Palliative & Supportive Care最新文献

{"title":"Accurate prognostic awareness is associated with increased emotional distress in Latino patients with advanced cancer.","authors":"Pedro E Pérez-Cruz, María Jesús San Martín, Josefa Palacios, Laura Tupper-Satt, Marcela González-Otaíza, Paula Repetto","doi":"10.1017/S1478951525000252","DOIUrl":"10.1017/S1478951525000252","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the frequency of prognostic awareness (PA) in a population of advanced cancer patients in a Latino community and to explore the relationship between accurate PA with emotional distress and other covariates.</p><p><strong>Methods: </strong>In this cross-sectional study performed in Puente Alto, Chile, advanced cancer patients in palliative care completed a survey that included a single question to assess PA (Do you believe your cancer is curable? yes/no). Patients reporting that their cancer was not curable were considered as having accurate PA. Demographics, emotional distress, quality of life, and patient perception of treatment goals were also assessed. Analyses to explore associations between PA and patient variables were adjusted.</p><p><strong>Results: </strong>A total of 201 patients were included in the analysis. Mean age was 65, 50% female. One hundred and three patients (51%) reported an accurate PA. In the univariate analysis, accurate PA was associated with not having a partner (<i>p</i> = 0.012), increased emotional distress (<i>p</i> = 0.013), depression (<i>p</i> = 0.003), and were less likely to report that the goal of the treatment was to get rid of the cancer (<i>p</i> < 0.001). In the multivariate analysis, patients with accurate PA had higher emotional distress or depression, were less likely to have a partner, and to report that the goal of the treatment was to get rid of the cancer.</p><p><strong>Significance of results: </strong>Half of a population of Latino advanced cancer patients reported an accurate PA. Accurate PA was associated with increased emotional distress, which is similar to what has been reported in other countries. Weaknesses in prognostic disclosure by clinicians, local cultural factors, or higher motivation to seek prognostic information among distressed cancer patients could explain this association. Strategies to emotionally support patients when discussing prognostic information should be implemented.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e97"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building dignity at the bedside: A reflective clinical model for clinical encounters.","authors":"Miguel Julião, Loredana Buonaccorso","doi":"10.1017/S1478951525000343","DOIUrl":"https://doi.org/10.1017/S1478951525000343","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e94"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the landscape of palliative care provision for black patients with hematologic cancers: A scoping review.","authors":"Osborn Owusu Ansah, Silas Selorm Daniels-Donkor, Leila Ledbetter, Matthew LeBlanc, Sophia K Smith","doi":"10.1017/S1478951525000471","DOIUrl":"10.1017/S1478951525000471","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with cancer benefit greatly from receiving palliative care (PC), improving their overall survival and quality of life. Despite its benefits, PC is underutilized among patients with hematologic malignancies (HMs), particularly among Black patients, who face higher symptom burdens and lower survival rates compared to White patients. The purpose of this review was to identify and describe what is known about PC use among Black HM patients in the United States.</p><p><strong>Methods: </strong>This review was conducted using the Joanna Briggs Institute approach for scoping reviews and included a search of the databases MEDLINE (PubMed), Embase (Elsevier), Scopus and Web of Science (Clarivate). The search was developed and conducted by a professional medical librarian in consultation with the author team and focused on keywords such as Black/African American patients, HM, and PC. Articles were screened and selected based on predefined inclusion criteria and carried out using Covidence software for systematic review management.</p><p><strong>Results: </strong>Seven publications were included in the final sample and most used quantitative methods and data from large national databases such as the National Cancer Database. Four of the studies reported that Black patients with HM were less likely to receive or use PC compared to White patients. Access to PC was associated with better outcomes, such as lower hospital charges and a reduced likelihood of dying within 30 days of initiating palliative radiotherapy.</p><p><strong>Significance of the results: </strong>This scoping review highlights ongoing inequities in the use of PC among Black patients with HM which mirrors trends in patients with solid cancers. Future studies should be conducted to understand the determinants of these disparities and to also build testable interventions to improve PC use within this underserved population.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e96"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effectiveness of psilocybin in alleviating distress among cancer patients: A systematic review.","authors":"Maria I Lapid, Sandeep R Pagali, Andrea L Randall, Kristine A Donovan, Carrie A Bronars, Trevor A Gauthier, Jonathan Bock, Samantha D Lim, Elise C Carey, Elizabeth Sokolowski, Angela M Ulrich, Leslie C Hassett, Simon Kung, Kevin J Whitford, Kenneth R Olivier, Stacy D D'Andre","doi":"10.1017/S147895152500032X","DOIUrl":"https://doi.org/10.1017/S147895152500032X","url":null,"abstract":"<p><strong>Objectives: </strong>Psychological and existential distress is prevalent among patients with life-threatening cancer, significantly impacting their quality of life. Psilocybin-assisted therapy has shown promise in alleviating these symptoms. This systematic review aims to synthesize the evidence on the efficacy and safety of psilocybin in reducing cancer-related distress.