Palliative medicine reports最新文献

{"title":"Spirituality and Health Summer Internship Program: Adapting Clinical Pastoral Education for Medical Student Instruction in Patient Spirituality.","authors":"Nasser Douge, Rhoda Toperzer, Horace M DeLisser","doi":"10.1089/pmr.2024.0101","DOIUrl":"https://doi.org/10.1089/pmr.2024.0101","url":null,"abstract":"<p><strong>Background: </strong>Training in spirituality and spiritual care is limited in medical education. A potentially novel approach for addressing these gaps in medical training is an immersive, experiential internship focused on patient spirituality and spiritual care based on pedagogical approaches adapted from clinical pastoral education (CPE).</p><p><strong>Methods: </strong>Mixed method analyses were undertaken of participants pre- and post-program surveys and comments to assess the first five years of the six-week Spirituality And Health Summer Internship Program, modeled on a unit of CPE, for first-year medical students.</p><p><strong>Results: </strong>On a 5-point Likert scale (1 = poor/strongly disagree, 5 = excellent/strongly agree) participants rated the educational value (4.7, standard deviation [SD] = 0.3) and overall quality (4.4, SD = 0.35) of the internship highly and strongly endorsed they would recommend the internship to peers (4.48, SD = 0.36). Participants strongly valued (4.58, SD = 0.35) the opportunity to visit and have conversations with patients as a core activity of the internship. Following the internship, participants reported significant (<i>p</i> = 0.013 to <i>p</i> < 0.0001) increases in their (1) awareness of how spirituality influences their lives, (2) knowledge of the potential impact of spirituality on the patient experience, and (3) knowledge of the role of spirituality in the lives of health care providers. Significant increases were also noted in participants' comfort in (1) talking to patients, (2) talking about spirituality, and (3) talking to patients about spirituality.</p><p><strong>Conclusions: </strong>A medical student summer internship focused on patient spirituality and spiritual care modeled after CPE provides a level of immersion in this content not obtainable in typical medical school curricula.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"76-83"},"PeriodicalIF":1.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and Cross-Cultural Adaptation of the Instrument for the Diagnosis of the Complexity of Palliative Care Needs.","authors":"Filippo Canzani, Sara Alquati, Francesca Bordin, Christian Barillaro, Marta De Angelis, Grazia Di Silvestre, Sabrina Dispenza, Gino Gobber, Caterina Magnani, Pietro Manno, Fiammetta Cosci, Silvia Tanzi","doi":"10.1089/pmr.2024.0065","DOIUrl":"https://doi.org/10.1089/pmr.2024.0065","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the palliative care (PC) paradigm is evolving from a prognosis-based approach to one centered on complexity, also in response to the aging population and the increase in chronic diseases. It is therefore necessary to strengthen PC networks with effective management of the specialist resources available. The use of tools such as the spanish Diagnostic Instrument for Complexity in Palliative Care (IDC-Pal) can help evaluate the complexity of PC needs, thus guiding the clinical care response. The aims of this study were the translation and the cultural adaptation of the IDC-Pal tool to the Italian language.</p><p><strong>Methods: </strong>The methodology proposed by Beaton et al. and Sousa et al. was used for the translation and cultural adaptation of the IDC-Pal tool. Phase 1: a forward-backward translation with linguistic and cultural adaptation of the tool by two native Spanish translators and two native Italian translators, including two PC professionals and two nonprofessionals, was performed. Phase 2: the translation was evaluated by a panel of 12 Italian PC experts, who assessed the comprehensibility of the translated instrument, and proposed changes to the text, which was found to be incomprehensible to at least 20% of them. Phase 3: this version of the tool was proposed to a sample of the Italian target population (93 professionals including general practitioners, nurses, and hospital doctors at 9 Italian PC networks tested it on 168 patients in home and hospital settings), to evaluate its comprehensibility and usability. At the end of the experimental phase, a semi-structured interview was organized with the main researcher of each network, with the aim of receiving information about the comprehensibility of the tool. Finally, a definitive version was developed.</p><p><strong>Results: </strong>The translation and adaptation were achieved without major problems.</p><p><strong>Conclusions: </strong>A conceptually, culturally, and linguistically equivalent italian version of the original IDC-Pal was obtained.