Palliative Medicine最新文献

{"title":"Does a novel community-based outpatient palliative care intervention for Parkinson's disease and related disorders improve care? Qualitative results from patients and care partners.","authors":"Meredith A Bock, Zachary A Macchi, Krista L Harrison, Maya Katz, Megan Dini, Jacqueline Jones, Roman Ayele, Jean S Kutner, Steven Z Pantilat, Christine Martin, Stefan Sillau, Benzi Kluger","doi":"10.1177/02692163231219923","DOIUrl":"10.1177/02692163231219923","url":null,"abstract":"<p><strong>Background: </strong>Palliative care has the potential to address significant unmet needs in people with Parkinson's disease and related disorders, but models that rely on in-person specialty palliative care teams have limited scalability.</p><p><strong>Aim: </strong>To describe patient and care partner experiences with a novel, community-based palliative care intervention for Parkinson's disease.</p><p><strong>Design: </strong>Qualitative study embedded in a randomized clinical trial to document participant experiences with a novel palliative care intervention (community neurologist training and remote team-based specialist palliative care). Transcripts were coded and thematically analyzed through a combination of team-based inductive and deductive coding.</p><p><strong>Setting/participants: </strong>Twenty-eight patients and 33 care partners purposively sampled from participants in a randomized clinical trial of a palliative care intervention for Parkinson's disease and related disorders conducted at nine sites.</p><p><strong>Results: </strong>Benefits of the intervention included management of a wider range of non-motor symptoms, facilitation of conversations about the future, greater engagement with the health care team, and increased referrals to resources. Participants identified areas of improvement, including uptake of palliative care training by community neurologists, additional prognostic counseling, and clarity and timeliness of communication with the multidisciplinary team.</p><p><strong>Conclusions: </strong>Clinicians caring for people with Parkinson's disease and related disorders should screen for non-motor symptoms, provide regular prognostic counseling, and refer to specialty palliative care services earlier in the course of illness. Future interventions should be designed to promote uptake of palliative care training by community neurologists and further optimize referral to and coordination with in-person or remote specialty palliative teams.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PALLiative care in ONcology (PALLiON): A cluster-randomised trial investigating the effect of palliative care on the use of anticancer treatment at the end of life.","authors":"Marianne Jensen Hjermstad, Aleksandra Pirnat, Nina Aass, Sigve Andersen, Guro L Astrup, Olav Dajani, Herish Garresori, Kristin V Guldhav, Hanne Hamre, Ellinor C Haukland, Frode Jordal, Tonje Lundeby, Erik Torbjorn Løhre, Svein Mjåland, Ørnulf Paulsen, Karin A Semb, Erik S Staff, Torunn Wester, Stein Kaasa","doi":"10.1177/02692163231222391","DOIUrl":"10.1177/02692163231222391","url":null,"abstract":"<p><strong>Background: </strong>Effects on anticancer therapy following the integration of palliative care and oncology are rarely investigated. Thus, its potential effect is unknown.</p><p><strong>Aim: </strong>To investigate the effects of the complex intervention PALLiON versus usual care on end-of-life anticancer therapy.</p><p><strong>Design: </strong>Cluster-randomised controlled trial (RCT), registered at ClinicalTrials.gov (No. NCT03088202). The complex intervention consisted of a physician education program enhancing theoretical, clinical and communication skills, a patient-centred care pathway and patient symptom reporting prior to all consultations. Primary outcome was overall use, start and cessation of anticancer therapy in the last 3 months before death. Secondary outcomes were patient-reported outcomes. Mixed effects logistic regression models and Cox proportional hazard were used.</p><p><strong>Setting: </strong>A total of 12 Norwegian hospitals (03/2017-02/2021).</p><p><strong>Participants: </strong>Patients ⩾18 years, advanced stage solid tumour, starting last line of anticancer therapy, estimated life expectancy ⩽12 months.</p><p><strong>Results: </strong>A total of 616 (93%) patients were included (intervention: 309/control:307); 63% males, median age 69, 77% had gastrointestinal cancers. Median survival time from inclusion was 8 (IQR 3-14) and 7 months (IQR 3-12), and days between anticancer therapy start and death were 204 (90-378) and 168 (69-351) (intervention/control). Overall, 78 patients (13%) received anticancer therapy in the last month (intervention: 33 [11%]/control: 45 [15%]). No differences were found in patient-reported outcomes.</p><p><strong>Conclusion: </strong>We found no significant differences in the probability of receiving end-of-life anticancer therapy. The intervention did not have the desired effect. It was probably too general and too focussed on communication skills to exert a substantial influence on conventional clinical practice.