Palliative medicine reports最新文献

{"title":"Death and Dying Attitude Through the Eyes of Nursing Students during Clinical Training: A Cross-Sectional Study in the United Arab Emirates.","authors":"Amina Elzeiny, Ahmed Loutfy, Corrien Van Belkum, Hussein M Magdi, Alaa Elbatanouny, Bushra Al Hariri, Haneen Alazazmeh, Abrar Alrefai","doi":"10.1177/26892820251395427","DOIUrl":"10.1177/26892820251395427","url":null,"abstract":"<p><strong>Background: </strong>Nursing students often encounter emotional challenges when facing death during their clinical training, which can negatively impact their academic performance and mental well-being. As they provide crucial support to patients and their families, this responsibility can induce significant stress.</p><p><strong>Objective: </strong>This study aims to examine nursing students' attitudes toward death and dying and to identify the demographic and educational factors influencing their preparedness for end-of-life care in the United Arab Emirates context.</p><p><strong>Methods: </strong>In March 2025, a cross-sectional study was conducted using a convenience sample of 122 nursing students (senior and junior) enrolled in clinical placements at a university in the United Arab Emirates. Data collection utilized the validated Death Attitude Profile-Revised (DAP-R) and Frommelt Attitudes Toward Care of the Dying (FATCOD) scales as assessment tools.</p><p><strong>Results: </strong>The study showed that nursing students typically hold neutral attitudes toward caring for patients nearing the end of life. There are statistically significant correlations between age, education level, grade point average, clinical scores, and overall scores on the DAP-R scale, as well as the FATCOD Scale, among the participants.</p><p><strong>Conclusions: </strong>While many students showed some acceptance of death, high degrees of fear, avoidance, and escape acceptance had a significant impact on their views about end-of-life care. The findings indicate that emotional distress and insufficient training may act as impediments to compassionate treatment. Furthermore, the comparatively low FATCOD ratings indicate a need for better integration of palliative care instruction within the nursing curriculum. Structured clinical exposure, psychological coping mechanisms, and reflective learning opportunities could all be used to help students gain the essential confidence and emotional resilience.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"588-596"},"PeriodicalIF":1.3,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672442","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":"<b>Initiating and Documenting Goals of Care Discussion in Patients with Advanced Pancreatic and Colorectal Cancers</b>: <b>A Quality Improvement Project in a Low Resource Setting</b>.","authors":"Daniel Raj Joseph Thangasamy, Meenakshi V Venketeswaran, Thendral Ramasamy, Vinutha Suresh, Rathipriya S, Robert Louis A, Ramakrishnan Ayloor Seshadri","doi":"10.1177/26892820251392545","DOIUrl":"10.1177/26892820251392545","url":null,"abstract":"<p><p>Patients with advanced malignancies often end up receiving aggressive interventions which are not aligned with their preferences especially during terminal stages. Discussing and documenting the goals of care (GOC) early in the course of the illness will help patients receive interventions based on their preferences. In resource-constrained settings such as our institution, a regional cancer center in India, a lower-middle socioeconomic country, this also enables effective utilization of life-saving equipment and Intensive care unit care. Since we did not have a standard GOC discussion and documentation process, we initiated a quality improvement (QI) project. This QI initiative was done using the A3 methodology between September 2023 to May 2024 and it was followed up till March 2025. For this project, we chose patients with advanced pancreatic and colorectal cancer with a life expectancy of less than one year. We followed various steps of the QI project such as defining the problem, setting SMART goals, process mapping, root cause analysis, identifying key drivers and interventions to solve the problem, and also planned sustainability measures. As a result of this QI project, we were able to increase the rates of GOC documentation from 0% to 92% in patients with advanced pancreatic and colorectal cancer. Root cause analysis revealed that the absence of a standard operating procedure/document and limited awareness about GOC were the main barriers for which we derived key drivers and interventions. Though creating awareness help to increase the number of patients referred for GOC discussion, our goal was achieved after we created a color-coded GOC document. Introducing a standardized, color-coded GOC documentation process through a QI initiative significantly improved discussion and documentation rates in patients with advanced cancer. Such QI initiatives are feasible in low- and middle-income settings and help align care with patient preferences and save resources.