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"187-195"},"PeriodicalIF":1.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Best Practice Advisory on the Utilization and Impact of Palliative Care Consultation in Heart Failure Hospitalizations.","authors":"Kaitlyn S Gooding, Vamsidhar V Naraparaju, Beth Esstman, Dorothy B Wakefield, Megan Evjen, Ahmed Naseer, Sara Tabtabai","doi":"10.1089/pmr.2024.0106","DOIUrl":"https://doi.org/10.1089/pmr.2024.0106","url":null,"abstract":"<p><strong>Background: </strong>Few studies examine palliative care consultations (PCC) in acute decompensated heart failure (ADHF) admissions. Prior data suggest that 6% of admitted patients are referred for PCC. This study evaluates the effect of a best practice alert (BPA) embedded in the electronic record on PCC utilization and outcomes.</p><p><strong>Methods: </strong>Patients admitted between May 1, 2020, and June 30, 2022, with ADHF were included. BPA was triggered at admission for patients with ≥3 ADHF admissions in 6 months or PCC during prior admission. Subjects were divided into early PCC (less than three days of admission), late PCC (more than three days), and no PCC. Demographics, BPA utilization, length of stay (LOS), and cost were compared between groups.</p><p><strong>Results: </strong>Of 684 patients, 18% received PCC: 13.1% had early PCC, 5.12% late PCC, and 81.6% no PCC. Early PCC patients were older with more comorbidities. Patients receiving PCC had lower ejection fraction (<i>p</i> = 0.04). Median LOS was longest in the late PCC group (12 days, <i>p</i> ≤ 0.01) and similar in early and no PCC groups (six and five days, respectively) and remained significant in multivariate analysis. White patients were more likely to receive PCC compared with Black and other races. The late PCC group had the lowest readmission rate at 5.7%; 28 of the 35 patients changed their goals of care to hospice, \"do not re-hospitalize,\" or \"do not intubate/do not resuscitate.\"</p><p><strong>Conclusions: </strong>PCC may influence therapy for patients with ADHF and reduce the readmission rate. Clinician biases remain despite the utilization of BPA, with a modest effect on PCC utilization.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"179-186"},"PeriodicalIF":1.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roadmap for Equitable Access and Responsible Use of Psilocybin-Assisted Psychotherapy in Palliative Care.","authors":"Michel Dorval, Sue-Ling Chang, Houman Farzin, Olivia Nguyen, Jean-François Stephan, Diane Tapp, Pierre Deschamps, Yann Joly, Florence Moureaux, Robert Foxman, Marianne Masse-Grenier, Jean-Sébastien Fallu","doi":"10.1089/pmr.2024.0108","DOIUrl":"10.1089/pmr.2024.0108","url":null,"abstract":"<p><p>Psilocybin-assisted psychotherapy represents a promising addition to palliative care interventions, potentially improving quality of life by addressing existential distress. Despite its safety and effectiveness, this therapy remains limited in Canada, underscoring the need for improved access to ease suffering from life-threatening illnesses. However, important questions remain regarding how to integrate psilocybin-assisted psychotherapy into existing health care frameworks, navigate regulatory challenges, and ensure equitable access for all patients. These unanswered questions highlight the complexity of expanding access and the need for thoughtful, informed approaches to its implementation. To address this, the P3A team (Psilocybin at End of Life: Audacity, Acceptability, Access) held a forum on March 22, 2024, in Quebec, Canada, to explore actionable steps for the responsible use and equitable access to psilocybin-assisted psychotherapy. A total of 57 participants with knowledge in palliative care, including professional and patient associations, patients, health care professionals, researchers, and policymakers, attended the event, which featured presentations, a panel discussion, and small-group workshops. This report provides 16 recommendations across six previously identified key topics: (1) patient eligibility and equity, (2) regulatory framework and respect for autonomy, (3) logistical and organizational aspects, (4) professional education and training, (5) public awareness and information, and (6) research. The elements and recommendations discussed in this article could offer valuable insights for expanding access to psilocybin-assisted psychotherapy in other jurisdictions, particularly in global contexts where similar barriers to care exist.