BMJ Supportive & Palliative Care最新文献

{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/spcare-2025-005605","DOIUrl":"https://doi.org/10.1136/spcare-2025-005605","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075946","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":"Duloxetine-induced myoclonus and sedation.","authors":"Helen Crispin","doi":"10.1136/spcare-2025-005535","DOIUrl":"https://doi.org/10.1136/spcare-2025-005535","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075943","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":"Acupuncture in obstetrics: delivery room integrative medicine for anxiety and pain.","authors":"Eran Ben-Arye, Tal Biron-Shental, William E Rosa, Noah Samuels, Oz Levy, Yael Keshet, Shunit Armon, Orit Gressel, Reuven Kedar, Aviv Messinger, Revital Lev Ari, Anat Lavie, Neta Atzil, Bosmat Ben Zohar, Cara Ferrer Sokolovski, Ido Solt, Hila Yaffe, Gil Shechter Maor, Moti Levy, Esther Maor-Sagie, Danit Katz Shtern, Gali Stoffman, Reut Ben Ze'ev, Maayan Lahav Sher, Betty Zidenberg, Shlomi Sagi, Elad Schiff","doi":"10.1136/spcare-2025-005512","DOIUrl":"10.1136/spcare-2025-005512","url":null,"abstract":"<p><strong>Objectives: </strong>Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel.</p><p><strong>Methods: </strong>A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding.</p><p><strong>Results: </strong>22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files.</p><p><strong>Conclusions: </strong>Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961597","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":"Blood transfusions in palliative medicine and symptom control in solid tumours.","authors":"Geena Kelly, Claire Kruger, Ita Harnett, Camilla Murtagh","doi":"10.1136/spcare-2025-005406","DOIUrl":"10.1136/spcare-2025-005406","url":null,"abstract":"<p><strong>Introduction: </strong>Fatigue and breathlessness are among the most distressing symptoms for palliative care patients and may be related to underlying anaemia. Red cell concentrate (RCC) transfusion is a common intervention, yet its efficacy in improving these symptoms in palliative populations remains unclear.</p><p><strong>Methods: </strong>This retrospective chart review examined the impact of RCC transfusion on fatigue, breathlessness and functional status in 33 patients admitted to a hospice inpatient unit over 30 months. Symptom and functional scores were assessed pre-transfusion, and at 14 and 30 days post-transfusion, using the Palliative Care Outcomes Collaboration Symptom Assessment Scale, Australian Karnofsky Performance Status (AKPS) and Resource Utilisation Groups-Activities of Daily Living (RUG-ADL) tools.</p><p><strong>Results: </strong>Results showed that fatigue scores improved in 58% of patients, with sustained improvement at 30 days in 36%. A statistically significant reduction in fatigue was observed at 14 days post-transfusion (p=0.02). However, the impact on breathlessness was limited, with only 18% of patients reporting improvement, and no significant changes in mean breathlessness scores over time. Functional status, measured by AKPS and RUG-ADL, declined in 36% and 27% of patients, respectively, likely reflecting the progressive nature of terminal illness.</p><p><strong>Conclusions: </strong>While RCC transfusion demonstrated potential for alleviating fatigue, particularly in the short term, its effects on breathlessness and functional status were limited. The high mortality rate (30% at 30 days) and small sample size highlight the challenges of research in this population. These findings support the role of RCC transfusion in managing fatigue in palliative care, though further prospective studies are warranted.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668632","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":"Serial fascia iliaca blocks for pathological hip fracture pain.","authors":"Adam Christopher Baker","doi":"10.1136/spcare-2025-005514","DOIUrl":"https://doi.org/10.1136/spcare-2025-005514","url":null,"abstract":"<p><p>It is estimated that one in ten palliative care patients may benefit from a peripheral nerve block, and although many hospices have growing links and collaboration with pain colleagues, delays still persist, time our patients may not have. This case report documents serial fascia iliaca blocks performed in a hospice by a palliative care doctor, with significant benefits for a patient's pain and quality of life. It highlights that palliative care doctors may benefit from learning to deliver a handful of specific nerve blocks as part of their training.