The American journal of hospice & palliative care最新文献

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Embracing Inclusivity in Hospice Care: A Case Study in Supporting HIV Patients. 安宁疗护中的包容性:支持艾滋病患者的案例研究。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-19 DOI: 10.1177/10499091241240132
Jeff Clyde G Corpuz
{"title":"Embracing Inclusivity in Hospice Care: A Case Study in Supporting HIV Patients.","authors":"Jeff Clyde G Corpuz","doi":"10.1177/10499091241240132","DOIUrl":"10.1177/10499091241240132","url":null,"abstract":"<p><p>Despite the growing prevalence of human immunodeficiency virus (HIV) and acquired immunodefiency syndrome (AIDS) in the Philippines and the psychosocial challenges it engenders, there remains a dearth of research on the intersection of HIV and hospice care. Stigma and discrimination further compound the challenges of providing inclusive hospice care to HIV patients in the country. Drawing upon the results of a recently published article centered on a Veteran assigned male at birth who expressed a desire for gender reassignment while receiving end-of-life care, this paper highlights the importance of sensitivity, understanding, and affirmation in hospice settings for HIV patients in the Philippines.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"217-218"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Graduate Nurses' Approaches to Death and Dying Patients and the Relationship Between Death Anxiety and Death Awareness: A Cross-Sectional Study. 新毕业护士对待死亡和临终病人的态度以及死亡焦虑和死亡意识之间的关系:一项横断面研究。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-27 DOI: 10.1177/10499091241243196
Merve Tarhan, Pinar Dogan
{"title":"New Graduate Nurses' Approaches to Death and Dying Patients and the Relationship Between Death Anxiety and Death Awareness: A Cross-Sectional Study.","authors":"Merve Tarhan, Pinar Dogan","doi":"10.1177/10499091241243196","DOIUrl":"10.1177/10499091241243196","url":null,"abstract":"<p><strong>Background: </strong>One of the challenges experienced by new graduate nurses during the transition into practice is caring for dying patients. This study aimed to determine new graduate nurses' approaches to death and dying patients and the relationship between death anxiety and death awareness.</p><p><strong>Methods: </strong>This descriptive, cross-sectional study was conducted with 226 new graduate nurses in Istanbul, Türkiye. A personal and work environment characteristics form, the Approach to Death and Dying Patients Attitude Scale, Templer's Death Anxiety Scale, and Multidimensional Mortality Awareness Measure were used to collect data.</p><p><strong>Results: </strong>Hardness in communicating with the dying patients (hardness: meaning difficulty) and their relatives and avoiding death and dying patients were considered moderate, with mean scores of 2.64 ± .63 and 2.45 ± .40, out of 4. Death anxiety accounted for approximately 7% of the variance of hardness in communicating with dying patients and their relatives, which is statistically significant. Death awareness statistically significantly explained 9.7% of avoiding death and dying patients.</p><p><strong>Conclusion: </strong>For new graduate nurses, besides simulation-based training on end-of-life care, approaches to sharing their experiences about death and programs to determine a value system related to death may be recommended.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"155-162"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survey of NCI-Designated Cancer Centers on the Utilization of Palliative Care in Pancreatic Cancer Patients. NCI 指定癌症中心关于胰腺癌患者姑息治疗使用情况的调查。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-28 DOI: 10.1177/10499091241242811
Anjali Goyal, Amir Steinberg
{"title":"Survey of NCI-Designated Cancer Centers on the Utilization of Palliative Care in Pancreatic Cancer Patients.","authors":"Anjali Goyal, Amir Steinberg","doi":"10.1177/10499091241242811","DOIUrl":"10.1177/10499091241242811","url":null,"abstract":"<p><p>Recognized as one of the deadliest cancers, pancreatic cancer underscores an urgent need for palliative care. We surveyed palliative care directors at all 65 National Cancer Institute (NCI) cancer centers to assess the utilization and timing of palliative care involvement in pancreatic cancer patients. 