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"153-160"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for Hiccups in Adults: A Scoping Review of Western and Eastern Approaches.","authors":"Yohei Kishi, Moe Nakawaga, Anri Inumaru, Michiko Nambu, Miwa Sakaguchi, Mayumi Murabata, Mari Matsuoka, Jun Kako","doi":"10.1089/pmr.2024.0109","DOIUrl":"https://doi.org/10.1089/pmr.2024.0109","url":null,"abstract":"<p><p>Hiccups are caused by involuntary spasms of the diaphragm and external intercostal muscles. When persistent, they can significantly reduce the quality of life. However, comprehensive reviews of available treatments and their corresponding evaluation metrics remain scarce. This scoping review aimed to comprehensively map the interventions used to treat hiccups in adults and clarify the current state of outcome measures employed in existing research. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) -ScR guidelines and the framework of Arksey and O'Malley. Using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ichushi-web databases, we identified studies published up to June 3, 2024. The search terms included \"HICCUP,\" \"HICCOUGH,\" and \"SINGULTUS.\" A total of 3248 articles were identified, with 499 duplicates removed. After screening 2749 titles and abstracts, 2708 articles were excluded. Full-text reviews of 41 articles led to the exclusion of 18, resulting in 23 that met the inclusion criteria. Of these, 17 studies focused on pharmacological interventions, including baclofen, metoclopramide, methylprednisolone, and Shitei-to, while 6 studies examined nonpharmacological interventions, such as acupuncture, infrared therapy, rebreathing techniques, and cervical epidural block. Outcome measures were categorized into objective and subjective evaluations. Objective measures included complete cessation, partial cessation, frequency reduction, and time to complete cessation. Subjective measures assessed the distress caused by hiccups using patient-reported scales, such as the numerical rating scale. This scoping review identified 23 studies on hiccup interventions, including five randomized controlled trials on pharmacological agents and one study on a nonpharmacological approach. Studies included both Western and Eastern medicine, offering new perspectives on hiccup management. The outcome measures were primarily objective, with some patient-reported assessments. These findings provide a foundation for future research on hiccup treatment and evaluation methods.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"171-178"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing and Developing Interprofessional Learning Experiences in Palliative Care: A Collaborative Workshop Approach.","authors":"Carolyn Kezar, Justine McGiboney, Michael D Barnett, Richard Taylor, Rebecca Edwards, Ella H Bowman, Elizabeth McAlister, Moneka A Thompson, Tara Schapmire, Chao-Hui Sylvia Huang","doi":"10.1089/pmr.2024.0081","DOIUrl":"https://doi.org/10.1089/pmr.2024.0081","url":null,"abstract":"<p><strong>Background: </strong>Team-based care is vital in palliative care, but there is limited interprofessional education (IPE) among health care providers, leading to siloed learning. This project addresses this gap by developing a workshop focused on the active dying process, promoting shared competencies among palliative medicine, geriatrics, nursing, and psychology subspecialty learners.</p><p><strong>Objective: </strong>We aimed to design, implement, and evaluate an Interprofessional Education Exchange (IPEX) Death and Dying workshop to foster interdisciplinary collaboration and improve participants' comfort with palliative care competencies.</p><p><strong>Design: </strong>A full-day, case-based workshop was developed using the Analysis, Design, Development, Implementation, Evaluation model, emphasizing experiential and collaborative learning.</p><p><strong>Setting/subjects: </strong>Two workshops were held at a tertiary southeastern academic university in the United States (US) in 2022 (cohort 1) and 2023 (cohort 2). A total of 25 participants, including palliative medicine fellows, geriatric medicine fellows, advanced nurse practitioner students, and psychology residents, completed the workshops.</p><p><strong>Measurements: </strong>Participants' comfort with palliative care competencies, perceptions of interprofessional collaboration, and qualitative feedback were assessed using post-workshop surveys.</p><p><strong>Results: </strong>Participants' comfort in providing anticipatory guidance, addressing spiritual distress, and supporting grief and bereavement improved. Interprofessional collaboration and professional growth, particularly in communication and understanding each other's roles and responsibilities in caring for the actively dying, also increased.</p><p><strong>Conclusions: </strong>The collaborative IPEX Death and Dying workshop has been shown to enhance competencies and foster interprofessional collaboration among palliative care subspecialty learners across four disciplines. This model holds potential for broader implementation across health care settings to improve care for the seriously ill patients.