Journal of Hospice & Palliative Nursing最新文献

A Goal-Concordant Prescribing Conceptual Framework: Implications for Practice and Measurement. 一个目标一致的处方概念框架：对实践和测量的启示。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-02-27 DOI: 10.1097/NJH.0000000000001112

Susan DeSanto-Madeya, Margaret F Clayton, Erik Fromme, Francesca Troiani, Jennifer Tjia

{"title":"A Goal-Concordant Prescribing Conceptual Framework: Implications for Practice and Measurement.","authors":"Susan DeSanto-Madeya, Margaret F Clayton, Erik Fromme, Francesca Troiani, Jennifer Tjia","doi":"10.1097/NJH.0000000000001112","DOIUrl":"10.1097/NJH.0000000000001112","url":null,"abstract":"Optimizing medication benefit and minimizing harm through effective and appropriate medication management is emerging as an important strategy in hospice and palliative care. This approach, however, often fails to align patient and family goals for remaining life with clinician priorities. Ascertaining patient and caregiver values and goals and aligning these goals with clinicians' priorities for care is a complex and iterative process. This process requires effective communication between all participants as a patient's illness trajectory moves toward death. The purpose of this article was to present a beginning conceptual framework for clinical consideration and use, as well as an example of a potential measurement framework envisioned from the conceptual framework for future research application. Both frameworks focus on goal-concordant prescribing among seriously ill older adults in home hospice. An environmental scan of existing deprescribing frameworks and approaches to goal ascertainment that inform hospice deprescribing was conducted. Feedback from practicing hospice clinicians engaged in a pilot project implementing a novel goal-concordant prescribing approach, as well as interprofessional clinicians and family caregivers from previous projects, were also used to identify theoretical and clinically relevant gaps in care as well as future research opportunities. The environmental scan and multiproject feedback served as the foundation for the development of the conceptual framework. The suggested communication frameworks for goal-concordant prescribing seek to bridge the gap between the preferences and priorities of the patient and family caregiver, and the risk-benefit considerations brought forth by clinicians.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"149-155"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525310","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}

引用次数: 0

Palliative Care for Patients With End-Stage Renal Disease: An Examination of Unmet Needs and Experiencing Problems. 终末期肾病患者的姑息治疗：未满足需求和经历问题的检查。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-01-30 DOI: 10.1097/NJH.0000000000001104

Muhammad W Darawad, Lynn F Reinke, Amani Khalil, Ghaith Bani Melhem, Malek Alnajar

{"title":"Palliative Care for Patients With End-Stage Renal Disease: An Examination of Unmet Needs and Experiencing Problems.","authors":"Muhammad W Darawad, Lynn F Reinke, Amani Khalil, Ghaith Bani Melhem, Malek Alnajar","doi":"10.1097/NJH.0000000000001104","DOIUrl":"10.1097/NJH.0000000000001104","url":null,"abstract":"Patients with end-stage renal disease face numerous physical, emotional, and financial burdens, necessitating palliative care (PC) interventions. This cross-sectional study assessed the problems and unmet needs of 129 patients under renal dialysis from 6 hospitals. Findings revealed that 64.7% of participants experienced significant challenges, primarily financial difficulties (78.5%), autonomy concerns (68.8%), and a need for information (68.0%). More than half (51.9%) reported needing PC, particularly for managing fatigue (78.3%), pain (79.8%), and depression (72.9%). Unmet needs were common (47.6%), with the most notable gaps in financial support (52.5%) and information provision (50%). Correlation analysis demonstrated strong positive associations between reported problems, care needs, and unmet needs ( r > 0.90, P < .001). Significant differences were observed by dialysis access type ( F = 5.71, P = .001), with arteriovenous fistula patients reporting higher problems and unmet needs. Increased dialysis frequency was linked to more problems and unmet needs ( F = 7.24, P < .001). In addition, patients with comorbidities experienced significantly higher problems, care needs, and unmet needs (all P s < .001). These findings underscored the urgent need for tailored PC interventions for end-stage renal disease patients, particularly in addressing symptom management, psychosocial and spiritual support, financial support, and information deficits, to enhance their quality of life.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E107-E117"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069280","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}