1) Does your palliative care team have a policy to get involved with every pancreatic cancer patient? a. Yes b. No 2) When palliative care is involved with pancreatic cancer patients, in what setting are you typically/primarily first asked to be involved? a. Early in the patient's treatment journey (focusing on symptom management) b. Later in the patient's treatment journey (focusing on end-of-life discussions and explaining hospice) All 65 NCI-designated centers responded, achieving 100% of the targeted sample. Among these centers, 64 lacked a policy for palliative care involvement with every pancreatic cancer patient. Additionally, 38 centers initiated intervention early, focusing on symptom management, while 15 centers started palliative care late in the treatment journey, emphasizing end-of-life discussions. Furthermore, 12 centers initiated intervention both early and late when treating pancreatic cancer. There is an increasing recognition among medical centers of palliative care's necessity for pancreatic cancer, with a rising trend toward early integration. Variation in the timing and emphasis of palliative care involvement remains. Future research should explore barriers to accessing palliative care and compare outcomes of early versus late intervention. By addressing these areas, healthcare providers can potentially improve outcomes for pancreatic cancer patients.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"168-171"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"COVID-19 and the New Hidden Curriculum of Moral Injury and Compassion Fatigue". "COVID-19 与道德伤害和同情疲劳的新隐藏课程"。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-05-20 DOI: 10.1177/10499091241253283
Ishani Joshi, Rachel Zemel
{"title":"\"COVID-19 and the New Hidden Curriculum of Moral Injury and Compassion Fatigue\".","authors":"Ishani Joshi, Rachel Zemel","doi":"10.1177/10499091241253283","DOIUrl":"10.1177/10499091241253283","url":null,"abstract":"<p><p>Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Repeated Filling of Elastomeric Pumps for Home-Based Subcutaneous Infusions: A Cost Analysis of 240 Devices. 用于家庭皮下输液的弹性泵的重复灌注:240 台设备的成本分析。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-20 DOI: 10.1177/10499091241239929
Carolina Simões, Miguel Julião, Patrícia Calaveiras, Elisabeth Costa, Eduardo Bruera
{"title":"Repeated Filling of Elastomeric Pumps for Home-Based Subcutaneous Infusions: A Cost Analysis of 240 Devices.","authors":"Carolina Simões, Miguel Julião, Patrícia Calaveiras, Elisabeth Costa, Eduardo Bruera","doi":"10.1177/10499091241239929","DOIUrl":"10.1177/10499091241239929","url":null,"abstract":"<p><strong>Background: </strong>The use of continuous subcutaneous infusion of drugs using the repeated filling of elastomeric infuser pumps (EIP) has gained clinical recognition for palliative care at home. However, to date, there has been a notable absence of research examining the cost implications associated with the repeated EIP filling procedure. We aimed to evaluate the cost associated to the repeated filling of EIP used in a home-based palliative care team.</p><p><strong>Methods: </strong>We conducted an analysis of the cost associated to the repeated filling of 240 EIP (1-day, n = 136; 2-day, n = 102; 7-day, n = 2) (110 patients).</p><p><strong>Results: </strong>The refilling procedure led to a reduction in the utilization of 409 devices, resulting in savings of €4.031. EIP refilling did not result in a decrease in the number of home visits, the duration of each visit, the expenses associated with transportation to patients' residences, or the nurse-to-hour cost.</p><p><strong>Conclusion: </strong>Refilling EIPs reduces costs by reducing the number of devices purchased. No additional cost savings were noted in nursing time, number of home visits and duration, and expenses with transportation. Further cost savings could be realized by training laycarers to refill EIP at home independently. Future research should assess the feasibility of laycarers training programs on performing EIP filling at home.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Survey of Jewish Attitudes and Experiences Relating to End-of-Life Care and the "Right to Die". 犹太人对临终关怀和 "死亡权 "的态度和经历调查。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-30 DOI: 10.1177/10499091241242817
Christopher M Moreman, Ayona Chatterjee
{"title":"A Survey of Jewish Attitudes and Experiences Relating to End-of-Life Care and the \"Right to Die\".","authors":"Christopher M Moreman, Ayona Chatterjee","doi":"10.1177/10499091241242817","DOIUrl":"10.1177/10499091241242817","url":null,"abstract":"<p><p>We conducted a survey of Jewish attitudes towards, and experiences with, end-of-life care. Questions fell into three areas: (1) Expectations for Jewish end-of-life care; (2) Experiences with such care; and (3) Attitudes toward the \"right to die.\" Examining denominational differences in belief in, and adherence to, Halakha (Jewish law), we confirm many expectations described in the literature. We find notable nuances in specific areas of need across Jewish denomination, and in terms of acceptance of the withdrawal of life support vs assisted suicide. Care for the nuances of Jewish belief is indicated for effective and satisfying Jewish end-of-life care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"197-206"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Digitally Recording Comfort Observations in the Last Days of Life. 以数字方式记录生命最后几天的舒适观察。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-02-20 DOI: 10.1177/10499091241234859
