Journal of Hospice & Palliative Nursing最新文献

{"title":"Nurses' Perceptions of Practice Supports Related to Medical Assistance in Dying.","authors":"Jill Henderson, Jennifer M L Stephens, Lorraine Thirsk","doi":"10.1097/NJH.0000000000001102","DOIUrl":"10.1097/NJH.0000000000001102","url":null,"abstract":"<p><p>Since the inception of medical assistance in dying (MAiD) in Canada in 2016, the health care system continues to refine MAiD delivery models. The frameworks informing nursing practice related to MAiD are subject to variability across the country, leading to nursing role ambiguity and barriers in relational practice. Using critical incident technique, this qualitative research study explores the experiences of 7 Canadian nurses engaging with patients seeking MAiD. Semistructured interviews were conducted to understand the nurses' perceptions of the helping, hindering, and desired elements of current nursing practice supports within the context of MAiD. Eighteen significant incidents were included in the data analysis. Findings demonstrate that gaps in practice support exist related to nursing role clarity, educational support to enrich therapeutic communication skills, and staff-focused resources, such as debriefing and improved communication networks. Understanding nursing experiences within this context highlights the need for more consistent nursing practice frameworks and clinical practice supports to facilitate improved therapeutic relationships and patient care.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"134-141"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907654","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":"Increasing Goals of Care Review and Fiscal Implications With an Embedded Palliative Care Specialist in the Emergency Department: A Quality Improvement Project at a Community-Based Hospital.","authors":"Rachel A Butler, Joy Elwell, Emilee Binette, Mary Jane Bowles","doi":"10.1097/NJH.0000000000001135","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001135","url":null,"abstract":"<p><p>Patients with terminal illnesses presenting to the emergency department (ED) may be admitted to the hospital receiving aggressive treatment that will not reverse the dying process and is not aligned with their wishes. Misdirected, incongruous care negatively impacts the comfort of the patient and increases health care costs. This project aimed to determine if embedding a palliative care nurse practitioner in the ED at a community-based hospital is a meaningful method for addressing goals of care early in the preadmission period, with the potential secondary benefit of improved fiscal health of the system. A preintervention and postintervention EPIC (electronic medical record) review was done to evaluate change in readmission rates, hospice and palliative care referrals, and advance care planning sessions. The target population was adults presenting to the ED with an expected mortality within 6 months. An EPIC-generated report compared how many similar patients, during the same month, 1 year prior (November 2022), explored goals of care in the ED (as evidenced by above measures). Exploring goals of care in the ED for patients with terminal illnesses may lead to a more comfortable death and result in better utilization of resources, reduced unnecessary admissions, and cost savings to the hospital system.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027331","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":"End-of-Life Care Competency in Long-term Care Facilities for Care Providers in Thailand: A Delphi Study.","authors":"Siriphan Sasat, Wasinee Wisesrith, Kieko Iida, Sumie Ikezaki, Mayuko Tsujimura","doi":"10.1097/NJH.0000000000001134","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001134","url":null,"abstract":"<p><p>The global shift toward an aging population, evident in Thailand, highlights the critical need for end-of-life care (EOLC) competencies among care providers in long-term care facilities (LTCFs). As the number of older people requiring complex and compassionate care at the end of life continues to rise, the competencies required for care providers in Thai LTCFs remain underexplored. This study aimed to identify the key competencies required to deliver effective EOLC in Thai LTCFs. A Delphi method was used, engaging a panel of 12 experts, including nurses, academics, and LTCF managers. The study achieved consensus on 7 core competencies, encompassing 32 subcompetencies essential for high-quality EOLC. These competencies include knowledge of EOLC, caregiving skills, communication, leadership, innovation, ethical decision-making, and professional development. This study provides a culturally relevant framework for EOLC competencies in Thai LTCFs, emphasizing the importance of integrating technical and interpersonal skills to enhance the quality of care for older people in their final stages of life. These findings can inform educational programs and policy development, ensuring that care providers are adequately prepared to meet the complex needs of this vulnerable population.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043473","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":"Rapid Review of Family Caregiver Engagement in Hospice and End-of-Life Patient Care: Implications for Nursing Practice.","authors":"Natalie S McAndrew, Alison Camarda, Christine A Fortney, Colleen McCracken, Jennifer Bartowitz, William E Rosa","doi":"10.1097/NJH.0000000000001133","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001133","url":null,"abstract":"<p><p>This rapid review provides an overview of active family engagement (defined as supporting the patient psychologically, physically, spiritually, or emotionally) in hospice and end-of-life care settings across the lifespan. A librarian-assisted search of the CINAHL (Cumulative Index to Nursing and Allied Health Literature) database over the past 5 years (English language only) yielded 1928 articles; 22 of these articles met the inclusion criteria for data extraction. The reviewed literature emphasized the importance of family engagement in hospice and end-of-life care, highlighting the need for effective communication, emotional support, and tailored interventions that nurses may use to support family caregivers. The literature highlighted opportunities to further educate and train palliative and hospice nurses on evidence-based and replicable approaches to supporting families as they deliver care at the end of life.