</p><p><strong>Methods: </strong>We searched MEDLINE, APA PsycINFO, Cochrane database, Embase, and Scopus from inception to February 8, 2024, for randomized controlled trials (RCTs), open-label trials, qualitative studies, and single case reports that evaluated psilocybin for cancer-related distress. Data were extracted on study characteristics, participant demographics, psilocybin and psychotherapy intervention, outcome measures, and results. Two authors independently screened, selected, and extracted data from the studies. Cochrane Risk of Bias for RCTs and Methodological Index for Non-Randomized Studies criteria were used to evaluate study quality. This study was registered with PROSPERO (CRD42024511692).</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria, comprising three RCTs, five open-label trials, five qualitative studies, and one single case report. Psilocybin therapy consistently showed significant reductions in depression, anxiety, and existential distress, with improvements sustained over several months. Adverse effects were generally mild and transient.</p><p><strong>Significance of results: </strong>This systematic review highlights the potential of psilocybin-assisted therapy as an effective treatment for reducing psychological and existential distress in cancer patients. Despite promising findings, further large-scale, well-designed RCTs are needed to confirm these results and address existing research gaps.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e99"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approach.","authors":"Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama","doi":"10.1017/S1478951525000409","DOIUrl":"https://doi.org/10.1017/S1478951525000409","url":null,"abstract":"<p><strong>Background: </strong>Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period.<b>Objectives.</b> This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences.</p><p><strong>Methods: </strong>This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1 week, and 1 month. Data were analyzed using quantitative methods and thematic analysis.</p><p><strong>Results: </strong>Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1 month (<i>p</i> < .01). Symptoms such as shortness of breath (<i>β</i> = -1.19, <i>p</i> < .001), drowsiness (<i>β</i> = -1.27, <i>p</i> = .01), and anxiety (<i>β</i> = -0.60, <i>p</i> = .03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (<i>β</i> = 0.26, <i>p</i> < .001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.</p><p><strong>Significance of results: </strong>Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e95"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive interviewing of the older adults with cancer - depression scale (OAC-D): A patient-reported outcome (PRO).","authors":"Rebecca M Saracino, Laura C Polacek, Rebecca Tutino, Hayley Pessin, Kathleen A Lynch, Thomas M Atkinson, Christian J Nelson","doi":"10.1017/S1478951525000355","DOIUrl":"10.1017/S1478951525000355","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to refine the content of a new patient-reported outcome (PRO) measure via cognitive interviewing techniques to assess the unique presentation of depressive symptoms in older adults with cancer (OACs).</p><p><strong>Methods: </strong>OACs (≥ 70years) with a history of a depressive disorder were administered a draft measure of the <i>Older Adults with Cancer - Depression (OAC-D) Scale</i>, then participated in a semi-structured cognitive interview to provide feedback on the appropriateness, comprehensibility, and overall acceptability of measure. Interviews were audio-recorded and transcribed, and qualitative methods guided revision of scale content and structure.</p><p><strong>Results: </strong>OACs (<i>N</i> = 10) with a range of cancer diagnoses completed cognitive interviews. Participants felt that the draft measure took a reasonable amount of time to answer and was easily understandable. They favored having item prompts and response anchors repeated with each item for ease of completion, and they helped identify phrasing and wording of key terms consistent with the authors' intended constructs. From this feedback, a revised version of the OAC-D was created.</p><p><strong>Significance of results: </strong>The <i>OAC-D Scale</i> is the first PRO developed specifically for use with OACs. The use of expert and patient input and rigorous cognitive interviewing methods provides a conceptually accurate means of assessing the unique symptom experience of OACs with depression.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e98"},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 a children's palliative care education and mentoring program (Project ECHO) on healthcare providers' knowledge, confidence, and attitudes in Bhutan.","authors":"Tara Devi Laabar, Spandana Rayala, Anisha Lynch-Godrei, Purushotam Bhandari, Megan Doherty","doi":"10.1017/S1478951525000033","DOIUrl":"10.1017/S1478951525000033","url":null,"abstract":"<p><strong>Background: </strong>Palliative care services are unavailable for the vast majority of children in Bhutan. Children's palliative care has not been incorporated into training programs for health professions, leading to limited knowledge and awareness of how best to support children facing serious or life-threatening conditions.</p><p><strong>Objectives: </strong>To describe the impact of the Project ECHO children's palliative care course on participants' knowledge, comfort, and attitudes and to evaluate the overall acceptability of an online training to support palliative care training in Bhutan.</p><p><strong>Methods: </strong>Before-and-after surveys of program participants were conducted, assessing changes in knowledge, comfort, and attitudes. Participants' overall experiences and acceptability of the learning program were assessed through an end-of-program survey.