Journal of palliative medicine最新文献

{"title":"Call Me Maybe: What Do We still Need To Learn About Telepalliative Care?","authors":"Mollie A Biewald, Robert Arnold","doi":"10.1089/jpm.2024.0373","DOIUrl":"10.1089/jpm.2024.0373","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1432-1434"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365573","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":"Quality of Life and Clinical Outcomes of Endosonography-Guided Biliary Drainage in Patients with Malignant Biliary Obstruction: A Single-Center, Prospective Analysis.","authors":"Łukasz Krupa, Wiktor Smyk, Robert Staron, Edyta Niemiec, Anna Jadwisiak, Piotr Milkiewicz, Michał Żorniak, Marcin Krawczyk","doi":"10.1089/jpm.2024.0084","DOIUrl":"10.1089/jpm.2024.0084","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Endosonography-guided biliary drainage (EUS-BD) serves as a rescue treatment modality for patients with malignant biliary obstruction when endoscopic retrograde cholangiopancreatography (ERCP) fails. <b><i>Objectives:</i></b> This study explores the effects of EUS-BD on liver function and quality of life (QoL). <b><i>Patients and Methods:</i></b> Patients with malignant biliary obstruction and failed ERCP were enrolled to undergo EUS-BD. QoL, including pruritus severity, was evaluated using EQ-5D-5L and PSS-10 questionnaires before and after EUS-BD. Serum bilirubin and liver function tests were measured on the procedure day, two days, and at least 14 days post-procedure. <b><i>Results:</i></b> During a 20-month study period, 1755 ERCPs were performed, with 595 for malignant cases. Of these, 49 underwent EUS-BD following failed ERCP, and 37 (54% women, age range 34-87 years) completed the 14-day follow-up. Pancreatic cancer was the most common (49%) condition, and the median hospital stay was 4 days. Serum bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase significantly decreased 2 and 14 days after EUS-BD (all <i>p</i> < 0.001). Pruritus significantly improved, with an average reduction of 5.19 points on the PSS-10 scale two weeks post-procedure (<i>p</i> < 0.001). EUS-BD led to improvements in anxiety and depression according to the EQ-5D-5L (<i>p</i> = 0.013). Conversely, deteriorations were observed in the Mobility, Self-Care, and Usual Activities domains over time (all <i>p</i> < 0.05). Successful EUS-BD enabled the resumption of chemotherapy in 11 (30%) patients. The median post-procedure survival was 112 (range 27-1030) days. <b><i>Conclusions:</i></b> EUS-BD improves liver parameters and some aspects of life quality in patients with malignant biliary obstruction, thereby increasing their eligibility for optimal palliative care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1475-1481"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875151","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 Impact of Legalizing Medical Aid in Dying on Patient Trust: A Randomized Controlled Survey Study.","authors":"Jessica B Anderson, Maria Cacciapuoti, Hannah Day, Taymour Hashemzadeh, Benjamin J Krohmal","doi":"10.1089/jpm.2023.0706","DOIUrl":"10.1089/jpm.2023.0706","url":null,"abstract":"<p><p><b><i>Background:</i></b> Some commentators and several professional medical associations have expressed concern that legalizing medical aid in dying (\"MAID\") will undermine patient trust in the medical profession, particularly among historically disadvantaged patient populations. While this concern remains influential, it has been subject to limited empirical scrutiny. <b><i>Objectives:</i></b> This study aims to empirically assess whether MAID legalization undermines patient trust, with considerations of potential trust/demographic correlations in marginalized and minority patient populations. <b><i>Design:</i></b> We developed an RCT survey study that assessed patients' trust in the medical professional using the Abbreviated Wake Forest Scale (\"AWFS\"). Two versions of the survey were used, each distributed at random to half of participants. One survey version included notification that MAID had been legalized in the jurisdiction where patients were receiving care and the other version omitted this information. <b><i>Setting/Population:</i></b> We surveyed capacitated, English-speaking adult patients who were receiving care at a not-for-profit, 912-bed academic and research hospital in Washington, D.C. Of those invited to participate, 494 patients (63.2%) completed all AWFS questions, and 70.1% identified as Black or African American and 32.9% as having a physical or mental disability. <b><i>Conclusions:</i></b> Most of the participants not notified that MAID was legal in DC were not aware of this fact (92.5%). Patients who were notified that MAID was legal in DC were significantly more likely to report approval of MAID legalization (<i>p</i> = 0.0410), but showed no significant difference in AWFS score for trust in their physicians. The study did not substantiate concerns that legalizing medical aid in dying undermines patient trust in the medical profession.