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"554-563"},"PeriodicalIF":1.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672918","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":"Physician Perception of Trust and Communication with Asian Patients with Serious Illness and Their Families in the United States: An Exploratory Qualitative Study.","authors":"Cloris Huan, Irene M Yeh, Francesca L Troiani, Jennifer Tjia","doi":"10.1177/26892820251389755","DOIUrl":"10.1177/26892820251389755","url":null,"abstract":"<p><strong>Background: </strong>Asians in the United States receive less palliative care and enter hospice less than Whites, disproportionately receive more invasive mechanical ventilation, and report less involvement in decision-making with physicians than they would like. Despite the growing literature addressing serious illness in diverse patient populations, communication with Asians is understudied. This study aimed to explore U.S. physician perceptions of clinical interactions with Asian patients with serious illness and barriers and facilitators to physician-patient communication.</p><p><strong>Methods: </strong>This is an exploratory qualitative descriptive study using semistructured interviews with U.S. physicians who cared for Asian patients with serious illness. We used an inductive content analysis approach to identify themes related to facilitators and barriers to communication between Asian patients, their families, and physicians.</p><p><strong>Results: </strong>We conducted 10 physician interviews between February and April 2024. Of participants, 50% were White and 50% were Asian, the majority were male, and 50% specialized in palliative care. Three major themes arose: (1) trust cannot be assumed; (2) understanding and honoring the role of family are key; and (3) honoring the patient's preferences for communication can build trust.</p><p><strong>Conclusion: </strong>This study is a step in illustrating how a cross-cultural approach to communication needs to align physicians, patients, and families on the process of communication and shared decision-making and not only on the goals for care. Moving toward a cultural adaptive approach can empower clinicians to engage in a trust-building process of inquiry, observation, and understanding of how sociocultural factors impact patient preferences for health care.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"542-553"},"PeriodicalIF":1.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672619","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":"Feasibility, Acceptability, and Preliminary Performance of Check In for Exchange of Clinical and Key Information: A Communication Guide to Facilitate Pre-Encounter Huddles with Medical Interpreters Prior to Conversations Around Serious Illness.","authors":"Mei-Ean Yeow, Daniel K Partain, Heather J Carmack, Megan Brandeland, Graciela D Porraz Capetillo, Karen M Fischer, Abraham Labrada Santiago, Ibrahim S Karakus, Amelia Barwise","doi":"10.1177/26892820251390817","DOIUrl":"10.1177/26892820251390817","url":null,"abstract":"<p><strong>Background: </strong>Patients with non-English Language Preference are at risk of adverse health outcomes, particularly at end of life and during serious illness. Medical interpreters often feel unprepared to interpret conversations about serious illness. Best practice guidelines recommend a pre-encounter huddle between clinician and interpreter to better prepare both providers. The CHECK-IN (Check in for Exchange of Clinical and Key Information) guide is a simple communication tool designed to facilitate this pre-encounter huddle. We describe the results of a pilot feasibility study of the CHECK-IN guide performed in a simulation environment. The primary objectives of the study were to evaluate the feasibility, acceptability, and preliminary performance of the CHECK-IN guide.</p><p><strong>Methods: </strong>This U.S.-based study is a single-center simulation-based nonblinded randomized pilot feasibility study. Participating clinicians were randomized to usual practice (control) vs. introduction to the CHECK-IN guide (intervention). Clinicians completed pre- and post-session surveys. Participating clinicians were evaluated using the Faculty Observation Rating Scale (FORS), Interpreter Scale (IS), and Interpreter Impact Rating Scale (IIRS).</p><p><strong>Results: </strong>Participants had a highly favorable opinion on the acceptability, appropriateness, and feasibility of the CHECK-IN tool; 91% of participants agreed/strongly agreed on the acceptability of the tool, 91% agreed/strongly agreed on the appropriateness of the tool, and 100% agreed/strongly agreed on the feasibility of the tool. There were no statistical differences between control and intervention groups for the IS, IIRS, and FORS scores.</p><p><strong>Conclusion: </strong>The CHECK-IN guide is a promising tool to guide a pre-encounter huddle between clinician and interpreter, thereby improving interpreter-mediated communication when having conversations about serious illness.