Journal of palliative medicine最新文献

{"title":"Patient and Caregiver Perspectives on a Coaching-Based Early Palliative Care Program (Enable, Nurture, Advise, Before Life Ends for Singapore): A Qualitative Study.","authors":"Apphia Jia Qi Tan, Eve Seraphina Qing Yi Low, Ke Yu, Neela Natesan, Su-Min Yeo, Hui Scen Cherry Kok, Marie Bakitas, J Nicholas Odom, Grace Meijuan Yang","doi":"10.1177/10966218251365263","DOIUrl":"https://doi.org/10.1177/10966218251365263","url":null,"abstract":"<p><p><b><i>Background:</i></b> Integrating early palliative care within oncology care is strongly recommended. Evidence suggests that early palliative care has the potential to improve symptom management for patients with cancer, increase care satisfaction, and improve quality of life for both patients and caregivers. The ENABLE-SG (Educate, Nurture, Advise, Before Life Ends for Singapore) program, culturally adapted from Project ENABLE in United States, aims to empower patients with cancer and their caregivers with essential self-management skills such as problem-solving, decision making, and communication. ENABLE-SG was pilot tested in an ambulatory oncology setting in Singapore. <b><i>Aim:</i></b> This study aimed to explore patient and caregiver experiences after they have completed ENABLE-SG. <b><i>Design:</i></b> A qualitative descriptive study was conducted. <b><i>Setting/Participants:</i></b> Seventeen patients with advanced cancer and 13 caregivers who completed the ENABLE-SG program were recruited and interviewed via telephone. Interviews were transcribed verbatim, and reflexive thematic analysis was adopted to analyze the interview data. <b><i>Results:</i></b> Three main themes were developed from participant experiences and their views on program elements: (1) personalized program delivery can optimize benefits for participants, (2) the coach-participant relationship lies at the core of ENABLE-SG, and (3) participant circumstances and attitudes impact usefulness of coaching. <b><i>Conclusions:</i></b> Study findings have wider implications for improving current early palliative care programs and designing future interventions. Developing inclusive and accessible coaching resources for patients and caregivers of varying health literacy, building strong coach-participant relationships during the coaching process, and introducing the program at an appropriate time potentially improve program outcomes. Future evaluation is required to assess the sustainability and implementation of the ENABLE program.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958098","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":"Professional Practice Assessment: Improving End-of-Life Care Through the Standardization of Treatment Limitation in the Long-Term Care Facilities of a French Hospital.","authors":"Felix Bachelet, Valentin Feraux, Tomislav Slovenski, Isabelle Defouilloy, Guillaume Deschasse, Cyrille Capel, Frédéric Bloch, Julien Moyet","doi":"10.1177/10966218251372366","DOIUrl":"https://doi.org/10.1177/10966218251372366","url":null,"abstract":"<p><p><b><i>Background:</i></b> Palliative support has been shown to improve the quality of end-of-life care provided in long-term care facilities (LTCF). In this context, a practice improvement plan, which included creating a withholding and withdrawing life-sustaining treatment (WLST) protocol, has been developed and implemented in our LTCF. We aimed to compare professional practices before and after the implementation of this improvement plan. <b><i>Methods:</i></b> The study population included all individuals who died in 2018 and in 2021. A clinical audit noted if WLST was decided and which palliative interventions were deployed. <b><i>Results:</i></b> WLST decisions were significantly more frequently taken in 2021 than in 2018, with a longer interval between the decisions and death, as well as fewer transfers to acute care facilities. <b><i>Conclusions:</i></b> Identifying and managing end-of-life situations more frequently leads to shared WLST decisions, which allow for more effective cessation of interventions and fewer transfers during the last month of life.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958111","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> Death Professionals as Health Advocates: Exploring Funeral Directors' Willingness to Support Goals-of-Care Conversations.","authors":"Jack Kimball, Kiira M Lyons, David Casarett, Deana Gillespie, Kathryn I Pollak","doi":"10.1177/10966218251371902","DOIUrl":"https://doi.org/10.1177/10966218251371902","url":null,"abstract":"","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958162","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":"Radiometric Measurement of the Effect of Nonpharmacological Interventions on Vital Signs of Patients with Palliative Care Using the Example of Music Therapy.","authors":"Katharina Roth, Anke Malessa, Stefan Grießhammer, Maria Heckel, Robert Richer, Kilin Shi, Alexander Kölpin, Nicolas Rohleder, Susanne Metzner, Christoph Ostgathe, Tobias Steigleder","doi":"10.1177/10966218251369969","DOIUrl":"https://doi.org/10.1177/10966218251369969","url":null,"abstract":"<p><p><b><i>Background:</i></b> Nonpharmacological, psychosocial interventions such as music therapy (MT) are common in palliative care. However, measuring the effects of these interventions is challenging. Contactless and therefore burden-free vital sign monitoring may provide a feasible solution. <b><i>Aim:</i></b> The aim is to investigate the use of a radar system for measuring the effect of nonpharmacological