BMJ Supportive & Palliative Care最新文献_第3页

Music therapy in adult hospices: a national multicentre survey. 成人临终关怀的音乐治疗：一项全国性多中心调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-07 DOI: 10.1136/spcare-2025-005418

Mariagrazia Baroni, Giorgos Tsiris, Annamaria Marzi, Nicola Barbero, Anna Guido, Claudia Murachelli, Tommaso Marvulli, Maria Cristina Nosenzo, Elena Scamuzzi, Filippo Giordano

{"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":"Background: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Omeprazole administration via short subcutaneous infusion. 奥美拉唑短时间皮下输注。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-05 DOI: 10.1136/spcare-2025-005561

Ranya Derrick, Cate Seton-Jones

引用次数: 0

Extracorporeal membrane oxygenation support: palliative care integration - patient experience and quality of life. 体外膜氧合支持：姑息治疗整合-患者体验和生活质量。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-05 DOI: 10.1136/spcare-2025-005503

Bridget H Highet, Kristin Cushenbery, Swapna Sarangi, Anek Jena, Himanshi Banker, Molly Kilpatrick, Maisha Robinson, Pramod K Guru

{"title":"Extracorporeal membrane oxygenation support: palliative care integration - patient experience and quality of life.","authors":"Bridget H Highet, Kristin Cushenbery, Swapna Sarangi, Anek Jena, Himanshi Banker, Molly Kilpatrick, Maisha Robinson, Pramod K Guru","doi":"10.1136/spcare-2025-005503","DOIUrl":"https://doi.org/10.1136/spcare-2025-005503","url":null,"abstract":"Objective: The pattern and timing of palliative care utilisation and end-of-life characteristics in extracorporeal membrane oxygenation (ECMO)-supported patients remain underused. We wanted to share our centre's experience.Methods: This is an institutional review board-approved retrospective study of 45 patients who underwent ECMO at a large ECMO centre in North America between January 2013 and July 2018.Results: Only 28.9% of the ECMO patients received in-hospital palliative care consultation at a median of 18 days (IQR 12-31) after hospitalisation and 10.5 days (IQR 1-28) from ECMO initiation. 1-year mortality was high, with 44% dying during hospitalisation and an additional 13% within the following year. Patients experienced prolonged hospitalisations (median hospital length of stay: 39 days, IQR 19-89) and exhibited high rates of tracheostomy (53%) and renal replacement therapy (60%). Most end-of-life cases involved the withdrawal of life-sustaining therapy during ECMO, yet only 53% had a completed living will.Conclusion: Our study underscores the need for early initiation of palliative care consultation to enhance symptom management, advance care planning, caregiver support and quality of life for ECMO patients and their families.","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":"143979066","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

Information provision in life-threatening illnesses: comprehensive framework. 危及生命疾病的信息提供：综合框架。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2024-005207

Liesbeth M van Vliet, Jonathan Koffman, Eve Namisango, Diah Martina, Daniela Gidaly, Martin Loucka, Anthony L Back, Lucy E Selman, Judith Ac Rietjens, Nicole Plum, Erica Borgstrom, Natashe Lemos Dekker, Sabrina Bajwah, Dwai Banerjee, M A de Meij, Masanori Mori, Fiona Brosig, Justin J Sanders, Annemarie Samuels

{"title":"Information provision in life-threatening illnesses: comprehensive framework.","authors":"Liesbeth M van Vliet, Jonathan Koffman, Eve Namisango, Diah Martina, Daniela Gidaly, Martin Loucka, Anthony L Back, Lucy E Selman, Judith Ac Rietjens, Nicole Plum, Erica Borgstrom, Natashe Lemos Dekker, Sabrina Bajwah, Dwai Banerjee, M A de Meij, Masanori Mori, Fiona Brosig, Justin J Sanders, Annemarie Samuels","doi":"10.1136/spcare-2024-005207","DOIUrl":"https://doi.org/10.1136/spcare-2024-005207","url":null,"abstract":"Background: In life-threatening illnesses, open information provision can benefit patients and families. However, not all patients prefer to have all information. There is a lack of clinical guidance on how to handle patient preferences for non-disclosure.Aim: To develop a conceptual framework and practical guidance for clinicians regarding the spectrum of patients' information provision preferences with a focus on when patients do not desire to have full information.Methods: Multidisciplinary expert stakeholder meeting.Results: 20 expert stakeholders from various disciplines and continents participated in the expert meeting. Based on the qualitative results, a conceptual framework was created. Our framework highlights that information is never value-free but attains value via healthcare provider and patient/family factors, including how information is interpreted by clinicians and patients/families. In this process, ethical and sociocultural tensions can arise, such as between patient and family autonomy, that can influence harmful effects of the attained value of information along several axes such as empowerment versus disempowerment. To mitigate tensions and minimise harm, our framework produces practical guidance for clinicians such as making a connection and having an open attitude.Conclusions: Our framework has clinical, research and policy implications and can be further refined and tested. Ultimately, it serves as a starting point to reduce social and cultural inequities in end-of-life care information in a global context.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971254","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