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"533-541"},"PeriodicalIF":1.3,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672675","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":"Evaluation of a Community-Based Advance Care Planning Campaign for a General Adult Population.","authors":"Peiyuan Zhang, Tiffany C Erbelding, Glenn E Schneider, Nikki Highsmith Vernick, John G Cagle","doi":"10.1177/10966218251362129","DOIUrl":"10.1177/10966218251362129","url":null,"abstract":"<p><strong>Background: </strong>Early advance care planning (ACP) has been widely recommended, but overall uptake remains low. Most efforts to improve formal ACP adoption, namely living will (LW) and health care agent (HCA) documentation, focus on medical settings targeted at older adults with serious or chronic illness, while community-based ACP campaigns are limited.</p><p><strong>Objectives: </strong>Describe the development and implementation of a community-based campaign (2017-2021) aimed at increasing ACP adoption and evaluating its outcomes at both the community level and across subgroups by race, ethnicity, and age.</p><p><strong>Setting: </strong>Howard County, Maryland, United States.</p><p><strong>Design: </strong>Nonexperimental study design.</p><p><strong>Measures: </strong>A mixed-mode, representative survey of 2000+ county residents was conducted biennially between 2016 and 2021 (one survey was delayed due to COVID-19). Main outcome measures were self-attestation to completing LW and HCA documentation.</p><p><strong>Results: </strong>In total, 6037 respondents over three years completed the survey. χ² analysis showed that the prevalence of ACP adoption increased overall by over 10% (<i>p</i> < 0.001) since 2016. While upward trends in ACP adoption were observed across all racial groups, statistically significant increases were found among only White and Hispanic residents (<i>p</i> < 0.001). Logistic regression analysis found that increased odds of ACP adoption were associated with the community campaign for residents ≤65 years of age, White residents, married individuals, and those with a regular health care provider after controlling for confounding factors (e.g., odds ratios = 1.35, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Community-based ACP campaigns can result in increased ACP awareness and adoption in the general adult population, though more work is needed to encourage ACP adoption in diverse communities.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"509-520"},"PeriodicalIF":1.3,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672528","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":"Pharmacological Strategies for Pain Relief in Patients with Terminal Delirium: A Secondary Data Analysis.","authors":"Takaaki Hasegawa, Masanori Mori, Takashi Yamaguchi, Kengo Imai, Yoshinobu Matsuda, Isseki Maeda, Yutaka Hatano, Hiroto Ishiki, Hiroyuki Otani","doi":"10.1177/26892820251390525","DOIUrl":"10.1177/26892820251390525","url":null,"abstract":"<p><strong>Background: </strong>Terminally ill cancer patients often experience pain and delirium. However, opioids administered for pain management may exacerbate patients' delirium.</p><p><strong>Objectives: </strong>To explore the real-world symptom trajectory associated with pharmacological interventions, including opioids and antipsychotics, in patients with cancer pain and terminal delirium.</p><p><strong>Design: </strong>A secondary analysis of a multicenter prospective observational study.</p><p><strong>Setting/subjects: </strong>Adult patients admitted to inpatient hospice or palliative care units in Japan. Participants were eligible if they had cancer pain (Integrated Palliative care Outcome Scale: IPOS ≥2) and delirium at the time that their Palliative Performance Scale had declined to ≤20 (day 1, immediately before death).</p><p><strong>Measurements: </strong>Pharmacological strategies, pain levels (using the IPOS), and delirium symptoms (using the Memorial Delirium Assessment Scale, item-9).</p><p><strong>Results: </strong>Among a total of 1896 patients, 1396 were assessed for eligibility on day 1, and 137 met the inclusion criteria for analysis. A total of 86 (63%) patients had agitated delirium (hyperactive or mixed) with a median survival time of three days. Regarding pharmacological strategies, 32 (23%) received opioid initiation/dose escalation and 94 (69%) received regular administration of antipsychotics. These figures also included 25 (18%) patients who received both opioid initiation/dose escalation and antipsychotics. Approximately 55% of all patients had persistent cancer pain (IPOS for pain ≥2) on day 2. Among those with agitated delirium, 79% continued to exhibit agitation symptoms on day 2.</p><p><strong>Conclusion: </strong>Despite specialized palliative care, the combined distress of cancer pain and delirium in the last days of life remains complex and refractory.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"527-532"},"PeriodicalIF":1.