引用次数: 0

Highlighting the Importance of Nurse Practitioner Fellowships in Palliative Care: A Model at the Columbia University School of Nursing. 强调护士执业奖学金在姑息治疗中的重要性：哥伦比亚大学护理学院的一种模式。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-03-18 DOI: 10.1097/NJH.0000000000001122

Pierce DiMauro, Nicolas Burry, Penelope Buschman, Mary Tresgallo, Marlene McHugh

{"title":"Highlighting the Importance of Nurse Practitioner Fellowships in Palliative Care: A Model at the Columbia University School of Nursing.","authors":"Pierce DiMauro, Nicolas Burry, Penelope Buschman, Mary Tresgallo, Marlene McHugh","doi":"10.1097/NJH.0000000000001122","DOIUrl":"10.1097/NJH.0000000000001122","url":null,"abstract":"The field of palliative care faces an impending clinician shortage, and nurse practitioners (NPs) are well-positioned to fill this critical need. However, there are currently not enough advanced practice educational opportunities for NPs in the form of fellowships/residencies to prepare them to fill this gap, despite the demonstrated benefit of such programs on self-reported preparedness for entry to practice and corresponding patient outcomes. Palliative care fellowship opportunities are limited by a lack of funding and developmental opportunities, with many experienced NPs in the field foregoing such an experience before entering practice. The purpose of this article is to overview the yearlong palliative care fellowship at Columbia University School of Nursing, wherein the part-time structure offers fellows the opportunity to build an exceptional foundation in palliative care while balancing other professional responsibilities. Palliative care will require NP leaders who are prepared to advance the field in practice, advocacy, education, and research; NP fellowships offer a remarkable foundation to prepare NPs to lead in this regard.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"107-112"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659660","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}

引用次数: 0

Predictors of Palliative Care Self-efficacy Among Health Care Professionals in Vietnam: A Cross-sectional Study. 越南卫生保健专业人员姑息治疗自我效能的预测因素：一项横断面研究。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2024-12-31 DOI: 10.1097/NJH.0000000000001101

Nhien Thi Thuy Huynh, Nghi Minh To, Huyen Thi Mong Hoang, Hoa Thanh Lam, Chi-Yin Kao

{"title":"Predictors of Palliative Care Self-efficacy Among Health Care Professionals in Vietnam: A Cross-sectional Study.","authors":"Nhien Thi Thuy Huynh, Nghi Minh To, Huyen Thi Mong Hoang, Hoa Thanh Lam, Chi-Yin Kao","doi":"10.1097/NJH.0000000000001101","DOIUrl":"10.1097/NJH.0000000000001101","url":null,"abstract":"This study aimed to investigate predictors of palliative care self-efficacy among Vietnamese health care professionals. An online descriptive cross-sectional survey was conducted at 1 hospital in Vietnam. Participants completed survey questionnaires including demographics, professional experience, Palliative Care Self-Efficacy, Palliative Care Quiz for Nursing, Frommelt Attitudes Toward Care of the Dying-Form B, Santa Clara Brief Compassion Scale, and Self-Compassion Scale-Short Form. After data collection, descriptive statistics and stepwise regression were applied for data analysis. A total of 128 nurses and 42 physicians completed the survey. The mean score for palliative care self-efficacy was 27.6 ± 10.6 out of 48. The results indicated that compassion for others, self-compassion, and palliative care knowledge explained 17.8% of health care professionals' self-efficacy levels. This study supports the positive relationship between self-efficacy, compassion for others, and self-compassion among health care professionals, underscoring the need for incorporating compassion training into the curriculum and the training program.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E98-E106"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958670","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}

引用次数: 0

Opportunities for Improvement in Caring for Critically Ill Patients Who Are Incapacitated With No Evident Advance Directives or Surrogates: A Nested Case-Control Study. 没有明确的预先指示或替代品的无行为能力的危重病人护理的改进机会：一项嵌套病例对照研究。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-04-07 DOI: 10.1097/NJH.0000000000001117

Morgan Kinsinger, Jiyoun Song, Maxim Topaz, Aviv Y Landau, Robert L Klitzman, Jingjing Shang, Patricia W Stone, Bevin Cohen