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1459-1466"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017811","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 the Physical Manifestations of Psychiatric Illness and Treatment.","authors":"Gregg A Robbins-Welty, Daniel Shalev, Paul A Riordan, Paul Noufi, Jason A Webb, Keri O Brenner, William E Rosa, Danielle Chammas","doi":"10.1089/jpm.2024.0131","DOIUrl":"10.1089/jpm.2024.0131","url":null,"abstract":"<p><p>Addressing the psychiatric aspects of serious illness in palliative care (PC) is crucial to both care delivery and outcomes. Psychiatric comorbidities are common among patients with PC needs and can significantly impact their total burden of symptomatic distress, overall quality of life, functional independence, and healthcare utilization. Yet, these aspects of care are often deferred to mental health consultant teams in the context of busy PC services and often limited human resources. To provide comprehensive and person-centered care, PC clinicians must understand the interplay between medical conditions and psychiatric presentations within a biopsychosocial framework to respond empathically, efficiently, and effectively. This article is the first of a two-part series developed in collaboration with a group of psychiatric-palliative care specialists. This article explores ten common physical manifestations of psychiatric illness and treatment among patients facing serious illnesses. The second article will provide pragmatic tips PC clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatment. Combined, these two articles support a holistic approach that PC clinicians can use to prioritize and integrate both mental and emotional well-being throughout the continuum of serious illness.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1531-1540"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896260","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 Thematic Analysis of Perceptions and Experiences Regarding Clinical Hypnosis from Palliative Care Health Professionals, Patients, and Their Relatives.","authors":"Anca-Cristina Sterie, Philip Larkin, Corine Guyaz, Chantal Berna, Fabienne Teike Lüthi","doi":"10.1089/jpm.2024.0085","DOIUrl":"10.1089/jpm.2024.0085","url":null,"abstract":"<p><p><b><i>Background:</i></b> Clinical hypnosis appears to hold some promising effects for patients at end-of-life. Patients and health care professionals (HPs) are inclined to adopt the practice. Yet, the experience of hypnosis in this context remains under-researched. <b><i>Objectives:</i></b> To understand the process of integrating hypnosis into conventional care and the needs of palliative care patients and their relatives. <b><i>Design:</i></b> A qualitative study based on semi-structured interviews conducted between February 2022 and January 2023 in Switzerland. Interviews were transcribed verbatim and analyzed using thematic analysis. <b><i>Setting/Subjects:</i></b> The total sample was composed of 44 participants, including 30 service users who received hypnosis (20 palliative care patients and 10 relatives) and 14 palliative care HPs, among whom 5 were hypnosis practitioners. <b><i>Results:</i></b> Based on the feedback of HPs, we mapped various practices of offering and integrating hypnosis in palliative care. Then, we identified five sub-themes relating to the participants' experience of hypnosis and self-hypnosis: (1) factors influencing the choice to engage in hypnosis; (2) reasons for not recommending hypnosis; (3) effects and meaning of hypnosis; (4) difficulties and drawbacks; and (5) the perception of the practice of self-hypnosis. <b><i>Conclusions:</i></b> The practice of hypnosis is very diverse and constrained by resources and limitations in institutional support. Patients and relatives identified that hypnosis had a positive impact to enable them to recognize and mobilize their personal resources toward greater self-empowerment. Our findings suggest that hypnosis might hold a real potential for patients and their relatives, thus warranting further study of its effects in palliative care.