The American journal of hospice & palliative care最新文献

{"title":"Application of Immersive Teaching in the Training of Hospice Care Professionals: A Randomized Clinical Trial.","authors":"Huirong Zhang, Ying Li, Qin Lu, Feng Cao","doi":"10.1177/10499091251357597","DOIUrl":"https://doi.org/10.1177/10499091251357597","url":null,"abstract":"<p><p>ContextHospice care landscape is the stark contrast between developed and developing countries. There is a pressing need to strengthen the construction of hospice care talent teams further and establish corresponding training and development systems. Moreover, the study on the immersive teaching in hospice care training is lacking.BackgroundThis study aimed to investigate the application and responses for immersive teaching in the training of hospice care professionals.MethodsThis was a randomized clinical trial. 48 hospice care professionals participating in training programs from May 2021 to November 2023 were divided into an intervention group and a control group, with 24 participants in each group. Traditional teaching was given to the control group, while traditional teaching methods combined with immersive teaching were given to the intervention group. Both groups' theory, operation, and satisfaction scores were compared.ResultsUnder the teaching modes adopted by both groups, both groups' theoretical and practical operation scores improved. The similar theoretical scores were found between the 2 groups (<i>P</i> > 0.05). However, the operational scores of the intervention group were significantly higher than those of the control group (<i>P</i> < 0.05). The satisfaction and simulated experience satisfaction of the trainees in the intervention group were significantly higher than those in the control group, with statistically significant differences (<i>P</i> < 0.05).ConclusionThe application of immersive teaching in the training of hospice care professionals helps enhance operational ability and simulate experience, and thus improve satisfaction among trainees.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251357597"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556299","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}

{"title":"Pharmacology Update: Suzetrigine: A Novel NaV1.8 Sodium Channel Inhibitor for Acute Pain Management.","authors":"Supriya Peshin, Claudia Villa Celi, Saima Rashid, Asti Rego, Steven J Baumrucker","doi":"10.1177/10499091251353455","DOIUrl":"https://doi.org/10.1177/10499091251353455","url":null,"abstract":"<p><p>Suzetrigine (formerly known as VX-548) is a novel sodium channel inhibitor that selectively targets NaV1.8, a key mediator in pain signal transmission, particularly in peripheral nociceptive neurons. This mechanism distinguishes suzetrigine from traditional opioid therapies, offering an effective alternative for acute pain management without the risks of addiction, sedation, or respiratory depression commonly associated with opioids. This literature review examines the pharmacology, mechanism of action, and clinical efficacy of suzetrigine, with an emphasis on its role in acute pain reduction, safety profile, and emerging clinical applications. Preclinical research on suzetrigine and earlier NaV1.8 inhibitors has demonstrated significant reductions in nociceptive behaviors in animal models of inflammatory and neuropathic pain, with minimal off-target effects on other sodium channels such as NaV1.7 and NaV1.9. Unlike opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), suzetrigine acts by selectively inhibiting NaV1.8 channels, which play a specialized role in pain amplification, while sparing central nervous system pathways. In Phase 2 clinical trials involving patients undergoing bunionectomy and abdominoplasty, suzetrigine achieved significant reductions in postoperative pain compared to placebo and demonstrated analgesic efficacy comparable to hydrocodone/acetaminophen. This review highlights the advantages of suzetrigine over current pain management drugs, particularly its ability to relieve pain without side the unwanted side effects from opioids. Suzetrigine has been well-tolerated in both preclinical and clinical settings, with mild gastrointestinal symptoms reported as the most common adverse effect. Its selective mechanism makes suzetrigine a strong candidate for use in multimodal analgesic regimens, especially in postoperative care or among patients at risk for opioid misuse. In the context of the ongoing opioid crisis, suzetrigine represents a promising advancement in acute pain treatment. However, further research is needed to evaluate its long-term safety and efficacy, especially in chronic pain conditions and in combination with other analgesics. As its clinical use expands, suzetrigine may offer a critical tool for reducing opioid dependency across both acute and long-term pain management strategies.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251353455"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556300","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}