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672643","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":"Allostatic Load Borne by Caregivers of Children with Serious Conditions: Acceptability of Self-Reported Data.","authors":"Daniel H Grossoehme, Sarah Friebert, Rachel Jenkins, Jonathan H Pelletier, P Cooper White, Michael L Forbes","doi":"10.1177/26892820251390489","DOIUrl":"10.1177/26892820251390489","url":null,"abstract":"<p><strong>Background: </strong>Stress due to a child's serious medical condition affects the entire family. The cumulative stress burden (\"allostatic load\") has deleterious health and economic effects.</p><p><strong>Objective: </strong>Demonstrate adequate caregiver willingness to disclose health care utilization and work/school attendance.</p><p><strong>Setting/subjects: </strong>We enrolled caregivers of well children (WC), children with medical complexity (CMC), and children receiving palliative care (PC) (<i>N</i> = 15; 5 per group) in a midwestern United States pediatric hospital.</p><p><strong>Measurements: </strong>A novel allostatic load questionnaire and the Family Appraisal of Caregiving Questionnaire for Palliative Care were used.</p><p><strong>Results: </strong>All caregivers (100% female) completed the study, with 9% of data missing. PC participants reported greater child health care appointments and admissions compared with WC and CMC.</p><p><strong>Conclusions: </strong>Caregivers will disclose sensitive information for health care research, providing evidence for subsequent, adequately powered studies to inform policy-making. While underpowered for between-group analyses, results suggest pediatricians should routinely assess caregiver burden even at well-child visits.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"521-526"},"PeriodicalIF":1.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672969","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":"What a Hug Does: A Qualitative Study of Chinese Immigrant Families' Experiences with Inpatient Palliative Care Specialists.","authors":"Zhimeng Jia, Allison Kurahashi, Ramona Mahtani, Siyi Fan, Lingsheng Li, Irene M Yeh, Richard E Leiter, Justin J Sanders, James A Tulsky, Rashmi K Sharma","doi":"10.1177/26892820251388866","DOIUrl":"10.1177/26892820251388866","url":null,"abstract":"<p><strong>Background: </strong>Compared with non-Chinese adults in high-income countries, ethnically Chinese patients are more likely to encounter palliative care (PC) closer to death and in hospital settings. Yet, Chinese families' experiences and perception of inpatient PC remain unknown.</p><p><strong>Objective: </strong>Identify barriers and facilitators to culturally respectful PC for Chinese immigrant inpatients and their caregivers.</p><p><strong>Design: </strong>Prospective, exploratory qualitative design involving phenomenological interviews.</p><p><strong>Setting/subjects: </strong>We consecutively recruited (<i>n</i> = 15) Chinese immigrant patients and their caregivers (<i>n</i> = 14) referred to PC at one Canadian academic teaching hospital. We collected participant self-reported sociodemographics and Suinn-Lew acculturation level and conducted semi-structured interviews (<i>n</i> = 10) in Mandarin and/or English. The interviews were recorded, transcribed, translated, and thematically analyzed using Tan's Health Communication framework.</p><p><strong>Results: </strong>Patients were older-aged (mean = 73.5 ± 16.2 years), 53.3% female, 60% college-educated, 66.7% nonreligious, and 93.3% diagnosed with cancer and had low acculturation (mean = 1.8 ± 0.9/5.0). Caregivers were middle-aged (mean = 50.6 ± 15.5 years), 78.6% children, 57.1% female, 85.7% college-educated, and 71.4% nonreligious and had moderate acculturation (mean = 2.5 ± 1.2/5.0). We identified four themes from post-consultation interviews: abandonment and alienation mark past experiences with serious illness care; emphasizing expertise and symptom relief may help overcome initial ambivalence toward PC; PC brokers competing priorities within the family unit; and PC alleviates time-related distress by addressing illness understanding.</p><p><strong>Conclusion: </strong>Chinese patients and caregivers may prefer a PC approach that is sensitive to historical mistrust, leverages expertise in symptom management to inspire confidence, and accommodates the information and care preferences of the family unit. Further research is needed to examine the impact of these PC strategies on clinical outcomes for Chinese families.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"494-502"},"PeriodicalIF":1.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672622","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":"Assessing the Impact of an Indigenous Palliative Care Nurse Navigator: A Program Evaluation.","authors":"Iain John McInnis, Cara Alison Bablitz, Juliet Foster, Trevor Morey, Natasha Gougeon, Reuben Quinn","doi":"10.1177/26892820251385777","DOIUrl":"10.1177/26892820251385777","url":null,"abstract":"<p><strong>Introduction: </strong>Indigenous peoples in Canada face significant health disparities rooted in colonization and experience inequitable access to palliative care. Patient navigation has proven effective in both Indigenous and palliative contexts, but integration of these roles has not been studied. This evaluation defines the scope of a patient navigator specializing in palliative care for Indigenous peoples and explores how it addresses service gaps.