Occupational therapy-led self-management anxiety and stress programme: a mixed methods evaluation in community palliative medicine. 职业治疗主导的自我管理焦虑和压力计划：社区姑息医学的混合方法评估。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2024-005314

Lauren Boland, Niamh Donnelly, Sarah Delaney, Julie Donohoe, Niamh Keaveny, Hayley Connolly, Deirdre Connolly

{"title":"Occupational therapy-led self-management anxiety and stress programme: a mixed methods evaluation in community palliative medicine.","authors":"Lauren Boland, Niamh Donnelly, Sarah Delaney, Julie Donohoe, Niamh Keaveny, Hayley Connolly, Deirdre Connolly","doi":"10.1136/spcare-2024-005314","DOIUrl":"https://doi.org/10.1136/spcare-2024-005314","url":null,"abstract":"Objectives: A key role of specialist palliative care occupational therapy is to enable patients to self-manage symptoms associated with a life-limiting illness. EMPOWER, a 4-week group programme, provides self-management interventions for stress and anxiety. The aim of this study is to evaluate the EMPOWER programme for community-based specialist palliative care patients.Methods: An action research feasibility study employing a mixed methods approach was undertaken. Self-reporting outcome measures were administered pre-EMPOWER and post-EMPOWER. Qualitative focus groups and feedback forms were completed postintervention. Ethical approval for this study was obtained from the Research Ethics Committee of the service site.Results: Six virtual and five inperson EMPOWER group programmes were facilitated with 33 participants. Twenty-five participants completed the preoutcome and postoutcome measures. Statistically significant improvements in anxiety (p=0.002), occupational performance (p=0.003) and satisfaction (p<0.001) were observed from preintervention to postintervention. Qualitative data analysis identified three main themes: (1) living with symptoms, (2) management of symptoms and (3) programme design and delivery.Conclusion: EMPOWER is considered an acceptable intervention by community-based palliative care patients. Improved understanding of self-management skills to manage anxiety encouraged participants to implement strategies and re-engage in meaningful goals. Recommendations were provided on the programme's design. Further research is required to evaluate the effectiveness of EMPOWER in a larger group of community-based palliative care patients.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062012","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

Crisis pack prescribing in terminal haemorrhage: a national survey of specialist palliative medicine physicians. 危重包处方在晚期出血：专科姑息医学医师的全国调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2025-005370

Grace Kennedy, Niall Manktelow, Ita Harnett, Camilla Murtagh

{"title":"Crisis pack prescribing in terminal haemorrhage: a national survey of specialist palliative medicine physicians.","authors":"Grace Kennedy, Niall Manktelow, Ita Harnett, Camilla Murtagh","doi":"10.1136/spcare-2025-005370","DOIUrl":"10.1136/spcare-2025-005370","url":null,"abstract":"Objectives: To establish practice among senior palliative medicine physicians regarding anticipatory prescribing to manage a terminal haemorrhage.To generate a guideline informed by data collected.Methods: An electronic questionnaire was sent to palliative medicine consultants and specialist registrars in Ireland.Results: The response rate was 50%. All respondents (100%) prescribe crisis packs. The most prescribed medications were morphine and midazolam. Over 95% prescribe medication via the subcutaneous route. Regarding indications for prescribing, about two-thirds of respondents would prescribe for a patient with a head and neck malignancy. Almost two-thirds of respondents do not follow any policy or guideline. The main area of variation is in the dose prescribed for those already on a scheduled opioid and/or benzodiazepine.Conclusions: The proposed guideline is based on the expert opinion of questionnaire respondents. The recommended medications, route of prescription and broad indications for prescribing included in the guideline were based on a clear consensus. Most respondents vary the dose of crisis medication prescribed based on whether the patient is on a baseline anxiolytic/opioid. As the calculations used for dose variation were not consistent between respondents, the most reported calculation, 1/6 of 24-hour dose, is recommended in the guideline.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555908","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

Orthostatic hypotension in pancreatic cancer. 胰腺癌的直立性低血压。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2025-005399