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"28-37"},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive End-of-Life Care: Implementation of a Canadian Guideline-Based Order Set for the Withdrawal of Life-Sustaining Therapy in the Intensive Care Unit.","authors":"Alison Knapp, Jennifer M O'Brien, Maria Cruz, Mary Ellen Walker, Joann Kawchuk, Carol Brons, Sabira Valiani","doi":"10.1089/pmr.2024.0091","DOIUrl":"https://doi.org/10.1089/pmr.2024.0091","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of patients receive end-of-life care in the intensive care unit (ICU). Death often occurs in the ICU after a decision has been made to withdraw life-sustaining therapies. In 2016, Downar et al. published Canadian consensus guidelines to standardize practices for withdrawal of life-sustaining therapy in the ICU. In this study, we sought to understand the feasibility and acceptability of implementing an order set, nursing flowsheet, and nursing care plan based on these guidelines in two ICUs in Saskatchewan, Canada.</p><p><strong>Methods: </strong>We used a hybrid effectiveness-implementation design, engaging a steering committee of ICU health care providers and leadership to guide implementation. We conducted a six-month pilot implementation. We collected data in the three months pre-implementation, during the six-month implementation period, and for three months post-implementation. To evaluate implementation outcomes, we used the Consolidated Framework for Implementation Research to develop semi-structured interviews and feasibility surveys. To measure effectiveness outcomes, bedside nurses completed Quality of Death and Dying surveys, and we performed a patient chart review.</p><p><strong>Results: </strong>The intervention materials added to the burden of paperwork of bedside health care providers but helped them provide quality end-of-life care, meet the needs of patients and their families, and lessen ethical tensions between symptom control and hastening death. There was no difference in cumulative sedative dosing and time to death after extubation in the pre-implementation, implementation, or post-implementation periods. A significant increase in symptom assessment (pain, dyspnea, and agitation) using standardized tools was observed during the implementation and post-implementation periods. There was an improvement in holistic care outcomes post-implementation.</p><p><strong>Conclusions: </strong>We implemented current Canadian best-practice guidelines for providing end-of-life care in the ICU using a multidisciplinary approach. This study offers insight into how standardized symptom assessment and medication titration can be incorporated into the complex ICU environment.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"161-170"},"PeriodicalIF":1.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desire to Die Communication Training for Professionals: Developing Online Formats.","authors":"Kathleen Boström, Thomas Dojan, Axel Doll, Thomas Montag, Raymond Voltz, Kerstin Kremeike","doi":"10.1089/pmr.2024.0075","DOIUrl":"https://doi.org/10.1089/pmr.2024.0075","url":null,"abstract":"<p><strong>Background: </strong>Severely ill patients often express a desire to die, which can turn into suicidality. To support health professionals in managing this issue, we initially created a two-day face-to-face training to enhance self-confidence, knowledge, attitudes, and skills. Due to the increasing need for more accessible formats, we aimed to transition this training online and develop a complementary website.</p><p><strong>Methods: </strong>Multimethod approach to develop and evaluate an online training and a website on dealing with the desire to die in palliative care in Germany. This involved: (1) reviewing literature on effective didactic elements, (2) digitalizing the face-to-face training and creating the website with ongoing expert feedback, and (3) piloting and evaluating these resources through online surveys.</p><p><strong>Results: </strong>We retrieved suggestions for the development of online trainings and websites from <i>n</i> = 39 publications. Through these results and expert discussion, an online version of our training and a website were developed. For evaluation, we conducted two trainings (face-to-face (<i>n</i> = 8) and online (<i>n</i> = 19)) with multiprofessional participants. All improved significantly in self-confidence after the training without differences between online and face-to-face training. Website evaluation of usability, comprehension, information quality, presentation, and sustainability by <i>n</i> = 71 users yielded favorable feedback with improvement suggestions for structure and plain language.</p><p><strong>Conclusions: </strong>Dealing with the desire to die can be taught not only face to face but also through online training and an educational website. This can ensure low-threshold access to scientifically sound information and training units for those health professionals confronted with the desire to die.