{"title":"Parental Goals of Care for Children With Rare Diseases: A Content Analysis of Pediatric Advance Care Planning Conversations.","authors":"Tamiko Younge, Hailey Moore, Jessica D Thompkins, Maureen E Lyon","doi":"10.1177/10499091251356237","DOIUrl":"https://doi.org/10.1177/10499091251356237","url":null,"abstract":"<p><p>IntroductionCaregivers and surrogate decision makers for children with rare diseases often make complex medical decisions with limited prognostic information specific to their child's disease. This diverse population may share common goals related to their child's future care. Our objective was to describe goals of care as explored through advance care planning conversations among the high-risk and high-need community of families with children with rare diseases.MethodsWe performed inductive content analysis of Respecting Choices Next Steps FAmily CEntered (FACE) pediatric advance care planning conversations to identify themes related to goals of care. Interviews were conducted in the context of beta testing and a randomized control trial of a palliative care and advance care planning intervention for parents of children with rare diseases who cannot participate in medical decision making.ResultsWe analyzed 15 interviews conducted with 19 parents. We identified 13 goals of care themes: <i>maintaining stability, being happy, moving the body, thriving along their own path, reducing interventions, living a long life, curing disease, avoiding complications, connecting with others, having a village, an understanding world, knowing our child,</i> and <i>partnering with our medical team</i>. Families identified goals within 3 to 11 themes (mean = 7).ConclusionsParents of children with rare diseases have a multitude of holistic goals related to their child's care. High-quality advance care planning conversations may help families articulate these goals. Using language expressed by families described here may help healthcare teams and families communicate effectively around treatment plans and goals of care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251356237"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546733","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}

{"title":"Factors Influencing Discharges to Hospice for Patients With Late-Stage Huntington's Disease.","authors":"Amy C Ogilvie, Ryan M Carnahan, Adys Mendizabal, Stephanie Gilbertson-White, Aaron Seaman, Elizabeth Chrischilles, Jordan L Schultz","doi":"10.1177/10499091241274725","DOIUrl":"10.1177/10499091241274725","url":null,"abstract":"<p><p><b>Background:</b> Hospice services for patients with Huntington's disease (HD) are likely beneficial in relieving significant burdens and minimizing costly hospitalizations at the end of life, though there has been little study or clinical guidance on hospice enrollment for patients with HD. <b>Objectives:</b> The primary objective of this study was to identify clinical, sociodemographic, and system-level factors associated with discharges to hospice compared to other dispositions for hospitalized patients with late-stage HD. <b>Methods:</b> These analyses used data from the Nationwide Inpatient Sample between the years 2007 and 2011. Weighted logistic regression with a forward selection approach was performed to identify factors associated with discharge to hospice compared to discharge to home, facility, other locations, and death in hospital. <b>Results:</b> These analyses included 6544 hospitalizations of patients with late-stage HD. There was a significant increasing trend in discharges to hospice over the study period (<i>P</i> < 0.001). After adjustment, multiple clinical, sociodemographic, and system-level variables were identified as being associated with discharges to hospice. Patients with aspiration pneumonia and non-aspiration pneumonias had lower odds of being discharged to hospice compared to dying in the hospital. When comparing to discharges to facilities and home, weight loss and palliative care consultation were associated with greater odds of discharge to hospice. <b>Conclusions:</b> Our findings serve as a foundation for future studies on these factors, and thus help clinician decision-making on when to start advance care planning or end-of-life care for patients with HD. These results also support studies developing hospice referral criteria specific to patients with HD.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"644-652"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020033","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":"Mental Health Service Integration in Hospice Organizations: A National Survey of Hospice Clinicians and Medical Leadership.","authors":"Catherine Lowenthal, Maureen Ekwebelem, Mary E Callahan, Katherine Pike, Samuel Weisblatt, Milagros Silva, Angela L Novas, Amy S Tucci, M Carrington Reid, Daniel Shalev","doi":"10.1177/10499091241233677","DOIUrl":"10.1177/10499091241233677","url":null,"abstract":"<p><p><b>Background:</b> Unmet mental health needs are associated with a range of negative consequences for individuals at the end of life. Despite the high prevalence of mental health needs among individuals enrolled in hospice, there is a paucity of data describing mental health service integration in hospices in the United States. <b>Objectives:</b> 1. To identify patterns of mental health service integration in hospice organizations nationally; 2. To characterize gaps in mental health service delivery in hospice settings as perceived by hospice clinicians and medical leadership. <b>Methods:</b> A cross-sectional survey querying hospice clinicians and hospice medical leadership nationally. <b>Results:</b> A total of 279 surveys were included. Clinically significant mental health symptoms were common among hospice patients; the most frequently encountered symptom groups were depression, anxiety, dementia, and delirium. A minority of hospices maintained relationships with psychiatrists (23%, n = 60), psychiatric nurse practitioners (22%, n = 56), or psychologists (19%, n = 49). Only 38% (n = 99) of respondents were satisfied with their patients' access to services and only 45% (n = 118) were satisfied with the quality of these services. Common limitations to providing adequate mental health services included lack of specialist services, short length of stay for patients, and reluctance of patients to engage in these services. <b>Conclusions:</b> Significant mental health symptoms are common among hospice patients, and hospice organizations perceive these needs are not being met. Further research is needed to better understand the current treatment landscape and design interventions to address these needs.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"665-671"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914374","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":"Frequency and Factors Associated With the Implementation of a Do-Not Resuscitate Order in Patients Admitted for Rehabilitation in a Post-Acute Care Unit: A Retrospective Cohort Study.","authors":"Isabela Maria Alves de Almeida Oliva, João Gabriel Rosa Ramos, Alef Santiago Rezende, Flaviane Ribeiro de Souza, Bruno Prata Martinez","doi":"10.1177/10499091251356593","DOIUrl":"https://doi.org/10.1177/10499091251356593","url":null,"abstract":"<p><p><b>Background:</b> Some patients in the post-acute recovery phase have poor prognosis and may benefit from a palliative care approach. However, little is known about potential gaps regarding palliative care needs in this population. <b>Methods:</b> This is a retrospective cohort of patients transferred from an acute hospital to a post-acute care unit with the aim of rehabilitation. The aim was to analyze factors associated with the implementation of a do-not-resuscitate (DNR) order during hospitalization, as a surrogate of clinical decline and palliative care needs. Multivariate analysis was performed to control for confounders. <b>Results:</b> There were 1143 individuals included in the study, of which 415 (36.3%) had a DNR order instituted during hospitalization. After adjusting for confounders, the following variables were positively associated with DNR implementation: age (OR = 1.06, 95% IC: 1.04-1.07, <i>P</i> < 0.001); use of a tracheostomy (OR = 1.65, 95% IC: 1.08-2.51, <i>P</i> = 0.019) and feeding tube (OR = 1.97, 95% IC: 1.37-2.82, <i>P</i> < 0.001) at admission. Functional improvement, as measured by a positive variation in the functional independence measure (FIM) scale was negatively associated with DNR implementation (OR = 0.94, 95% IC: 0.93-0.95, <i>P</i> < .001). <b>Conclusion:</b> This study contributes to understanding the frequency and factors associated with the need for palliative care in patients admitted for rehabilitation in a post-acute care unit. The identification of factors associated with DNR implementation in post-acute care may improve clinicians' decision-making when transitioning those patients from acute hospitals.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251356593"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532150","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}

