BMJ Supportive & Palliative Care最新文献

Validation and modification of a short-term survival index using shock index and consciousness in terminal cancer patients: a multicentre prospective cohort study. 使用休克指数和意识对晚期癌症患者短期生存指数的验证和修正：一项多中心前瞻性队列研究

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-22 DOI: 10.1136/spcare-2026-006461

Ko Sato, Mika Baba, Tatsuya Morita, Masanori Mori, Jun Hamano, Hiroto Ishiki, Naosuke Yokomichi, Yukako Hattori

引用次数: 0

Short-term decline in weaker-side handgrip strength is associated with shorter survival in patients with advanced cancer admitted to a palliative care unit: a prospective cohort study. 一项前瞻性队列研究表明，入住姑息治疗病房的晚期癌症患者，较弱侧握力的短期下降与较短的生存期有关。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-16 DOI: 10.1136/spcare-2026-006645

Osamu Kowata, Tomoyuki Watanabe, Takeshi Sato, Tomoki Nagae, Makoto Sekine, Kazuhiko Onuki, Toshie Aita, Hiroyuki Suzuki, Yukina Yamamoto, Ai Oyamada, Ai Sasaki, Shinichiro Morishita

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Del-IT study: delirium incidence and treatment in an acute palliative care unit - a prospective cohort study. Del-IT研究：急性姑息治疗病房谵妄发生率和治疗——一项前瞻性队列研究。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-16 DOI: 10.1136/spcare-2026-006587

Teresa Tavares, Edna Gonçalves, Carla Paiva, Carla Maia, Pedro Vieira, Vasco Cardoso, José Queirós, Rui Môço, Delfim Oliveira, Fernando Abelha

引用次数: 0

Perceived social support and death anxiety among patients with advanced lung cancer: potential independent and serial mediating roles of psychological resilience and yielding coping in a Chinese cultural context. 中国文化背景下晚期肺癌患者感知社会支持与死亡焦虑：心理弹性和屈服应对的潜在独立和系列中介作用

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-12 DOI: 10.1136/spcare-2026-006596

Yawen Su, Shu Zhang, Liyang Duan, Xiaolin Hu

引用次数: 0

Barriers and facilitators to providing end-of-life care to people with intellectual disabilities in the home setting: a qualitative study of bereaved caregivers in Ireland. 在家庭环境中为智障人士提供临终关怀的障碍和促进因素：对爱尔兰失去亲人的照顾者的定性研究。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-09 DOI: 10.1136/spcare-2026-006568

Margaret Haigh, Mary McCarron, Philip McCallion, Martin McMahon

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Becoming a palliative care physician: how reflective learning shapes professional identity in postgraduate training - a qualitative study. 成为一名姑息治疗医生：反思性学习如何在研究生培训中塑造职业认同——一项定性研究。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-08 DOI: 10.1136/spcare-2026-006251

Kristoffer Marså, Dorte Høst, Louise Lausen, Bryan Cleal, Hanne Konradsen

引用次数: 0

Systemic anticancer therapy for refractory malignant bowel obstruction in advanced cancer patients: a retrospective cohort study. 晚期癌症患者难治性恶性肠梗阻的系统性抗癌治疗：一项回顾性队列研究。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-07 DOI: 10.1136/spcare-2026-006508

Emma Ferber, Marc-Antoine Benderra, Joseph Gligorov, Jean-Pierre Lotz, Mathieu Jamelot, Ahmed Khalil, Lauren Seknazi, Xavier Barthere, Elise Vandra, Djamel Ghebriou

{"title":"Systemic anticancer therapy for refractory malignant bowel obstruction in advanced cancer patients: a retrospective cohort study.","authors":"Emma Ferber, Marc-Antoine Benderra, Joseph Gligorov, Jean-Pierre Lotz, Mathieu Jamelot, Ahmed Khalil, Lauren Seknazi, Xavier Barthere, Elise Vandra, Djamel Ghebriou","doi":"10.1136/spcare-2026-006508","DOIUrl":"https://doi.org/10.1136/spcare-2026-006508","url":null,"abstract":"Objectives: Malignant bowel obstruction (MBO) is a common but severe complication of advanced cancer. The role of systemic anticancer therapy in patients with inoperable MBO remains poorly defined. This study aimed to assess the efficacy of systemic anticancer therapy in this setting.Methods: We conducted a retrospective, single-centre cohort study including patients hospitalised for MBO between January 2015 and February 2025 at Tenon University Hospital (Paris, France). Eligible patients had advanced cancer with inoperable MBO refractory to medical management and treated by systemic anticancer therapy. The primary endpoint was the rate of bowel resolution. Secondary endpoints included overall survival (OS), time to resolution, reobstruction rate and treatment-related toxicity. Subgroup analyses were performed according to line of therapy and tumour type.Results: 64 patients were included (median age 62 years; 84% female; 50% Eastern Cooperative Oncology Group Performance Status ≤2). Obstruction resolution occurred in 33% of patients. Median OS was 50 days (95% CI 39 to 83). Among responders, 38% experienced reobstruction (median time 33 days, IQR 24-48). Toxicity was substantial (70% adverse events in all grades; 58% grade ≥3). Patients with gynaecological tumours had improved OS compared with others (66 vs 39 days; HR 1.66; p=0.046). In this subgroup, first-line therapy was associated with higher resolution rates (OR 8.67; p=0.019).Conclusions: In inoperable MBO, anticancer therapy achieved obstruction resolution in one-third of patients but was associated with substantial toxicity and limited survival. Careful patient selection and early goals-of-care discussions are essential. Prospective studies incorporating quality-of-life outcomes are needed.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126547","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

