The American journal of hospice & palliative care最新文献_第4页

Non-Pharmacologic Modalities in Hospice Care: The Use of a Rubik's Cube for Anxiety and Depression: A Case Study.

The American journal of hospice & palliative care Pub Date : 2025-03-25 DOI: 10.1177/10499091251330875

David B Brecher, David Anthony Johnson

引用次数: 0

Describing the Impact of Physician End-of-Life Communication Training on Simulated Stress Using a Novel Stress Marker.

The American journal of hospice & palliative care Pub Date : 2025-03-25 DOI: 10.1177/10499091251330279

Amy H J Wolfe, Pamela S Hinds, Adre J du Plessis, Heather Gordish-Dressman, Lamia Soghier

{"title":"Describing the Impact of Physician End-of-Life Communication Training on Simulated Stress Using a Novel Stress Marker.","authors":"Amy H J Wolfe, Pamela S Hinds, Adre J du Plessis, Heather Gordish-Dressman, Lamia Soghier","doi":"10.1177/10499091251330279","DOIUrl":"https://doi.org/10.1177/10499091251330279","url":null,"abstract":"IntroductionEmpathetic end-of-life (EOL) communication is important for high quality pediatric patient and family outcomes. Trainees may have limited exposure and training in caring for patients at EOL which may impact communication-related stress. This study had 2 aims: (1) describe pediatric resident physician EOL exposure and training (2) measure objective and subjective stress during simulated critical communication encounters and the impact of prior communication training/exposures on stress responses.MethodsWe performed a prospective, pilot observational cohort study measuring physician exposure to caring for patients/families at EOL and simulated communication stress. Simulated stress was measured subjectively using the state-trait anxiety inventory (STAI) and objectively using heart rate variability (HRV) during a communication training intervention.Results85.7% (18/21) of residents reported seldom/never caring for patients at EOL and universally felt ill-prepared to provide care. Subjective and objective stress increased when directly communicating with the simulated parent/patient actor compared to baseline in all HRV domains. Residents with limited exposure to patients/families at EOL had a smaller stress response than those who cared for a substantial number.ConclusionsPediatric residents report limited opportunities to communicate with patients/families at EOL, which may impact stress responses when communicating life-altering news to families. Simulated communication encounters can be designed to evoke subjective and objective stress which can be measured using novel technology and may help address limited EOL opportunities.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251330279"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702582","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

Prevention of Acute Hospital Transfers for Long-Term Care Residents at the End of Life.

The American journal of hospice & palliative care Pub Date : 2025-03-24 DOI: 10.1177/10499091251329511

Kirsten Lanpher, Kirsten Brondstater

{"title":"Prevention of Acute Hospital Transfers for Long-Term Care Residents at the End of Life.","authors":"Kirsten Lanpher, Kirsten Brondstater","doi":"10.1177/10499091251329511","DOIUrl":"https://doi.org/10.1177/10499091251329511","url":null,"abstract":"BackgroundLong-term care (LTC) residents continue to be acutely transported to the hospital at the end of life (EOL). This frail and dependent population are known to have multiple chronic conditions with more acute and complex medical care needs, which places them at risk for frequent transfers to the hospital. When these multifactorial events transpire at the EOL, they are deemed inappropriate in terms of patient care and healthcare costs. Yet these costly, unnecessary and burdensome transitions still occur, regardless of adverse clinical outcomes and jeopardizing the quality of EOL care provided to LTC residents.ObjectiveTo highlight the burdensome impact acute hospital transfers have on LTC residents at the EOL with the detriment to quality of life and care, in addition to providing strategies to prevent these unnecessary events.FindingsLong-term care residents are a vulnerable population with advanced comorbidities who often require high acuity care and are subject to preventable transfers to the hospital at the EOL. These disruptions in EOL care cause harm and complications, negatively impacting quality of care. The consequences of these events can be mitigated with early advance care planning to include documentation of EOL care goals, onsite medical clinicians to make critical decisions and provide care within LTC facilities, and adequate staffing with proper palliative and hospice care training.ConclusionImmediate action is needed to advocate for this high risk population and implement interventions to prevent hospital transfers at the EOL, therefore improving quality of care and positively influencing LTC residents' EOL experience.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251329511"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695053","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

Implications for End-of-Life Care: Comparative Analysis of Advance Directives Laws in Taiwan and the United States.