</p><p><strong>Results: </strong>Participants were primarily nurses (49%) or physicians (34%). Most participants (68%) worked in pediatric and/or neonatal care. Participants' knowledge of core palliative care concepts improved significantly between the beginning and end of the course. Participants' comfort and attitudes toward palliative care also improved, with significance effect sizes in most domains (11/18). Satisfaction with the program was high, with 100% of participants agreeing that the training was applicable to their clinical practice. Although most participants (56%) identified a personal need for additional clinical training to support practice change.</p><p><strong>Significance of results: </strong>Project ECHO can be used to deliver palliative care education, with improved palliative care knowledge, comfort, and attitudes among program participants. A short online training program can generate interest in palliative care, which can be leveraged to further develop palliative care services in settings where palliative care is currently unavailable.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e89"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posthumous dignity therapy: Challenges and opportunities in the Brazilian cultural context.","authors":"Ana Carolina Kotinda Bennemann, Carlos Eduardo Paiva, Bianca Sakamoto Ribeiro Paiva","doi":"10.1017/S1478951525000276","DOIUrl":"https://doi.org/10.1017/S1478951525000276","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e91"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helping Her Heal-Ghana: A pilot feasibility study of a culturally adapted educational counseling intervention for spouse caregivers of women with breast cancer.","authors":"Brenda Adei Osei-Assibey, Frances Marcus Lewis","doi":"10.1017/S1478951524002153","DOIUrl":"10.1017/S1478951524002153","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the leading cancer in Ghana, Africa, accounting for 31% of all cancers in women. The effects of breast cancer are not limited to the woman but also impact the spouse's anxiety, depressed mood, and coping behavior. Helping Her Heal (HHH)-Ghana is a culturally adapted evidenced-based intervention with potential to improve health outcomes of spouse caregivers.</p><p><strong>Objectives: </strong>The purpose of the study was to ascertain the feasibility, acceptability, and short-term impact of HHH-Ghana, a culturally adapted evidenced-based intervention for spouses of women with breast cancer in Ghana.</p><p><strong>Methods: </strong>The study used a single group pre-post design. Participants (<i>n</i> = 14) were recruited from medical care providers and were eligible if they were spouse caregivers of wives with Stage I, II, or III breast cancer, were 18 years or older, and had been living with their wives for at least 6 months. Data were obtained by spouse self-report on standardized measures of depressed mood, anxiety, self-care skills, self-efficacy to support their wife, self-efficacy to carry out their own self-care, and the quality of marital communication about breast cancer. Exit interviews were additionally obtained to describe the gains spouses attributed to their participation in the study.</p><p><strong>Results: </strong>The HHH-Ghana study was feasible and acceptable. Spouses actively engaged in each intervention session and completed the at-home assignments; retention was 87.5%. Spouses significantly improved on standardized measures of anxiety (<i>p</i> = 0.010), depressed mood (<i>p</i> = 0.002), self-care skills (<i>p</i> = 0.006), and their self-efficacy in supporting their wife (<i>p</i> = 0.001) and in carrying out their own self-care (<i>p</i> = 0.011). Although there was no statistically significant change in marital communication, spouses reported in their exit interviews that the intervention enabled them to communicate better and be more attentive listeners to their wives.</p><p><strong>Significance of results: </strong>Results warrant a larger clinical trial in Ghana.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e88"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance care planning discussions - Perspectives from oncology patients with advanced-stage disease.","authors":"Delinda Pendleton, Brian L Egleston, Carolyn Y Fang","doi":"10.1017/S1478951525000069","DOIUrl":"10.1017/S1478951525000069","url":null,"abstract":"<p><p>Evidence in the literature confirms that advance care planning (ACP) discussions, assumed to benefit patients, their caregivers, and clinicians, occur at various rates, lower than intended and not as early as thought to be beneficial. The literature, however, provides limited reasons why this trend continues. When ACP discussions do occur, particularly between clinicians and patients with advanced-stage cancer, we have even less understanding of the ACP experience. Thus, the goal of our study was to characterize patient beliefs and experiences pertaining to ACP discussions, and to explore factors that may be associated with patient experiences. One hundred adults with advanced cancer participated in this cross-sectional survey study. The majority (63%) had heard about ACP, and 81% believed that health care providers should have ACP discussions with their patients. However, only 23% of participants in this sample had an ACP discussion. Among those who reported having an ACP discussion, 74% indicated that they spoke with family members about ACP, and 48% reported having spoken with their oncologist about ACP. Among those who had not had an ACP discussion with a health care provider, commonly reported reasons for not doing so included the respondent's desire to speak with family members first and the perception that one was not sick enough to need such a discussion yet. These findings can be used to inform the development of future interventions to improve provider communication about ACP and enhance patient experiences around ACP discussions.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e90"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}