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"38-49"},"PeriodicalIF":1.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient, Provider, and Health System Determinants of Hospice Length of Stay.","authors":"Eliza Thompson, Daniel Sanchez Pellecer, Gregory J Hanson, Shealeigh A Inselman, Jenn M Manggaard, Kevin J Whitford, Jacob J Strand, Rozalina G McCoy","doi":"10.1089/pmr.2024.0077","DOIUrl":"https://doi.org/10.1089/pmr.2024.0077","url":null,"abstract":"<p><strong>Background: </strong>Benefits of hospice care, such as improvement in quality of life and reduced costs, depend on duration of enrollment in hospice services, making timely hospice referral essential. Patient-, provider-, and system-level factors associated with hospice referral timing and length of stay (LOS) are unclear.^1-6.</p><p><strong>Objective: </strong>To review existing hospice referral patterns to identify patient- and system-level factors associated with hospice LOS.</p><p><strong>Methods: </strong>We performed a retrospective review of all adult patients referred from our institution (located in Rochester, Minnesota, USA) to a nonprofit hospice agency between 2013 and 2017. The primary dependent variable was hospice LOS. Patient-level variables included demographic characteristics, place of residence, and hospice diagnosis. System-level variables included referral setting and provider-specific variables, such as title and gender. Statistical analyses were performed using multivariate logistic regression.</p><p><strong>Results: </strong>A total of 2072 patients were referred to hospice during the study period. Patient-level factors associated with LOS included hospice diagnosis and place of residence. Patients referred for cancer had a higher odds of a long LOS, while patients from long-term care facilities had a higher odds of a short LOS. System-level factors associated with LOS included provider gender and title. Referral by a female provider or by a physician, rather than an advanced practice provider, was associated with a lower odds of a short LOS.</p><p><strong>Conclusion: </strong>Based on a review of hospice referral patterns, the integration of hospice care into subspecialty practices, long-term care facilities, and advanced practice education could be an effective strategy to improve hospice LOS.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"144-152"},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Insights: End-of-Life Care for Patients with Terminal Gastric Cancer at Home.","authors":"Hiroaki Yamane, Aki Yoshimitsu, Etsushi Akimoto, Tomoyuki Abe, Motoi Yamane","doi":"10.1089/pmr.2024.0104","DOIUrl":"https://doi.org/10.1089/pmr.2024.0104","url":null,"abstract":"<p><strong>Background: </strong>As the Japanese population continues to age, home health care provision has greater significance. However, the number of patients with terminal cancer receiving end-of-life care at home remains limited, and predicting the prognosis of patients with terminal-stage gastric cancer is challenging.</p><p><strong>Objective: </strong>To analyze the real-world data of patients with terminal gastric cancer receiving end-of-life care at home to provide insights into their care and health outcomes.</p><p><strong>Design: </strong>A two-center retrospective study.</p><p><strong>Setting/subjects: </strong>This study focused on terminal patients with gastric cancer who died at home between 2021 and 2024 in Japan. A total of 27 participants (14 males and 13 females) were included in the study, with a median age of 78 years.</p><p><strong>Measurements: </strong>First, we analyzed the detailed clinical course of the patients during home care. Second, we performed a comparative analysis by dividing the patients into two groups based on median overall survival (OS).</p><p><strong>Results: </strong>The median OS during home care was 22 days. The patients were divided into two groups: long OS (OS-L) and short OS (OS-S). Strong opioid use and home oxygen therapy were recorded in 22 and nine patients, respectively. In the OS-S group, oral intake was significantly reduced (25.0% vs. 66.7%, <i>p</i> = 0.032). There was a notable difference in serum albumin levels between the two groups (2.8 vs. 2.4 mg/dL, <i>p</i> = 0.038). The neutrophil-to-lymphocyte ratio (NLR)/albumin was significantly higher in the OS-S group compared to the OS-L group (1.0 vs. 2.3, <i>p</i> = 0.032).</p><p><strong>Conclusions: </strong>Oral intake, serum albumin level, and NLR/albumin were important prognostic factors in end-of-life care at home of patients with terminal gastric cancer.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"137-143"},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}