interventions on heart and respiratory rate in patients with palliative care utilizing MT as an example. <b><i>Design:</i></b> Radar devices were installed under patients' mattresses of the palliative care ward to record heart and respiratory rate data. The pre-, peri-, and post-intervention heart rates were compared for 10-minute intervals, respectively. Heart rate changes were assessed for all interventions and two subgroups (receiving MT and MT with physiotherapy). Data from 77 patients were recorded as part of the GUARDIAN project performed at the palliative care unit of the University Hospital Erlangen-Nürnberg. <b><i>Results:</i></b> The heart rate of patients with palliative care was monitored continuously, prior to and following a complex intervention. Significant changes in heart rate were recorded depending on the intervention: A reduction of heart rate by -3.342 bpm (-3.913%, ±6.011 bpm, <i>p</i> = 0.0229) was found in the first 10 minutes after the MT intervention. The monitoring of the respiratory rate was only possible on an intermittent basis. <b><i>Conclusions:</i></b> Our study shows that radiometric heart rate monitoring is feasible during MT, highlighting the radar system's potential for assessing complex interventions in palliative care. However, reliability issues in respiratory rate measurement call for further research.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958088","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 Case Report on Home-Based End-of-Life Care with Traditional Korean Medicine Acupuncture and Herbal Medicine for an Elderly Patient with Parkinson's Disease.","authors":"Kyung-Hwan Kim, Hanbit Jin, Hoyoel Bang, Myung-Ho Kim","doi":"10.1177/10966218251368491","DOIUrl":"https://doi.org/10.1177/10966218251368491","url":null,"abstract":"<p><p><b><i>Background:</i></b> Managing multiple symptoms in home-based palliative care (HBPC) is challenging. Acupuncture and herbal medicine have been widely used to alleviate symptoms in patients with cancer receiving palliative care, but their role in HBPC for nonmalignant diseases such as Parkinson's disease (PD) remains underexplored. <b><i>Case Presentation:</i></b> We report the case of an 86-year-old woman with end-stage PD who received HBPC. She suffered from seborrheic dermatitis, constipation, and dyspnea, which significantly impaired her quality of life. Conventional treatments provided limited relief, prompting the integration of acupuncture and herbal medicine as complementary therapies. Over a two-month HBPC period, she experienced notable symptom improvement, including alleviation of skin conditions, relief from constipation, and reduction in dyspnea. Notably, acupuncture was administered until her final moments, contributing to a peaceful and comfortable end of life without severe respiratory distress. <b><i>Conclusion:</i></b> This case suggests that acupuncture and herbal medicine may serve as valuable adjunctive therapies for managing symptoms in patients with PD receiving HBPC. Notably, their integration into end-of-life care may help alleviate terminal dyspnea and support a peaceful death. These findings warrant further research and policy support to establish their role in palliative care for neurodegenerative diseases.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958140","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 Use of Palliative Care Consults During Extracorporeal Membrane Oxygenation: A Multicenter Observational Study.","authors":"Bridget S Dillon, William C Miller, Olivia A Hood, Jillian K Wothe, Fatima Alwan, Misty A Radosevich, Troy G Seelhammer, Ramiro Saavedra-Romero, Joshua S Huelster, Matthew E Prekker, Melissa E Brunsvold","doi":"10.1177/10966218251365264","DOIUrl":"https://doi.org/10.1177/10966218251365264","url":null,"abstract":"<p><p><b><i>Background:</i></b> Palliative care can help alleviate the suffering of a person as they face a serious life-threatening disease. Extracorporeal membrane oxygenation (ECMO) supports patients who have severe cardiac or respiratory failure; however, there is a mortality rate of roughly 50%. Despite this, the role of palliative care remains poorly characterized. <b><i>Objectives:</i></b> To characterize the use of palliative care among patients on venovenous ECMO (VV-ECMO). <b><i>Design:</i></b> A retrospective cohort study was performed and included patients supported by VV-ECMO at all four ECMO centers in Minnesota, USA. Variables associated with palliative care consultations (PCCs) were collected, stratified, and compared across protocols. <b><i>Results:</i></b> Of the 420 patients in this study, 230 patients (54.8%) received a PCC during their admission. Individuals who received a PCC were significantly less likely to survive to discharge (52.6%) compared to those who did not receive a PCC (72.6%; <i>p</i> value <0.001). Centers 1 and 2 had an automatic palliative consult included in the VV-ECMO electronic health record (EHR) order set, whereas Centers 3 and 4 did not. Center 1 had the highest PCC rate of 81.6%, followed by Center 2 with 49.4%. In comparison, Centers 3 and 4 had significantly lower PCC rates of 36.9% and 29.7%, respectively (χ² = 81.92, <i>p</i> value <0.0001). <b><i>Conclusions:</i></b> In this study we found a majority of patients on VV-ECMO received a PCC. However, the absence of her-embedded PCC was associated with a significantly reduced rate of PCCs.