstract":"<p><p><b><i>Background:</i></b> Children who lose a sibling often receive inadequate attention, leading to lasting psychological and emotional challenges. Health care providers recognize the importance of comprehensive bereavement support but may lack knowledge for effective delivery. <b><i>Aim:</i></b> This study sought to analyze and synthesize primary research on children bereaved by a sibling to gain insight into their actual grieving experiences. <b><i>Methods:</i></b> A systematic review of qualitative studies was conducted following the Joanna Briggs Institute (JBI) methodology. The review protocol was registered on PROSPERO (CRD42022289604). Electronic databases including MEDLINE, CINAHL, PsycInfo, Scopus, and Igaku Chuo Zasshi were searched from inception to April 15, 2024. Critical appraisal was performed using the JBI Critical Appraisal Checklist for Qualitative Research. <b><i>Results:</i></b> Twenty-three articles met inclusion criteria, synthesizing experiences of 466 children. Four synthesized findings were generated: Children recognized internal and external changes in themselves after losing their siblings; children found it hard to believe their sibling had died, experienced feelings of loss and fear of death, and sometimes hid their emotions; various types of grief work allowed children to find their place after the loss, but ineffective grief work led to prolonged grief; and children's relationships with others were either strengthened or weakened depending on others' understanding and reactions to the loss. <b><i>Conclusions:</i></b> This review highlights the complex nature of sibling grief in children. It emphasizes the importance of recognizing children's unique grief experiences, facilitating effective grief work, and providing appropriate support from family, friends, and health care professionals. The findings suggest a need for tailored grief support programs for children who have lost siblings, considering their cultural backgrounds. However, the low ConQual score of the synthesized findings indicates that recommendations should be considered with caution.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468101","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> Error in Estimating Prevalence of Iatrogenic Opioid Use Disorder.","authors":"Jeremy Hirst, Charles F von Gunten","doi":"10.1089/jpm.2025.0056","DOIUrl":"10.1089/jpm.2025.0056","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448571","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":"Emotional Supportive Care Needs in Patients with Advanced Cancer and Their Associated Characteristics: A Multicenter Observational Cohort Study (eQuiPe Study).","authors":"Danny Bastings, Tjard Schermer, Janneke van Roij, Marieke H J van den Beuken-Everdingen, Mathijs P Hendriks, Hanneke W M van Laarhoven, Caroline Mandigers, Tineke J Smilde, Dirkje W Sommeijer, Cathrien Tromp, Birgit Vriens, Natasja J H Raijmakers","doi":"10.1089/jpm.2024.0142","DOIUrl":"10.1089/jpm.2024.0142","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients with advanced cancer often have emotional problems such as inadequate coping, fear of new metastases, or the prospect of enduring physical suffering. Some will need professional emotional support to cope with these problems. Accurately identifying these patients requires a thorough understanding of their characteristics. <b><i>Aim:</i></b> To assess the need for emotional supportive care in patients with advanced cancer who have emotional problems, and their associated sociodemographic, disease-related, clinical, and psychosocial characteristics. <b><i>Design:</i></b> Prospective multicenter observational study on experienced quality of care and quality of life in patients with advanced cancer and their relatives. <b><i>Setting/Participants:</i></b> Baseline data were used of 892 patients with advanced cancer who had emotional problems. <b><i>Results:</i></b> In total, 92% of the patients with advanced cancer had emotional problems and 33% of these had emotional supportive care needs. Most patients without emotional supportive care needs had contact with an oncology nurse (70%), while a minority received additional psychosocial support. Our multivariable logistic regression analysis shows that fatigue (odds ratio [OR]: 2.65, 95% confidence interval [CI]: 1.82-3.86), pain (OR: 1.50, 95% CI: 1.07-2.12), and less social support (OR: 0.95, 95% CI: 0.91-0.99) were associated with having emotional supportive care needs. <b><i>Conclusions:</i></b> One-third of patients with advanced cancer who have emotional problems in the eQuiPe study report emotional supportive care needs. Oncologists and oncology nurses should be aware that emotional supportive care needs are more common in patients with advanced cancer who experience increased pain, fatigue, or decreased social support in addition to their emotional problems. The eQuiPe study is registered as NTR6584 in the Netherlands Trial Register.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449136","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":"Does Having an Individualized End-of-Life Care Record Actually Make a Difference?","authors":"Gabriella E Swanepoel, Sophie Williams, Daniel Monnery","doi":"10.1089/jpm.2024.0556","DOIUrl":"https://doi.org/10.1089/jpm.2024.0556","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The National Institute for Health and Care Excellence (NICE) recommends an individualized approach to end-of-life care (EOLC), including an individualized record of care, which supports shared decision-making and timely rationalization of futile observations and medications. <b><i>Aim:</i></b> To assess the impact of the individualized record of care in supporting patients at the end of life at a UK tertiary cancer center. <b><i>Method:</i></b> In May 2024, we audited the case notes of 100 consecutive patients who received EOLC at our center. Data regarding clinical decision-making and rationalization were collected. Outcomes for those supported by an individualized record of care were compared to those who were not. <b><i>Results:</i></b> A total of 98 patient records were analyzed. 97.3% with an individualized care record had their observations rationalized compared to 75% without, and 74.3% versus 41.7% for medications, respectively (<i>p</i> < 0.01). Certain medications, e.g., prophylactic low molecular weight heparin (LMWH), were less likely to be rationalized. Evidence of discussion about rationalization of observations and medications was present in approximately half of the case notes and often occurred after the rationalization had taken place. <b><i>Conclusion:</i></b> The presence of an individualized end-of-life record of care improved rates of review and rationalization of observations and medications. Future qualitative work is needed to identify challenges regarding these conversations, including examining the role of shared decision-making on rationalization versus patients' refusal.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416779","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> Response to Ouchi et al., A Case of Esophagogastric Junction Cancer Treated with Pain Control by Administering Methadone Tablets Through a Gastrostomy.","authors":"Meenakshi V Venketeswaran","doi":"10.1089/jpm.2025.0008","DOIUrl":"https://doi.org/10.1089/jpm.2025.0008","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414592","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":"Navigating Emotional Landscapes: The Role of Psychological Safety in Palliative Care A Forward-Looking Perspective on Palliative Care.","authors":"Mathias Schlögl","doi":"10.1089/jpm.2025.0069","DOIUrl":"https://doi.org/10.1089/jpm.2025.0069","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416784","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}