{"title":"Does Family Functioning Matter? Understanding the Relationship Between Family Interactions and Depressive Symptoms for Caregivers of Cancer Patients.","authors":"Keisha White Makinde, Kyle A Pitzer, Jacquelyn J Benson, Maysara Mitchell, Debra Parker Oliver, George Demiris, Karla T Washington","doi":"10.1177/10499091241263016","DOIUrl":"10.1177/10499091241263016","url":null,"abstract":"<p><p>BackgroundCaregivers of cancer patients are at increased risk of depression and other health challenges. There is limited understanding of the role of the caregiver's own family members in promoting or discouraging mental wellbeing. Family functioning conceptualizes how family members interact to promote a positive family environment and has the potential to impact caregiver mental health. The purpose of this study is to assess the association between family interactions and depressive symptoms among family caregivers of cancer patients.MethodsSecondary analysis of baseline data from an NIH-funded randomized control trial of family caregivers of cancer patients recruited from academic palliative care clinics at three sites (2 Midwest, 1 East). We tested for an association between caregiver responses to the Family Quality of Life in Dementia-Family Interactions Subscale and Patient-Reported Outcomes Measurement Information System Depression Short Form 8A using a block-wise approach to linear modeling.ResultsA total of 246 caregivers were included in analysis; caregivers were mostly White (82%), not Hispanic or Latina/o (96%), and female (65%), with an average age of 55 years. Overall, participants had high family interactions (mean 57.7, sd 11.7) and an average depressive symptom burden (t-score 52.4, SD 8.57). Family interactions was significantly negatively associated with depressive symptoms (b = -.163, se = .057) when accounting for relevant covariates.ConclusionFamily caregivers with more positive family interactions are likely to have fewer depressive symptoms, suggesting family functioning may play a key role in bolstering family caregiver mental health and wellbeing.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"696-704"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332788","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":"Increasing Awareness and Access to Integrated Behavioral Health and Palliative Care: An Introduction to the American Journal of Hospice and Palliative Medicine's.","authors":"James Gerhart, Michael Hoerger, Stacie Levine, Sean O'Mahony","doi":"10.1177/10499091251321086","DOIUrl":"10.1177/10499091251321086","url":null,"abstract":"<p><p>Mental health symptoms are common in the general population and are overrepresented in patients receiving palliative care and hospice services. This introduction to the special issue on Mental Health in Palliative Care and Hospice highlights the ongoing need for research and training to prepare our palliative care workforce to address the concerns of patients experiencing serious illness and mental health concerns. Multilevel approaches are needed to enhance understanding of mental health needs among people with serious illness. Public health outreach is needed within our communities, targeted support is needed for family caregivers, and structured training for palliative care and hospice clinicians is needed to enhance competent mental health in these settings.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"661-664"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525677","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}