{"title":"Opportunities for Improvement in Caring for Critically Ill Patients Who Are Incapacitated With No Evident Advance Directives or Surrogates: A Nested Case-Control Study.","authors":"Morgan Kinsinger, Jiyoun Song, Maxim Topaz, Aviv Y Landau, Robert L Klitzman, Jingjing Shang, Patricia W Stone, Bevin Cohen","doi":"10.1097/NJH.0000000000001117","DOIUrl":"10.1097/NJH.0000000000001117","url":null,"abstract":"Providing ethical, timely, and goal-concordant care for critical patients who are incapacitated with no evident advance directives or surrogates (INEADS) can pose challenges to nursing staff and other care team members and may delay or alter care trajectories. In a nested case-control study, we aimed to determine whether critical care patients who are INEADS have different hospitalization timelines, consultative services, and discharge dispositions relative to matched control subjects. Data were obtained from the publicly accessible Medical Information Mart for Intensive Care III database of 23 904 adult critical care hospitalizations in a Boston, Massachusetts, hospital from 2001 to 2012. Using natural language processing and verifying by manual chart review, we identified 40 patients in this cohort who were INEADS and matched them 1:1 with control subjects based on age, sex, and comorbidity index. Average length of hospitalization was 11 days for patients and 9 days for control subjects; average time until code status documentation was 8 days for patients and 6 days for control subjects, and average time until documentation of social work involvement was 9 days for patients and 2 days for control subjects. Although these differences were not statistically significant, procedures to support timely ethical decision-making for patients who are INEADS require attention.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":"27 3","pages":"E135-E142"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042963","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}

引用次数: 0

Assessing Advance Care Planning Readiness in Older Adults: A Pilot Study. 评估老年人提前护理计划准备：一项试点研究。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI: 10.1097/NJH.0000000000001115

Sarah Oliveira, Karen A Karlowicz

引用次数: 0

Implementation of an Advance Directives Completion Protocol for Hospitalized Patients With Serious Illness: A Quality Improvement Initiative. 实施预先指示完成协议的住院病人与严重疾病：质量改进倡议。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-01-21 DOI: 10.1097/NJH.0000000000001098

Ifeoma Onyeike, Amy Smith, Carrie Cormack

{"title":"Implementation of an Advance Directives Completion Protocol for Hospitalized Patients With Serious Illness: A Quality Improvement Initiative.","authors":"Ifeoma Onyeike, Amy Smith, Carrie Cormack","doi":"10.1097/NJH.0000000000001098","DOIUrl":"10.1097/NJH.0000000000001098","url":null,"abstract":"Despite mandates requiring hospitals to offer advance directives to all patients, many adults do not have advance directives in place at the end of life. This quality improvement project aimed to implement an evidence-based, standardized protocol to increase advance directive completion rates for hospitalized patients with serious illnesses. A preimplementation and postimplementation design was used to evaluate the impact of an educational intervention and advance directive completion protocol. The project was conducted at a midsized urban community hospital in the Northeastern United States. Charts were reviewed for 250 patients with serious, chronic illnesses admitted under family medicine. Over the 11-month project period, advance directive completion rates increased from 21% (17/82) preintervention to 43% (73/168) postintervention, a statistically significant improvement of 22% ( P = .001). Protocol compliance rates increased from 0% to 50% (8/16) for nurses and from 17% to 31% (9/52 to 21/68) for resident providers. The results support the use of a standardized advance directive completion protocol, combined with educational sessions, to improve advance directive completion rates for seriously ill patients and safeguard their autonomy at the end of life.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"126-133"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034823","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}

引用次数: 0

The Role of Palliative Nursing in the Context of Immunotherapies: A Scoping Review of Patient- and Family-Centered Care Considerations. 姑息护理在免疫治疗背景下的作用：以患者和家庭为中心的护理考虑的范围审查。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-03-10 DOI: 10.1097/NJH.0000000000001111

Djin L Tay, Rebekah Perkins, Jordan R Muehlberger, Tallie Casucci, Toby Campbell, Mary M McFarland, Lee Ellington