Eleanor Stewart, Suzanne Ford-Dunn, Steve Bass, Charlotte Ede, Julie Elliott, Debbie Peters, Rita Caputo, Luis Moreira, Emily Savage, Ollie Minton
{"title":"Digitally Recording Comfort Observations in the Last Days of Life.","authors":"Eleanor Stewart, Suzanne Ford-Dunn, Steve Bass, Charlotte Ede, Julie Elliott, Debbie Peters, Rita Caputo, Luis Moreira, Emily Savage, Ollie Minton","doi":"10.1177/10499091241234859","DOIUrl":"10.1177/10499091241234859","url":null,"abstract":"<p><p><b>Background:</b> 37.5% of deaths in our area occur in hospital. There are known high unmet needs of adult patients dying in hospital, this unmet need can be reduced by using an individualised care plan and specialist palliative care review. <b>Intervention:</b> In 2022 UHSussex developed an electronic comfort observation chart and individualised care plan, with a centralised dashboard allowing Palliative Care Teams (SPCT) to view trends, target interventions, and a rolling prospective audit. <b>Results:</b> 3000 patients have had their care supported with electronic comfort observations (e-comfort obs). Over 72% of all deaths in the Trust in the last 3 months have been on e-comfort obs, with 2/3 of all deaths in the first 12 months on e-comfort obs. The average length of time on e-comfort obs is 4 days resulting in 70,000 sets of e-comfort obs recorded since launch. Seven percent of e-comfort obs record moderate or severe symptoms. We have identified benefits to people who are dying, those important to them, ward staff, SPCT and on a systems level. <b>Conclusion:</b> E-comfort obs can be successfully embedded in a large acute Trust. This development should improve quality of end of life care in our hospitals both for individuals and for future patients, through on-going targeted education and intervention. Further work is needed to develop the system further including integrating data from electronic prescribing.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"163-167"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study. 在居家癌症姑息治疗中实施 e-IPOS:一项准实验性试点研究。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-03-19 DOI: 10.1177/10499091241240667
Letteria Consolo, Daniele Rusconi, Stella Colombo, Ilaria Basile, Tiziana Campa, Daniele Pezzera, Salvatore Benenati, Augusto Caraceni, Maura Lusignani
{"title":"Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study.","authors":"Letteria Consolo, Daniele Rusconi, Stella Colombo, Ilaria Basile, Tiziana Campa, Daniele Pezzera, Salvatore Benenati, Augusto Caraceni, Maura Lusignani","doi":"10.1177/10499091241240667","DOIUrl":"10.1177/10499091241240667","url":null,"abstract":"<p><strong>Introduction: </strong>Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation.</p><p><strong>Aim: </strong>To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care.</p><p><strong>Outcomes: </strong>The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients' perceived quality of life.</p><p><strong>Design: </strong>A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks.</p><p><strong>Setting/participants: </strong>Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan.</p><p><strong>Results: </strong>Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions (<i>P</i> < .05) and a decrease in unscheduled visits (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients' perceptions of its use to better understand its clinical benefits.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"186-196"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178548","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}
引用次数: 0
Transitional Changes of Anxiety, Pain and Other Symptoms in Cancer Patients Admitted to a Palliative Care Unit, Evaluated Using the Support Team Assessment Schedule - Japanese Version. 使用 "支持团队评估表 "评估入住姑息治疗病房的癌症患者的焦虑、疼痛和其他症状的过渡性变化--日文版。
The American journal of hospice & palliative care Pub Date : 2025-02-01 Epub Date: 2024-05-15 DOI: 10.1177/10499091241254522
Tetsuya Ito, Emi Tomizawa, Yuki Yano, Dai Akiyama, Haruko Konishi, Kiyozumi Takei, Masahiro Ikeda, Naoko Takahashi, Fumio Shaku