Response to 'Oral health in cancer palliative care: cross-sectional study'. 对“癌症姑息治疗中的口腔健康：横断面研究”的回应。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-10-01 DOI: 10.1136/spcare-2026-006688

Elizabeth Watts, Marie Hannon, Niamh Cleary

引用次数: 0

The algorithmic palliative medicine clinic prediction, prudence and clinical wisdom. 姑息医学的算法临床预测，审慎和临床智慧。

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-09-30 DOI: 10.1136/spcare-2026-006572

Abel Garcia Abejas

{"title":"The algorithmic palliative medicine clinic prediction, prudence and clinical wisdom.","authors":"Abel Garcia Abejas","doi":"10.1136/spcare-2026-006572","DOIUrl":"https://doi.org/10.1136/spcare-2026-006572","url":null,"abstract":"Background: AI is rapidly transforming palliative care, enabling earlier identification of patients with unmet needs, improving prognostic estimation, recognising symptom trajectories and supporting clinical decision-making. Much of the contemporary debate has focused on predictive accuracy, explainability, transparency and algorithmic bias. These questions are essential, yet they do not reach the deeper philosophical challenge that algorithmic medicine introduces.Aim: This essay examines whether increasingly powerful predictive systems risk obscuring the nature of clinical judgement itself, arguing that prediction and prudence are distinct but complementary forms of rationality.Approach: Drawing on Aristotle's concept of phronesis, Pellegrino's philosophy of medicine and Ricoeur's hermeneutics of practical wisdom, the essay examines how AI expands medicine's predictive capacity without replacing the practical reasoning through which clinicians determine what ought to be done for a particular patient. Predictive knowledge remains ethically incomplete until interpreted within the concrete circumstances of an individual's life, relationships and values.Main argument: Building on these philosophical foundations, the essay proposes an Architecture of Prudence for AI-enabled palliative care. Predictive systems should initiate deliberation rather than replace clinical judgement, preserve interpretative space, support the cultivation of practical wisdom and remain accountable to the relational-temporal dignity articulated in the DiRePal model.Conclusion: The future of palliative care will not be determined solely by the increasing accuracy of algorithms. It will depend on whether healthcare systems remain capable of preserving clinical wisdom as the form of judgement through which predictive knowledge becomes ethically responsible care. AI may change how medicine knows; only practical wisdom can determine how medicine ought to act.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104266","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

Higher education palliative care programmes in Latin America: where do we stand? 拉丁美洲高等教育姑息治疗规划：进展如何？

IF 2.5 4区医学

BMJ Supportive & Palliative Care Pub Date : 2026-09-30 DOI: 10.1136/spcare-2026-006349

José Miguel Gutierrez Mendoza, Miguel Fortin Magaña, Mario López-Saca

{"title":"Higher education palliative care programmes in Latin America: where do we stand?","authors":"José Miguel Gutierrez Mendoza, Miguel Fortin Magaña, Mario López-Saca","doi":"10.1136/spcare-2026-006349","DOIUrl":"10.1136/spcare-2026-006349","url":null,"abstract":"Background: Palliative medicine education is a crucial factor in addressing gaps in the provision of palliative care. In Latin America, the availability of specialised training in palliative medicine is limited. Postgraduate study opportunities are heterogeneous and varied.Aim: The objective of this study is to describe postgraduate education in palliative care in Latin America, focusing on characteristics such as duration, educational format, credits and prerequisites.Methods: We searched online for postgraduate palliative medicine programmes, compared them with the second Latin American Atlas of Palliative Care, qualitatively described and compared existing programmes and verified findings with regional palliative care professionals and educators.Results: About 30% of Latin American countries offer a palliative medicine specialty, and 52% provide higher education programmes (eg, master's or diploma), meaning roughly 63% offer some postgraduate training. However, programme duration and requirements remain highly variable.Conclusions: In recent years, Latin America has seen substantial growth across most measurable indicators of palliative care development. Significant gaps remain in education and access to advanced palliative care training at the local level. The findings of this study aim to support the selection of appropriate training programmes and to guide health policymakers in reducing regional inequalities.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036512","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