{"title":"The Role of Palliative Nursing in the Context of Immunotherapies: A Scoping Review of Patient- and Family-Centered Care Considerations.","authors":"Djin L Tay, Rebekah Perkins, Jordan R Muehlberger, Tallie Casucci, Toby Campbell, Mary M McFarland, Lee Ellington","doi":"10.1097/NJH.0000000000001111","DOIUrl":"10.1097/NJH.0000000000001111","url":null,"abstract":"Immunotherapies are increasingly used to treat advanced cancers and can extend survival in some patients. The potential for longer survival may inflate prognosis expectations among patients and caregivers and delay palliative care. This review sought to identify issues impacting patients and caregivers that influence specialized palliative care use in the context of immunotherapies. A scoping review was conducted with guidance from the JBI Manual for Evidence Synthesis. Studies were identified using MEDLINE, EMBASE, CINAHL Complete, AgeLine, Cochrane Library, and APA PsycINFO, without any database filters or limiters. Inclusion criteria included palliative care utilization among adult cancer patients receiving immunotherapy and their family caregivers in any geographical or specialty setting. The protocol was registered in the Open Science Framework. Using Covidence, 11 898 studies were screened by reviewers, with 10 studies meeting inclusion criteria. Themes of patient and family considerations that affect the use of specialized palliative care included (1) understanding of disease/treatment, (2) hope/optimism, (3) communication barriers, and (4) emotional distress and uncertainty. This review is one of the first to identify issues impacting patients receiving immunotherapies and their families. Findings have implications for nurse communication, education, and psychosocial support with advanced cancer patients and families receiving immunotherapies.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E118-E128"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598429","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}

引用次数: 0

Palliative Care Nurse Specialists' Perspectives on Spiritual Care at End of Life-A Scoping Review. 临终关怀护理专家对临终精神关怀的看法——范围综述。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-03-06 DOI: 10.1097/NJH.0000000000001114

Bronagh Dunning, Michael Connolly, Fiona Timmins

{"title":"Palliative Care Nurse Specialists' Perspectives on Spiritual Care at End of Life-A Scoping Review.","authors":"Bronagh Dunning, Michael Connolly, Fiona Timmins","doi":"10.1097/NJH.0000000000001114","DOIUrl":"10.1097/NJH.0000000000001114","url":null,"abstract":"The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist's perspectives of spiritual care at end of life. The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews Checklist was followed. Searches were conducted in 6 online databases (PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane, HSELibrary). Following a rigorous review process, 15 studies met the inclusion criteria. Data were extracted using a template analyzing aims, population, mean age, setting, year of study, methodology, and key findings. The findings were organized into 4 categories: communication, education and experience, religion, and nurse-patient relationship. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses' own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"113-125"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568843","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}

引用次数: 0

Caring Beyond Cure: Perspectives of Pediatric Oncology Nurses on End-of-Life Care. 超越治疗的关怀：儿科肿瘤护士对临终关怀的看法。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI: 10.1097/NJH.0000000000001107

Peter Scarperi, Meredith MacKenzie Greenle

{"title":"Caring Beyond Cure: Perspectives of Pediatric Oncology Nurses on End-of-Life Care.","authors":"Peter Scarperi, Meredith MacKenzie Greenle","doi":"10.1097/NJH.0000000000001107","DOIUrl":"10.1097/NJH.0000000000001107","url":null,"abstract":"Pediatric oncology patients should receive high-quality end-of-life care when needed. Little is known about nurses' attitudes toward providing end-of-life care in pediatric oncology and the role of work experience in developing comfort with providing this care. In a sample of nursing students and nurses working in pediatric oncology, this mixed-methods study aimed to describe attitudes toward and experiences of providing end-of-life care and examine the relationship between education, work experience, and attitudes. Participants completed a demographic survey and the Frommelt Attitude Toward Care of the Dying, modified for pediatrics. Qualitative interviews were then completed with 10 participants. Participants (N = 38) were primarily female (87%) and White (89%). Overall, participants held positive attitudes toward end-of-life care, with staff nurses more positive than student nurses. All participants had provided end-of-life care, yet only 2 (5.41%) thought their education thus far prepared them. Age, education, experience, and burnout were associated with attitudes toward providing end-of-life care. Qualitative themes included challenges of preparedness and training, the nurse's role, and parent team barriers. Training in pediatric end-of-life care is crucial to improve nurses' comfort with providing this care. Further research should explore the impact of burnout, compassion fatigue, and interdisciplinary conflict on end-of-life care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"142-148"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525312","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}

引用次数: 0