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958117","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 Future of Artificial Intelligence.","authors":"Pragat Patel, Raj Patel, Gilad Kuperman, Monica Consolandi, David Collett, Shunichi Nakagawa, Nicolas Burry, Karl B Bezak, Jake Strand, Mihir Kamdar, Judith E Nelson, William E Rosa, Craig D Blinderman","doi":"10.1177/10966218251366117","DOIUrl":"10.1177/10966218251366117","url":null,"abstract":"<p><p>Artificial intelligence (AI) is transforming health care and has implications for palliative care (PC) and serious illness communication (SIC). This article integrates interdisciplinary and interprofessional expertise, providing key tips for PC clinicians to best leverage AI-driven tools to enhance PC practices, care efficiency, and patient- and family-centered outcomes. AI-driven tools range from predictive analytics to improve intervention delivery to AI-assisted communication and documentation of goals of care. Beyond these potential benefits are important ethical, logistical, and equity considerations that must be carefully addressed.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873626","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":"An Exchange of Wards: Opportunities and Challenges Caring for Incarcerated Patients in Inpatient Palliative Care.","authors":"Michael A Lourie, Joseph M Schnitter, Joshua M Hauser","doi":"10.1177/10966218251369978","DOIUrl":"10.1177/10966218251369978","url":null,"abstract":"<p><p>Rates of chronic and life-limiting illness among incarcerated people are expected to increase, leading to a concurrent rise in the need for palliative care services within this population. In this report, we present a case of a patient with newly diagnosed cancer admitted to the hospital from the carceral system. This case illustrates the individual, interpersonal, and health care and carceral systems-level obstacles that may arise when providing palliative care services to someone currently experiencing incarceration. We take this opportunity to reflect on opportunities in which palliative care clinicians can address the unique needs of incarcerated patients.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873625","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 Intensive Care Unit Consultation.","authors":"Ankita Mehta, Karen Bullock, Jillian L Gustin, Rachel A Hadler, Judith E Nelson, William E Rosa, Jennifer B Seaman, Shelley E Varner-Perez, Douglas B White","doi":"10.1177/10966218251366072","DOIUrl":"10.1177/10966218251366072","url":null,"abstract":"<p><p>The intensive care unit (ICU) is distinct in population, culture, and palliative care needs. Critical illness and ICU stays can be extremely distressing for patients and their loved ones. Providing palliative care in the ICU, although a standard component of comprehensive care delivery, involves understanding the individual culture of each specific ICU, collaboration with multiple providers, and interfacing with surrogate decision makers while patients may not be able to communicate and are undergoing interventions that are unfamiliar to them and loved ones. These top ten tips aim to support palliative care clinicians providing consultation in ICUs. Specifically, these tips address initial relationship building with ICU clinicians and teams to foster effective collaboration, establishing goals of care by assessing health-related values, explaining treatment options, individualizing prognostic discussions, and managing end-of-life symptoms for patients while in the ICU and throughout ICU discharge transition.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804278","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 Trauma-Informed Care.","authors":"J Janet Ho, Chelsea K Brown, Heather Bemis, L Emily Cotter, Jennifer DiBiase, Megan R Gerber, Dana E Greenfield, Nancy Kusmaul, Hedieh Matinrad, Jason Mills, Abigail Nathanson, Sarah Peck, Linda M Radbill, Cara L Wallace, William E Rosa","doi":"10.1177/10966218251366151","DOIUrl":"10.1177/10966218251366151","url":null,"abstract":"<p><p>Trauma is a personal stress response to experiences perceived as harmful or life-threatening, and has ongoing impacts on illness and health. Exposure to trauma is increasingly prevalent, and the risk of medical trauma or re-traumatization is heightened for people living with serious illness. Trauma not only impacts health outcomes, but can also interfere with decision-making and worsen symptom burden at the end of life. Thus, it is critical that palliative care clinicians in all professions be skilled at providing high-quality trauma-informed care (TIC). TIC seeks to provide more holistic and equitable care through better understanding of how a person's life situation impacts behavior, reactions, behavior, responses, or relationships. A clinician using a trauma-informed lens asks, \"What has happened to this person?\" instead of, \"What is wrong with this person?\" A \"universal precautions\" approach is recommended, encouraging broad acknowledgment of possible trauma and recognition of signs of trauma responses, to better understand triggers for medical retraumatization among patients, caregivers, and even us as clinicians. TIC provides a framework that guides clinicians to acknowledge the widespread experience and consequences of trauma, recognize the symptoms of traumatic stress, mitigate mistrust and disempowerment, and advocate for culture change in health care systems to reduce the risk of further health care-based traumatization.</p>","PeriodicalId":16656,"journal":{"name":"Journal of palliative medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804279","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}