Siwan Seaman, Stephanie Hemmings

引用次数: 0

Medical communication at end-of-life in palliative care units: nationwide bereavement family survey. 临终关怀病房的医疗沟通：全国丧亲家庭调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2025-005530

Isseki Maeda, Masako Shirasaka, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

{"title":"Medical communication at end-of-life in palliative care units: nationwide bereavement family survey.","authors":"Isseki Maeda, Masako Shirasaka, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita","doi":"10.1136/spcare-2025-005530","DOIUrl":"https://doi.org/10.1136/spcare-2025-005530","url":null,"abstract":"Objectives: Communicating prognosis and changes in a patient's condition is essential in patient-centred care. However, little is known about how families experience medical communication during the dying phase. This study aimed to evaluate family members' satisfaction with such communication, identify factors associated with dissatisfaction and explore preferred approaches by healthcare professionals.Methods: A nationwide survey was conducted among bereaved family members of cancer patients who had died in inpatient palliative care units in Japan. The survey collected data on family characteristics, prebereavement conditions and satisfaction with medical communication during the dying phase, rated on a 3-point scale. Preferences regarding healthcare professionals' communication styles and the timing of postdeath discussions were also assessed.Results: Of 527 respondents (response rate: 53%), only 8% reported dissatisfaction with medical communication. Factors associated with dissatisfaction included older age, female sex, poor mental health and higher household income. Families favoured clear and direct communication over indirect approaches and valued receiving information from both physicians and nurses.Conclusions: While most bereaved families were satisfied with medical communication, certain factors contributed to dissatisfaction. Enhancing end-of-life care requires collaboration between physicians and nurses to provide clear information, emotional support and tailored, patient-centred communication.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958413","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

Shifting US location patterns in leukaemia mortality: retrospective analysis. 美国白血病死亡率地区模式的变化：回顾性分析。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2025-005520

Ahmed Sami Raihane, Muhammad Ahmad Nadeem, Ahsan Raza Raja, Arlin A Bustillos, Abdul Rafeh Awan, Mohammed A Quazi, Jibran Ikram, Abdullah Khan, Asad Ullah, Marjan Khan, Abu Baker Sheikh, Amir Humza Sohail

{"title":"Shifting US location patterns in leukaemia mortality: retrospective analysis.","authors":"Ahmed Sami Raihane, Muhammad Ahmad Nadeem, Ahsan Raza Raja, Arlin A Bustillos, Abdul Rafeh Awan, Mohammed A Quazi, Jibran Ikram, Abdullah Khan, Asad Ullah, Marjan Khan, Abu Baker Sheikh, Amir Humza Sohail","doi":"10.1136/spcare-2025-005520","DOIUrl":"https://doi.org/10.1136/spcare-2025-005520","url":null,"abstract":"Objectives: Leukaemia is a haematological malignancy with high mortality, yet end-of-life care patterns remain underexplored. This study analysed trends in the place of death among leukaemia decedents and assessed demographic disparities in end-of-life care.Methods: A retrospective observational study was conducted using the Centres for Disease Control and Prevention's WONDER and National Center for Health Statistics mortality databases (2008-2020). Leukaemia deaths were identified from death certificates, and place of death was categorised as hospice, home, inpatient, nursing home or outpatient/emergency room. Temporal trends were analysed using the Mann-Kendall test, and logistic regression assessed associations between place of death and demographics.Results: Among 295 057 leukaemia-related deaths, inpatient deaths declined from 51% to 37% (τ=-0.872, p<0.001), while home deaths increased from 26% to 40% (τ=0.897, p<0.001). Hospice deaths nearly doubled from 5% to 9% (τ=0.692, p=0.001), and nursing home deaths declined from 11% to 8% (τ=-0.795, p<0.001). No significant trend was observed for outpatient/emergency room deaths. Younger adults (20-34 years) had the highest inpatient death rate (74%), decreasing with age, while home and hospice deaths increased among older adults. Racial disparities were evident, with non-Hispanic black, Hispanic and Asian patients more likely to die in hospitals and less likely to use hospice care than non-Hispanic whites.Conclusions: Leukaemia-related deaths have increasingly shifted from hospitals to home and hospice, reflecting broader palliative care trends. However, racial disparities persist, highlighting the need for targeted interventions to improve equitable access to hospice and home-based palliative care.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954119","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

Vagus nerve and cancer symptom science. 迷走神经与癌症症状科学。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-05-02 DOI: 10.1136/spcare-2025-005483

Aynur Aktas, Dori Beeler, Jake Waldman, Declan Walsh

引用次数: 0