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026679","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":"Identifying Palliative Care Needs in Heart Failure Patients With Nurse-Led Screening.","authors":"Christina Cantey, Yhaneek Douglas-Mattis, Jillian Lisiakowski, Caley Fowler, Deborah Ejem","doi":"10.1097/NJH.0000000000001131","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001131","url":null,"abstract":"<p><p>Patients with heart failure benefit from specialty palliative care but are often not evaluated for these services. The lack of standardized screening tools and limited nurse training for assessing palliative care needs are contributing factors. This quality improvement project aimed to improve the identification of unmet palliative care needs in patients with heart failure admitted to a progressive care unit by implementing a standardized nurse-administered palliative care screening tool. The nursing staff administered the Integrated Palliative Care Outcome Scale (IPOS) tool. The number of palliative consultations before project implementation was compared with those during the project. Spearman ρ was assessed for correlation between screening tool score and New York Heart Association (NYHA) heart failure class. Thirty-eight patients completed the screening tool. NYHA class was documented in 29% of patients. Among all patients, those categorized as NYHA III with heart failure with reduced ejection fraction demonstrated the highest need scores. Spearman ρ indicated a nonsignificant ( P > .05), very weak negative correlation between the IPOS scores and NYHA class ( rs = -0.18, P = .60). Implementing a nurse-administered screening tool effectively identified unmet palliative care needs among patients with heart failure with reduced ejection fraction and NYHA III. Despite low rates of palliative consults, standardization using IPOS could increase screening, contribute to institutional triggering palliative consultations, and improve awareness of unmet needs.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000034","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":"Integration of Community Health Workers Into Palliative Care Teams: Challenges, Barriers, Facilitators, and Implementation Strategies.","authors":"Angela Kroeze Visser, Sabina Kupershmidt, DenYelle B Kenyon, Susan Puumala, Anne Pithan","doi":"10.1097/NJH.0000000000001130","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001130","url":null,"abstract":"<p><p>In rural communities, primary care providers and other nonspecialists provide palliative care services when specialty care is not available. Recognizing the need to improve palliative care knowledge of providers across the care spectrum, groups across South Dakota have initiated programs to expand palliative care education. South Dakota also has a growing community health worker (CHW) infrastructure, and integrating CHWs into palliative care teams may be a way to further expand the reach of palliative care services. This mixed-methods study examines challenges, barriers, and facilitators of integrating CHWs into palliative care teams from the perspective of palliative care providers and advocates. Organizational culture and implementation climate are included as potential barriers and facilitators, and the results of the mixed-methods inquiry are used to select implementation strategies for integrating CHWs into palliative care teams in the South Dakota context from the Expert Recommendations for Implementation Change project.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052335","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":"Opportunities and Barriers to Artificial Intelligence Adoption in Palliative/Hospice Care for Underrepresented Groups: A Technology Acceptance Model-Based Review.","authors":"Tuzhen Xu, Gloria M Rose","doi":"10.1097/NJH.0000000000001120","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001120","url":null,"abstract":"<p><p>Underrepresented groups (URGs) in the United States, including African Americans, Latino/Hispanic Americans, Asian Pacific Islanders, and Native Americans, face significant barriers to accessing hospice and palliative care. Factors such as language barriers, cultural perceptions, and mistrust in healthcare systems contribute to the underutilization of these services. Recent advancements in artificial intelligence (AI) offer potential solutions to these challenges by enhancing cultural sensitivity, improving communication, and personalizing care. This article aims to synthesize the literature on AI in palliative/hospice care for URGs through the Technology Acceptance Model (TAM), highlighting current research and application in practice. The scoping review methodology, based on the framework developed by Arksey and O'Malley, was applied to rapidly map the field of AI in palliative and hospice care. A systematic search was conducted in 9 databases to identify studies examining AI applications in hospice and palliative care for URGs. Articles were independently assessed by 2 reviewers and then synthesized via narrative review through the lens of the TAM framework, which focuses on technology acceptance factors such as perceived ease of use and usefulness. Seventeen studies were identified. Findings suggest that AI has the potential to improve decision-making, enhance timely palliative care referrals, and bridge language and cultural gaps. Artificial intelligence tools were found to improve predictive accuracy, support serious illness communication, and assist in addressing language barriers, thus promoting equitable care for URGs. However, barriers such as limited generalizability, biases in data, and challenges in infrastructure were noted, hindering the full adoption of AI in hospice settings. Artificial intelligence has transformative potential to improve hospice care for URGs by enhancing cultural sensitivity, improving communication, and enabling more timely interventions. However, to fully realize its potential, AI solutions must address data biases, infrastructure limitations, and cultural nuances. Future research should prioritize developing culturally competent AI tools that are transparent, explainable, and scalable to ensure equitable access to hospice and palliative care services for all populations.