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075947","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":"Caregivers' impact in heart failure: a cross-sectional study.","authors":"Camilla Lykke, Birgit Jurlander, Per Sjøgren, Geana Paula Kurita, Ann-Dorthe Zwisler, Lene Vibe Høyer, Niels Tønder, Sille Larsen, Inge Eidemak, Ola Ekholm","doi":"10.1136/spcare-2024-005262","DOIUrl":"https://doi.org/10.1136/spcare-2024-005262","url":null,"abstract":"<p><strong>Objectives: </strong>Caregivers play a pivotal role in supporting patients with heart failure (HF). Caregiving may be associated with significant impact on the caregivers' health. This study aimed at exploring the impact of caregiving in relation to self-rated health, anxiety and depression compared with the general Danish population.</p><p><strong>Methods: </strong>A cross-sectional exploratory study was conducted with caregivers of adult patients with HF New York Heart Association (NYHA) II, III and IV from the Department of Cardiology at the North Zealand Hospital in Denmark. Patients with HF were asked to indicate the caregiver ≥18 years to participate. Assessment of caregivers included the Zarit Burden Interview, Patient Health Questionnaire-4 and the 36-item Short-Form Health Survey.</p><p><strong>Results: </strong>Of 127 included caregivers, 119 completed the questionnaire (96 women). The mean age was 67 years (range 28-87 years). Overall, 31% of caregivers found caregiving burdensome. The heaviest burden was found in caregivers of patients with the highest symptom burden and NYHA class (p=0.005). Caregivers had 1.63 (95% CI: 1.00 to 2.66) times higher odds of reporting signs of anxiety than individuals in the general population. However, caregivers had 1.88 (95% CI: 1.09 to 3.25) times higher odds of rating their health as good than the general Danish population.</p><p><strong>Conclusions: </strong>Our finding of a higher proportion of caregivers reporting good health compared with the general population is in keeping with other recent studies. However, educational and supportive interventions supporting caregivers in providing care while maintaining their own health should still be considered.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977125","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":"Palliative treatment disparities in metastatic colon cancer: US retrospective cohort study with disaggregated ethnic groups.","authors":"Sruthi Ranganathan, Alessandro Hammond, Urvish Jain, Khushi Kohli, Nishwant Swami, Tej A Patel, Erin Jay G Feliciano, Paul L Nguyen, Kenrick Ng, Edward Christopher Dee, Bhav Jain","doi":"10.1136/spcare-2025-005478","DOIUrl":"https://doi.org/10.1136/spcare-2025-005478","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is important in addressing the needs of patients and their caregivers holistically, particularly where patients are diagnosed with an advanced cancer such as metastatic colon cancer. Racial or ethnic disparities in the receipt of palliative treatment have not been well studied.</p><p><strong>Methods: </strong>Data from the National Cancer Database were used to identify patients with metastatic colon cancer. Patients were categorised into one of the following racial or ethnic groups: White, Black, Southeast Asian, East Asian, South Asian, Native Hawaiian or Other Pacific Islander (NHPI), other Asian and American Indian, Aleutian or Eskimo. The dependent variable was the receipt of palliative treatment, while the independent variable was the patients' racial or ethnic group. Multivariable logistic regressions were performed to derive the adjusted ORs (AOR) and p values.</p><p><strong>Results: </strong>Relative to White patients, patients who identified as Black, Southeast Asian or other Asian were less likely to receive palliative treatment (Black AOR=0.944, 95% CI 0.905 to 0.985, p=0.008; Southeast Asians AOR=0.678, 95% CI 0.553 to 0.830, p<0.001; other Asian AOR=0.781, 95% CI 0.637 to 0.957, p=0.017). However, NHPI patients had greater odds of receiving palliative treatment (NHPI AOR=1.696, 95% CI 1.267 to 2.271, p<0.001).</p><p><strong>Conclusions: </strong>Black, Southeast Asian or other Asian patients had decreased odds of receiving palliative treatment, while NHPI patients had greater odds of receiving palliative treatment, compared with White patients. Further studies are needed to disaggregate reasons behind these disparities in the receipt of palliative treatment.