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study.","authors":"Séverine M Surges, Holger Brunsch, Birgit Jaspers, Kathi Apostolidis, Antonella Cardone, Carlos Centeno, Nathan Cherny, Àgnes Csikós, Robin Fainsinger, Eduardo Garralda, Julie Ling, Johan Menten, Sebastiano Mercadante, Daniela Mosoiu, Sheila Payne, Nancy Preston, Lieve Van den Block, Jeroen Hasselaar, Lukas Radbruch","doi":"10.1177/02692163231220225","DOIUrl":"10.1177/02692163231220225","url":null,"abstract":"<p><strong>Background: </strong>The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability.</p><p><strong>Aim: </strong>To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers.</p><p><strong>Design: </strong>Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure.</p><p><strong>Setting: </strong>European.</p><p><strong>Participants: </strong>International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation.</p><p><strong>Results: </strong>A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms <i>suffering</i> used to encompass distressing physical and psychological symptoms as well as existential suffering and <i>refractory</i> to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided.</p><p><strong>Conclusions: </strong>This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education modalities for serious illness communication training: A scoping review on the impact on clinician behavior and patient outcomes.","authors":"Melissa Lavecchia, Jeff Myers, Daryl Bainbridge, Nadia Incardona, Oren Levine, Leah Steinberg, Daniel Schep, Joanna Vautour, Shilpa Jyothi Kumar, Hsien Seow","doi":"10.1177/02692163231186180","DOIUrl":"10.1177/02692163231186180","url":null,"abstract":"<p><strong>Background: </strong>Several clinician training interventions have been developed in the past decade to address serious illness communication. While numerous studies report on clinician attitudes and confidence, little is reported on individual education modalities and their impact on actual behavior change and patient outcomes.</p><p><strong>Aim: </strong>To examine what is known about the education modalities used in serious illness communication training and their impact on clinician behaviors and patient outcomes.</p><p><strong>Design: </strong>A scoping review using the Joanna Briggs Methods Manual for Scoping Reviews was conducted to examine studies measuring clinician behaviors or patient outcomes.</p><p><strong>Data sources: </strong>Ovid MEDLINE and EMBASE databases were searched for English-language studies published between January 2011 and March 2023.</p><p><strong>Results: </strong>The search identified 1317 articles: 76 met inclusion criteria describing 64 unique interventions. Common education modalities used were: single workshop (<i>n</i> = 29), multiple workshops (<i>n</i> = 11), single workshop with coaching (<i>n</i> = 7), and multiple workshops with coaching (<i>n</i> = 5); though they were inconsistently structured. Studies reporting improved clinician skills tended to be in simulation settings with neither clinical practice nor patient outcomes explored. While some studies reported behavior changes or improved patient outcomes, they did not necessarily confirm improvements in clinician skills. As multiple modalities were commonly used and often embedded within quality improvement initiatives, the impact of individual modalities could not be determined.</p><p><strong>Conclusion: </strong>This scoping review of serious illness communication interventions found heterogeneity among education modalities used and limited evidence supporting their effectiveness in impacting patient-centered outcomes and long-term clinician skill acquisition. Well-defined educational modalities and consistent measures of behavior change and standard patient-centered outcomes are needed.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9754638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the extent to which PROMs and PREMs used with older people with severe frailty capture their multidimensional needs: A scoping review.","authors":"Faith D Howard, Richard Green, Jenny Harris, Joy Ross, Caroline Nicholson","doi":"10.1177/02692163231223089","DOIUrl":"10.1177/02692163231223089","url":null,"abstract":"<p><strong>Background: </strong>Older people with severe frailty are nearing the end of life but their needs are often unknown and unmet. Systematic ways to capture and measure the needs of this group are required. Patient reported Outcome Measures (PROMs) & Patient reported Experience Measures (PREMs) are possible tools to assist this.</p><p><strong>Aim: </strong>To establish whether, and in what ways, the needs of older people living with severe frailty are represented within existing PROMs and PREMs and to examine the extent to which the measures have been validated with this patient group.</p><p><strong>Design: </strong>The scoping review follows the method of Arksey and O'Malley.