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782091","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":"Effect of a Peaceful End-of-Life Care Program on Perceived Good Death in People With Advanced Cancer and Their Family Caregivers.","authors":"Benchamart Trakoolngamden, Supreeda Monkong, Suchira Chaiviboontham, Pratana Satitvipawee, Yotsawaj Runglodvatana","doi":"10.1097/NJH.0000000000001100","DOIUrl":"10.1097/NJH.0000000000001100","url":null,"abstract":"<p><p>Early integration of palliative care benefits both people with advanced cancer and their family caregivers, yet research on holistic end-of-life care and advance care planning remains limited. The primary objective of this study was to examine the effect of a peaceful end-of-life care program on perceived good death outcomes in people with advanced cancer and their family caregivers. Secondary objectives included exploring the program's effect on the quality relationship and end-of-life care knowledge among family caregivers. In this quasi-experimental design with repeated measures, 122 participants were enrolled. On the basis of the Theory of the Peaceful End of Life, the experimental group received a 4-week program comprising health education, self-care for symptom management, advance care planning, psychosocial support, and family involvement plus standard care, whereas the control group received standard care alone. The Good Death Inventory was the primary measurement tool. The results showed a significant improvement in perceived good death, quality relationships, and end-of-life care knowledge in the experimental group, with no such improvements observed in the control group. The program improved good death outcomes, caregiver relationships, and end-of-life care knowledge. Therefore, early initiation of this program is recommended to optimize its benefits.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"94-101"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973386","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":"A Rapid Review of Psychedelic-Assisted Therapy in the Context of Palliative Care.","authors":"Megan Miller, Molly Meyers, Annona Martin, Stephanie Napolitano, Caroline Dorsen, Andrew Penn, William E Rosa","doi":"10.1097/NJH.0000000000001096","DOIUrl":"10.1097/NJH.0000000000001096","url":null,"abstract":"<p><p>Psychedelic-assisted therapy (PAT) involves supported experiences with psychedelic medicines in carefully curated environments. Early evidence suggests possible utility of PAT for addressing psychosocial-spiritual-existential concerns, yet gaps remain in understanding findings related to PAT's role in palliative care. This rapid review aims to synthesize current literature on applications of PAT in the context of palliative care. Through a systematic process, we identified 34 articles published between January 2021 and July 2024. Protocols varied yet included common components of participant screening, preparation, dosing, and integration. Psilocybin was the most commonly studied compound. Results support safety and initial efficacy of PAT for psycho-spiritual-existential outcomes among carefully screened and highly homogonous samples of patients with serious illness (predominantly cancer). Current efforts and challenges around integrating PAT into systems of palliative care were highlighted. Additional work is needed to (1) explore PAT's safety and efficacy within more diverse samples and contexts, (2) train palliative care providers on PAT, (3) determine systems of care delivery best suited for translation of PAT into practice, and (4) begin developing policy solutions to support safe and equitable access to PAT. Because many patients lack access to basic psychosocial-spiritual-existential care, careful consideration is needed around integration of PAT. The psychedelic substances which are the topic of this article are not currently FDA approved for use in the United States.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"67-73"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857065","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":"Cultural or Spiritual End-of-Life Practice Preference Assessment and Documentation: Identifying Current Practice in Pediatric Hospice.","authors":"Kayla Combs, Robyn Stamm, Rachel Thienprayoon, Kimberly Ann Foster, Karen Behm, Laura Rozcicha","doi":"10.1097/NJH.0000000000001092","DOIUrl":"10.1097/NJH.0000000000001092","url":null,"abstract":"<p><p>Communities use rituals at end of life to foster a peaceful death, ensure passage to the afterlife, and grieve their lost loved ones. Studies report fear of misunderstanding or impeding rituals as a barrier to accepting hospice care. However, there has been little research on cultural and spiritual rituals in the setting of hospice care or how patient preference should be assessed, documented, and supported by hospice staff. This project sought to identify the current practice for assessment of cultural or spiritual end-of-life practice preferences, and the documentation of those preferences, within pediatric hospice programs in a Midwestern state. In surveys of 2 pediatric hospice programs, employee respondents reported routine assessment (97.3%) and routine documentation (70.3%) of cultural or spiritual end-of-life practice preferences. Most respondents reported documentation was written by various disciplines and in various locations in the medical record. Additionally, a retrospective chart review was performed including decedents of 1 pediatric hospice program over a 5-year period. Documentation affirming familial spiritual beliefs was identified in 75.9% of charts, of which, only 12.2% had documentation regarding end-of-life-specific spiritual needs. Standardized documentation practices may help foster equitable hospice care for all patients by ensuring care providers are aware of the patient and/or family's end-of-life spiritual needs.</p>","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"74-80"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191452","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}