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965966","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":"Acceptance and commitment therapy in metastatic gastrointestinal cancer: patient and caregiver qualitative study.","authors":"Catherine E Mosher, Ashley B Lewson, Miriam Austin-Wright, Marianne S Matthias, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Shelley A Johns","doi":"10.1136/spcare-2025-005548","DOIUrl":"https://doi.org/10.1136/spcare-2025-005548","url":null,"abstract":"<p><strong>Objectives: </strong>Acceptance and commitment therapy (ACT) is a promising behavioural intervention to improve quality of life in patients with advanced cancer and their family caregivers. Little qualitative research has examined the effects of ACT in cancer populations. Thus, this qualitative study examined the perceived impact of ACT, including mindfulness practice and values-based action, on patients with advanced gastrointestinal (GI) cancer and their family caregivers.</p><p><strong>Methods: </strong>Individual, semistructured qualitative interviews were conducted with 13 patients with stage IV GI cancer and 14 family caregivers following their participation in a six-session ACT intervention. Data were analysed using an immersion/crystallisation approach.</p><p><strong>Results: </strong>Most participants identified benefits of ACT that facilitated their adjustment to cancer or caregiving. Patients and caregivers described several effects of mindfulness, including improved management of fatigue and other symptoms, improved emotion regulation skills and an ability to savour the present moment. Some participants reported misperceptions of the purpose of mindfulness, such as emptying the mind of thoughts or relaxing. In addition, engaging in actions based on personal values often led to patient empowerment (eg, renewed sense of purpose in life), improved caregiver self-care and better relationship quality between patients and caregivers.</p><p><strong>Conclusions: </strong>Results raise hypotheses about potential mechanisms and outcomes of ACT interventions that warrant examination. Findings also suggest that enhancing education on mindfulness in ACT interventions may reduce conceptual misunderstandings. Finally, results suggest that a dyadic ACT intervention may improve relationship functioning between family members.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974501","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":"Music therapy in adult hospices: a national multicentre survey.","authors":"Mariagrazia Baroni, Giorgos Tsiris, Annamaria Marzi, Nicola Barbero, Anna Guido, Claudia Murachelli, Tommaso Marvulli, Maria Cristina Nosenzo, Elena Scamuzzi, Filippo Giordano","doi":"10.1136/spcare-2025-005418","DOIUrl":"https://doi.org/10.1136/spcare-2025-005418","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an increased demand for non-pharmacological, complementary therapies and psychosocial provisions in hospices, aimed at creating spaces for communication and personalised expression in response to the bio-psycho-socio-existential needs of patients and their caregivers. As a contemporary evidence-based professional practice, music therapy is an integral part of multidisciplinary teams in many palliative care settings internationally. In Italy, however, music therapy is a developing area of practice facing certain challenges around professionalisation, funding and service development. This study seeks to explore the current state of music therapy in Italian hospices.</p><p><strong>Methods: </strong>From January 2024 to March 2024, an online survey was disseminated to 213 hospices across Italy. The survey consisted of 10 closed-ended questions. Data was analysed using descriptive statistics.</p><p><strong>Results: </strong>A 73.7% completion rate was achieved. Music-based interventions are provided in 49.6% of hospices (n=62), and 43.5% of these offer a music therapy service led by a qualified music therapist. Most hospices (n=17) offer music therapy sessions for 3 hours per week. Across all hospices, sessions are primarily individual and take place in patients' rooms. The presence of caregivers varies, and patients are referred to music therapy by different professionals in the team. Information was gathered regarding the use of music therapy during sedation and for bereavement support of caregivers, along with details on assessment tools used.</p><p><strong>Conclusion: </strong>This study offers an initial overview of music therapy in hospices across Italy and highlights critical questions regarding team integration, training standards, evaluation and funding.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974887","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":"Omeprazole administration via short subcutaneous infusion.","authors":"Ranya Derrick, Cate Seton-Jones","doi":"10.1136/spcare-2025-005561","DOIUrl":"https://doi.org/10.1136/spcare-2025-005561","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981014","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}