{"title":"Undergraduate Students' Attitudes Towards Medical Assistance in Dying for Mental Illness.","authors":"Stephen Claxton-Oldfield, Emma Mackley","doi":"10.1177/10499091231223713","DOIUrl":"10.1177/10499091231223713","url":null,"abstract":"<p><p>Seventy-one undergraduate students took part in a study examining their attitudes toward medical assistance in dying (MAiD) for mental illness. More than half (52%) of the students did not know that a change to Canada's MAiD law will allow people with a mental illness as their sole underlying condition to request a medically assisted death next spring (ie, March, 2024). Less than a one-third (28%) of the students agreed/strongly agreed with the statement that MAiD should be offered to people receiving treatment for mental illness (42% disagreed/strongly disagreed), and even less (14%) agreed/strongly agreed with the statement that people waiting for treatment for mental illness should be able to access MAiD (71% disagreed/strongly disagreed). In explaining their answers to the second statement, over two-thirds (68%) of the students believed that people who are waiting to be treated for mental illness should receive treatment first, before considering MAiD. In other words, undergoing treatment for mental illness that might work was seen as a better option than dying.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"672-677"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503315","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}

{"title":"Examining the Relationship Between Rural and Urban Clinicians' Familiarity With Patients and Families and Their Comfort With Palliative and End-of-Life Care Communication.","authors":"Brandi Pravecek, Howard Wey, Mary J Isaacson","doi":"10.1177/10499091241265406","DOIUrl":"10.1177/10499091241265406","url":null,"abstract":"<p><p><b>Background:</b> Effective healthcare clinician communication is a key component of quality palliative and end-of-life (PEOL) care. However, communication may be hampered when clinicians are not comfortable initiating these conversations with patients and their families. Clinicians working in rural areas report several barriers to providing palliative care. This study examined the relationship between rural and urban clinicians' reported familiarity with their patients and families end-of-life, their reported comfort in initiating PEOL conversations, and their PEOL care knowledge. <b>Method:</b> This study used a cross-sectional design to examine the relationships between rural and urban clinicians' familiarity, their comfort in PEOL communication, and their PEOL care knowledge. <b>Results:</b> N = 548 rural and urban clinicians participated. Rural clinicians reported greater familiarity, more PEOL knowledge, and more comfort with PEOL communication. Multiple regression analyses of PEOL knowledge showed significant associations in knowledge with older clinicians (<i>P</i> < 0.01) and additional palliative care training (<i>P</i> < 0.01); comfort in PEOL communication had significant associations with more palliative care training (<i>P</i> < 0.01) and opportunities to provide palliative care (<i>P</i> < 0.01). <b>Conclusion:</b> The concept of familiarity is highly complex and poorly understood in relation to PEOL care in both rural and urban settings. Future research is needed to explore how additional training in PEOL care and clinician reported familiarity positively impact patient outcomes by increasing the number of advance directives completed and followed and improved documentation of advance care planning.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"621-628"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753737","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}