</p><p><strong>Results: </strong>Seventeen papers from 9 countries meeting the inclusion criteria and 18 multi-dimensional measures were identified: 17 PROMs, and 1 PROM with PREM elements. Seven out of the 18 measures had evidence of being tested for validity with those with frailty. No measure was developed specifically for a frail population. Using the adapted framework of palliative need, five measures covered all five domains of palliative need (IPOS, ICECAP-SCM, PDI, WHOQOL-BREF, WHOQOL-OLD). The coverage of items within the domains varied between the measures.</p><p><strong>Conclusion: </strong>Existing PROMs and PREMs are not well designed for what we know about the needs of older people with severe frailty. Future research should firstly focus on adapting and validating the existing measures to ensure they are fit for purpose, and secondly on developing a better understanding of how measures are used to deliver/better person-centred care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing and deprescribing in older people with life-limiting illnesses receiving hospice care at the end of life: A longitudinal, retrospective cohort study.","authors":"Tahani Alwidyan, Noleen K McCorry, Chris Black, Rachel Coulter, June Forbes, Carole Parsons","doi":"10.1177/02692163231209024","DOIUrl":"10.1177/02692163231209024","url":null,"abstract":"<p><strong>Background: </strong>Although prescribing and deprescribing practices in older people have been the subject of much research generally, there are limited data in older people at the end of life. This highlights the need for research to determine prescribing and deprescribing patterns, as a first step to facilitate guideline development for medicines optimisation in this vulnerable population.</p><p><strong>Aims: </strong>To examine prescribing and deprescribing patterns in older people at the end of life and to determine the prevalence of potentially inappropriate medication use.</p><p><strong>Design: </strong>A longitudinal, retrospective cohort study where medical records of eligible participants were reviewed, and data extracted. Medication appropriateness was assessed using two sets of consensus-based criteria; the STOPPFrail criteria and criteria developed by Morin et al.</p><p><strong>Setting/participants: </strong>Decedents aged 65 years and older admitted continuously for at least 14 days before death to three inpatient hospice units across Northern Ireland, who died between 1st January and 31st December 2018, and who had a known diagnosis, known cause of death and prescription data. Unexpected/sudden deaths were excluded.</p><p><strong>Results: </strong>Polypharmacy was reported to be continued until death in 96.2% of 106 decedents (mean age of 75.6 years). Most patients received at least one potentially inappropriate medication at the end of life according to the STOPPFrail and the criteria developed by Morin et al. (57.5 and 69.8% respectively). Limited prevalence of proactive deprescribing interventions was observed.</p><p><strong>Conclusions: </strong>In the absence of systematic rationalisation of drug treatments, a substantial proportion of older patients continued to receive potentially inappropriate medication until death.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and families' perspectives on telepalliative care: A systematic integrative review.","authors":"Eithne Hayes Bauer, Anders Nikolai Ørsted Schultz, Frans Brandt, Anthony C Smith, Georg Bollig, Karin Brochstedt Dieperink","doi":"10.1177/02692163231217146","DOIUrl":"10.1177/02692163231217146","url":null,"abstract":"<p><strong>Background: </strong>Telepalliative care is increasingly used in palliative care, but has yet to be examined from a patient and family perspective. A synthesis of evidence may provide knowledge on how to plan and provide telepalliative care that caters specifically to patients and families' needs.</p><p><strong>Objective: </strong>To synthesise evidence on patients and families' perspectives on telepalliative care.</p><p><strong>Design: </strong>A systematic integrative review (PROSPERO #CRD42022301206) reported in accordance with PRISMA 2020 guidelines. Inclusion criteria; primary peer-reviewed studies published 2011-2022, patient and family perspective, >18 years, telepalliative care and English/Danish language. Quality was appraised using the mixed-methods appraisal tool, version 2020. Guided by Toronto and Remington, data were extracted, thematically analysed and synthesised.</p><p><strong>Data sources: </strong>MEDLINE, EMBASE, PsycINFO and CINAHL were searched in March 2022 and updated in February 2023.</p><p><strong>Results: </strong>Forty-four studies were included. Analysis revealed five themes; the effect of the Covid-19 pandemic on telepalliative care, adding value for patients and families, synchronous and asynchronous telepalliative care, the integration of telepalliative care with other services and the tailoring and timing of telepalliative care.