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1497-1511"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133028","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 Institution's Response to Milestone Change in Palliative Education.","authors":"Ryan Joseph, Sheri M Kittelson, Raed Al Yacoub, Margaret C Lo","doi":"10.1089/jpm.2024.0220","DOIUrl":"10.1089/jpm.2024.0220","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":"1435-1436"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751945","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":"Safety and Prognostic Factor for Survival in Patients with PleurX Drain for Malignant Ascites: AscitX Study.","authors":"Aurélien Proux, Yanis Dahel, Alexandre de Nonneville, Géraldine Capodano, Nathalie Ramirez, Anne-Deborah Bouhnik, Vanessa Collin, Michaël Dassa, Nassima Daidj","doi":"10.1089/jpm.2024.0217","DOIUrl":"https://doi.org/10.1089/jpm.2024.0217","url":null,"abstract":"<p><p><b><i>Background:</i></b> Malignant ascites (MA) represents 10% of all causes of ascites and is associated with a poor prognosis. The PleurX tunneled peritoneal catheter is a device that allows the management of MA at home in a palliative care context (renamed AscitX catheter for this work). The objective of this study was to analyze real-world data of AscitX use for cancer patients with MA, to describe complications associated with the insertion of this device, and to identify factors influencing patient outcomes. <b><i>Methods:</i></b> Fifty-six patients with AscitX catheter insertion between October 2018 and October 2022 in our comprehensive cancer center were retrospectively analyzed. Computed tomography (CT) scans were reviewed by two radiologists to determine the presence of liver and peritoneal metastases and to identify portal hypertension. <b><i>Results:</i></b> The majority of patients were followed for pancreatic cancer (39%), followed by ovarian cancer (18%). We identified four cases of severe infections post-insertion and two moderate infections. The median survival time after AscitX insertion was 18 days. A Kaplan-Meier analysis did not identify differences in survival time between patients with peritoneal metastases and those with liver metastases. In contrast, CT-diagnosed portal hypertension and the absence of diuretic treatment were independently associated with a better prognosis. Regarding post-catheter end-of-life management, 41% of the patients died at home. <b><i>Conclusions:</i></b> AscitX catheter safety appears to be acceptable and most of the palliative care patients included in our study died at home. We identified CT-diagnosed portal hypertension as associated with better prognosis, as well as the absence of diuretic treatment.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522189","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 Last Visit\": Saying Goodbye to Patients #493.","authors":"Veronica Bujdos, Kimberly Chekan, Buddy Marterre, Erica Frechman, Jennifer Gabbard","doi":"10.1089/jpm.2024.0442","DOIUrl":"10.1089/jpm.2024.0442","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522187","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":"Art Therapy and Narrative Therapy Interventions for Pain Management: A Case Study with a Post-Quadruple Amputation Oncology Patient.","authors":"Leara Glinzak, Melissa Palmer, Jeniffer Dickman Portz, Ashley Dixon-Anderson, Darcy Campbell, Jean Youngwerth, Ian Kwok","doi":"10.1089/jpm.2024.0280","DOIUrl":"https://doi.org/10.1089/jpm.2024.0280","url":null,"abstract":"<p><p>This case discussion describes the use of an expanded interdisciplinary palliative care team structure that integrated art therapy and narrative therapy to meet the needs of a woman with a history of chronic pain and Burkitt lymphoma, who had received quadruple amputation due to complications of treatment. The concurrent interventions of art therapy, narrative therapy, and traditional palliative care consultation services resulted in high-quality, trauma-informed care, contributing to effective psychosocial coping and enhanced total pain management. The addition of expressive therapeutic modalities to inpatient palliative care consultation requires close collaboration and may be particularly valuable when addressing complex needs in the setting of prolonged hospitalizations.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522188","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 CMO Curtain.","authors":"Jennifer A Carolan","doi":"10.1089/jpm.2024.0438","DOIUrl":"https://doi.org/10.1089/jpm.2024.0438","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502400","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}