{"title":"Transitional Changes of Anxiety, Pain and Other Symptoms in Cancer Patients Admitted to a Palliative Care Unit, Evaluated Using the Support Team Assessment Schedule - Japanese Version.","authors":"Tetsuya Ito, Emi Tomizawa, Yuki Yano, Dai Akiyama, Haruko Konishi, Kiyozumi Takei, Masahiro Ikeda, Naoko Takahashi, Fumio Shaku","doi":"10.1177/10499091241254522","DOIUrl":"10.1177/10499091241254522","url":null,"abstract":"<p><p><b>Objective:</b> Association between physical symptoms and psychosocial difficulties of cancer patients has been reported widely. Nevertheless, the effects of pain and other symptom control on anxiety in such patients have not been investigated well. We investigated the association of improvement of pain and other symptoms with patient anxiety, and assessed factors associated with improvement of such symptoms. <b>Methods:</b> Data of patients with advanced cancer admitted to a palliative care unit during August 2018 - June 2022 were analyzed retrospectively. Severity of pain, other symptoms, and anxiety was assessed by the Support Team Assessment Schedule Japanese version (STAS-J) administered at admission and after 2 weeks. Patients' physical data, their Palliative Prognostic Index (PPI) at admission, and their overall survival were collected and recorded. <b>Results:</b> Data of 701 patients were analyzed. Improvement of pain or other symptoms after 2 weeks was not associated with the PPI total score or actual survival (<i>P</i> = .105 and .999). Patients with higher anxiety on admission experienced improvement of pain or other symptoms more frequently (<i>P</i> = .005). Worsening of anxiety was observed less in patients who experienced improvement in pain or other symptoms after 2 weeks (<i>P</i> = .027). <b>Conclusion:</b> Pain or other symptoms of patients with advanced cancer was improved irrespective of the general condition indicated with actual survival and prognosis-predictive factors. These findings suggest the importance of pain and other symptoms' improvement and its important roles in the management of patient psychosocial problems such as anxiety.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"172-177"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is Routine Discharge Enough? Needs and Perceptions Regarding Discharge and Readmission of Palliative Care Patients and Caregivers.
The American journal of hospice & palliative care Pub Date : 2025-01-05 DOI: 10.1177/10499091241311222
Aaron A Kuntz, Victoria H Chen, Leena Ambady, Benjamin Osher, Catherine DesRoches
{"title":"Is Routine Discharge Enough? Needs and Perceptions Regarding Discharge and Readmission of Palliative Care Patients and Caregivers.","authors":"Aaron A Kuntz, Victoria H Chen, Leena Ambady, Benjamin Osher, Catherine DesRoches","doi":"10.1177/10499091241311222","DOIUrl":"https://doi.org/10.1177/10499091241311222","url":null,"abstract":"<p><strong>Context: </strong>The hospital discharge process is fraught for patients with serious illness and their caregivers.</p><p><strong>Objectives: </strong>We sought to understand palliative care patient and caregiver concerns regarding the patient-centeredness of the hospital discharge process.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 11 patients receiving palliative care and 4 caregivers. Caregivers were interviewed with patient or alone, for a total of 13 interviews. Interviews were focused on the patient-centeredness of the discharge process, completeness of discharge education, and readmission. Transcripts were analyzed using an inductive approach with open coding.</p><p><strong>Results: </strong>We identified four themes: (i) symptoms, (ii) relationship to illness, (iii) variance in patient-provider alignment, and (iv) discharge readiness, including readmission. Physical and non-physical symptoms were common, though non-pain symptoms were more frequently concerns. Illness understanding and empowerment by the discharge process were low, with participants seeking more information. Alignment varied by provider with closer relationships with bedside nurses and outpatient providers, especially oncologists, than inpatient providers. Readmission was not perceived to be avoidable but was associated with symptom burden. Discharge readiness was mixed; common concerns included lack of clarity regarding next steps and post-discharge services. Up to 40% of participants reported incomplete education on given topics.</p><p><strong>Conclusion: </strong>Our qualitative study of patients and caregivers receiving palliative care identified unmet needs in the discharge process: non-pain symptom burden, gaps in empowerment and illness understanding, and mixed discharge readiness. Relationship to care informs subsequent engagement with care and medical decision-making. Future interventions should focus on strengthening patient and caregiver empowerment and illness understanding.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241311222"},"PeriodicalIF":0.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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