</p><p><strong>Conclusion: </strong>Enhanced access to care and convenience, as attributes of telepalliative care, are highly valued. Patients and families have varying needs during the illness trajectory that may be addressed by early integration of telepalliative care based on models of care that are flexible and combine synchronous and asynchronous solutions. Further research should examine telepalliative care in a post-pandemic context, use of models of care and identify meaningful outcome measures from patient and family perspectives for evaluation of telepalliative care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of regular, low-dose, sustained-release morphine for chronic breathlessness on caregiver burden: An exploratory analysis of the BEAMS trial.","authors":"Slavica Kochovska, Diana Ferreira, Sungwon Chang, Tim Luckett, Jessica Roydhouse, Magnus Ekström, David C Currow","doi":"10.1177/02692163231211227","DOIUrl":"10.1177/02692163231211227","url":null,"abstract":"<p><strong>Background: </strong>Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers' perceived burden.</p><p><strong>Aim: </strong>To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial.</p><p><strong>Design: </strong>Exploratory analysis of self-reported caregiver burden at baseline and end of week 3 in a randomised, double-blind, placebo-controlled study. Caregiver measures included: demographics and perceived burden (Zarit Burden Interview 12-item short-form questionnaire). Patient measures included: <i>worst</i> breathlessness and FitBit^R-measures.</p><p><strong>Setting/participants: </strong>All consenting caregivers of trial patient participants in a multi-site study recruiting from palliative care and respiratory services.</p><p><strong>Results: </strong>Caregivers (<i>n</i> = 49; 59% women; median age 68 years [IQR 50-75]) reported median baseline caregiver burden 12 [IQR 5-17], with 53% reporting high burden (⩾13). Eighty-four percent of caregivers reported no change in burden. In people whose <i>worst breathlessness</i> improved, caregiver burden moved in the same direction, though the correlation was not significant (<i>r_s</i> = 0.25, <i>p</i> = 0.17). Conversely, caregiver burden worsened as patients' <i>minutes lightly active</i> increased, with the correlation being significant (<i>r_s</i> = 0.56, <i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>Caregivers reported high levels of caregiver burden, but patients' response to treatment in terms of their symptom and function may influence change in caregiver burden over a three-week period.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy siblings' perspectives about paediatric palliative care: A qualitative systematic review and meta-synthesis.","authors":"Priyadharshni Rajendran, Gabija Jarasiunaite-Fedosejeva, Gözde Gökçe İsbir, Shefaly Shorey","doi":"10.1177/02692163231217597","DOIUrl":"10.1177/02692163231217597","url":null,"abstract":"<p><strong>Background: </strong>Siblings of children requiring palliative care are often forgotten and overlooked, as the focus tends to be on the ill child and their parents. Limited knowledge of non-bereaved siblings' perspectives makes it challenging to provide appropriate support for them. A review of existing literature is thus needed to better understand the experiences of these siblings and to identify research gaps that may require further examination.</p><p><strong>Aim: </strong>To consolidate the available qualitative evidence on the perspectives of non-bereaved healthy siblings regarding paediatric palliative care.</p><p><strong>Design: </strong>A qualitative systematic review using a meta-synthesis approach was conducted.</p><p><strong>Data sources: </strong>Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus and ProQuest Dissertations and Theses Global) were searched from each database's inception date until October 2022. The search included qualitative and mixed-method studies that reported the perceptions and associations of siblings of patients receiving paediatric palliative care. Data were synthesised using thematic analysis.</p><p><strong>Results: </strong>Eleven studies were included. The overarching theme of the review would be 'A walking shadow: Living in the darkness shaped by the dying sibling', and three key themes and nine subthemes were identified from the included articles: (1) Changing family dynamics; (2) Impact on school and socialisation and (3) Psychological impact and coping.</p><p><strong>Conclusion: </strong>Siblings demonstrated negative psychological impacts and were affected by changing family structure and relationships. However, socialisation with society, and varied coping skills such as cognitive coping and using distraction techniques, were significant for siblings to go through this journey and even led to some positive outcomes for them.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Writing for the world: Enhancing engagement and connection with an international audience.","authors":"Catherine Walshe, Kim Beernaert, Poh Heng Chong, Sonya Lowe, Sandra Martins Pereira, Sarah Yardley","doi":"10.1177/02692163231215980","DOIUrl":"10.1177/02692163231215980","url":null,"abstract":"","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}