</p><p><strong>Methods: </strong>A program evaluation tool was developed to track key performance indicators (KPIs) of an Indigenous Palliative Care Nurse Navigator (IPCNN) over six months. Responsibilities were organized into three domains: (1) social vulnerabilities, (2) mainstream palliative care navigation, and (3) barriers to palliative care for Indigenous peoples. Sixteen categories further captured the scope of responsibilities. KPIs were classified as either \"working\" indicators, reflecting activities undertaken for future outcomes, or \"outcome\" indicators, which tracked the achievement of results. A single IPCNN provided care to 164 Indigenous patients across Alberta, Canada with a prognosis of less than 24 months, conducting initial assessments and maintaining ongoing contact through home visits, clinic appointments, and phone calls every two to four weeks. KPIs were tabulated and analyzed by frequency (low, moderate, and high), domain, category, and classification.</p><p><strong>Results: </strong>One IPCNN logged 714 activities across three domains: social vulnerabilities (191), mainstream palliative care navigation (394), and barriers to palliative care for Indigenous peoples (129). Most KPIs (77%) were \"working\" activities, reflecting upstream tasks required to achieve outcomes. The majority of KPIs addressing barriers to palliative care for Indigenous peoples were high-frequency activities.</p><p><strong>Discussion: </strong>The IPCNN role supports Indigenous patients to navigate gaps in palliative care delivery, including distrust of health care providers, jurisdictional challenges, and incongruencies between Indigenous culture and Western medicine. These findings underscore the potential of Indigenous palliative care navigation as an effective intervention to improve the accessibility and quality of palliative care for Indigenous peoples.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"485-493"},"PeriodicalIF":1.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12726364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829223","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":"Impact of Coronavirus Disease 2019 on Inpatient Palliative Care Services in Japan: A Hybrid Time-Series Analysis Before, During, and After the Pandemic Using 10-Year Claims Data.","authors":"Yuki Egashira, Syo Nakamura, Naoki Suzuki, Ryo Watanabe","doi":"10.1177/26892820251385778","DOIUrl":"10.1177/26892820251385778","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) reduced the use of routine medical care, particularly the treatment of nonlife-threatening conditions. Previous studies have examined the impact of the COVID-19 pandemic; however, most focused on the effect of early stages, lacking data on the later stages and post-pandemic recovery.</p><p><strong>Objective: </strong>To examine the impact of COVID-19 on inpatient palliative care services in Japan throughout the pandemic and after its reclassification as a Category 5 infectious disease.</p><p><strong>Design: </strong>Retrospective time-series analysis of claims data from April 2014 to March 2024.</p><p><strong>Setting/subjects: </strong>National Health Insurance participants in Kanagawa Prefecture who received the \"Palliative Care Unit Inpatient Fee\" or \"additional fee for inpatient palliative care treatment.\"</p><p><strong>Measurements: </strong>The observed-to-expected (OE) ratios were calculated using Seasonal Autoregressive Integrated Moving Average model predictions. Interrupted time-series (ITS) analysis was used to examine the level and trend changes after the reclassification of COVID-19 to Category 5 (May 2023).</p><p><strong>Results: </strong>During COVID-19, the Palliative Care Unit Inpatient Fee showed OE ratios ranging from -25.1% to 22.9% (April 2020-November 2021), which eventually reached -36.0% (October 2022). After COVID-19 reclassification, OE ratios improved to -9.5% to 12.5%. Additional fees for inpatient palliative care treatment showed similar patterns, with the lowest point being -42.7% (February 2022). The ITS analysis revealed significant positive trends for both services after reclassification.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic has influenced inpatient palliative care services, particularly since its sixth wave. The reclassification of COVID-19 to Category 5 showed immediate positive effects, suggesting that policy interventions can effectively restore palliative care services. These findings highlight the vulnerability of palliative care, impact of policy interventions during pandemics, and need for strategic planning in a future-aging society.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"475-484"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380076","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}