The American journal of hospice & palliative care Pub Date : 2025-03-24 DOI: 10.1177/10499091251328007

Yufang Tu, Yuchi Young, Melissa O'Connor

{"title":"Implications for End-of-Life Care: Comparative Analysis of Advance Directives Laws in Taiwan and the United States.","authors":"Yufang Tu, Yuchi Young, Melissa O'Connor","doi":"10.1177/10499091251328007","DOIUrl":"https://doi.org/10.1177/10499091251328007","url":null,"abstract":"This study explores end-of-life care decisions across cultures by comparing advance directives (ADs) laws in the United States (U.S.) and Taiwan. Specifically, it examines the U.S.'s 1991 Patient Self-Determination Act (PSDA) and Taiwan's 2019 Patient Right to Autonomy Act (PRAA). By analyzing key legal differences and similarities, the study provides insights into improving end-of-life care policies and understanding how legal frameworks shape patient autonomy globally. This review utilized the keywords \"United States or Taiwan,\" \"Patient Self-Determination Act,\" \"Patient Right to Autonomy Act,\" \"advance directives,\" and \"advance care planning,\" with searches restricted to English or Chinese publications since 1991. The analysis shows that both the U.S. and Taiwan view ADs as crucial for healthcare autonomy, enabling individuals to make decisions in advance and allowing healthcare agents to act on their behalf if they become incapacitated. However, ADs laws differ notably in their requirements, scope, completion processes, healthcare agent eligibility, portability, and promotional efforts. In the U.S., while various types of ADs are available (e.g., MOLST, POLST, Five Wishes), stricter regulations are needed to govern interactions between patients and healthcare agents to ensure that healthcare decisions align more closely with patients' preferences. Improving AD portability, particularly in emergencies, through cross-state recognition or digital sharing, is essential. For Taiwan, recommendations include enhancing palliative care practices and expanding ADs to include emotional and spiritual preferences. Integrating psychiatric ADs into Taiwan's PRAA could provide significant benefits. Additionally, reducing the costs associated with advance care planning and increasing AD awareness through active healthcare involvement would further strengthen patient autonomy.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251328007"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702584","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 a Goals-of-Care Communication Priming Intervention Tailored to Outpatient Stroke Survivors: A Pilot Study. 针对门诊脑卒中幸存者实施护理目标沟通引导干预：试点研究。

The American journal of hospice & palliative care Pub Date : 2025-03-23 DOI: 10.1177/10499091251328949

Nauzley C Abedini, Erin K Kross, Ruth A Engelberg, Gigi Garzio, Claire J Creutzfeldt

{"title":"Implementation of a Goals-of-Care Communication Priming Intervention Tailored to Outpatient Stroke Survivors: A Pilot Study.","authors":"Nauzley C Abedini, Erin K Kross, Ruth A Engelberg, Gigi Garzio, Claire J Creutzfeldt","doi":"10.1177/10499091251328949","DOIUrl":"https://doi.org/10.1177/10499091251328949","url":null,"abstract":"Background: Serious illness communication priming guides like the Jumpstart Guide can increase goals-of-care conversations (GOCC), but have not been evaluated in the stroke population. Objectives: To conduct a randomized pilot study evaluating feasibility and acceptability of the Jumpstart Guide adapted for outpatient stroke survivors, their surrogates, and clinicians. Methods: We recruited stroke survivors ≥60 years of age (or their surrogates if patients had communication barriers) at a single academically-affiliated stroke clinic. Patients/surrogates were randomized to intervention (patient/surrogate and clinician received pre-visit Jumpstart Guide) or control arms. We assessed feasibility of participant enrollment, survey completion and extraction of GOCC documentation. We assessed acceptability using patient/surrogate and clinician surveys. Results: We enrolled 15/24 (63%) of eligible patients or surrogates, 8 of which were randomized to the intervention vs 7 to the control arm. Six clinicians were enrolled for the 8 intervention encounters. Patient characteristics in both groups were similar with mean age 74.7 years, 10/15 male, 12/15 white, and 10/15 with acute ischemic stroke. Most patients/surrogates (7/8 intervention vs 7/7 control) and all intervention clinicians completed post-visit surveys. Most intervention participants reported successful pre-visit receipt of the Jumpstart Guide (6/7 patient/surrogates; 6/8 clinicians). Of these, all intervention patients/surrogates and 5/6 clinicians stated they would \"definitely\" or \"probably\" recommend it to others. Two intervention vs no control patients had newly documented GOCC post-visit. Conclusions: Implementation of a stroke-specific Jumpstart guide in an outpatient stroke clinic is feasible and acceptable. A large randomized controlled trial is needed to evaluate its efficacy in improving GOCC.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251328949"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695049","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

Do Automated Reminders Decrease No-Show Visits in an Outpatient Palliative Medicine Clinic?

The American journal of hospice & palliative care Pub Date : 2025-03-23 DOI: 10.1177/10499091251329924

Ruth L Lagman, Renato V Samala, Ahed Makhoul, Kyle Neale, Chirag Patel, Elizabeth Weinstein, Wei Wei, Xiaoying Chen

{"title":"Do Automated Reminders Decrease No-Show Visits in an Outpatient Palliative Medicine Clinic?","authors":"Ruth L Lagman, Renato V Samala, Ahed Makhoul, Kyle Neale, Chirag Patel, Elizabeth Weinstein, Wei Wei, Xiaoying Chen","doi":"10.1177/10499091251329924","DOIUrl":"https://doi.org/10.1177/10499091251329924","url":null,"abstract":"BackgroundIndividuals who do not show up for medical appointments can lead to unfavorable outcomes for both patients and health systems. Automated methods are available to confirm appointments in addition to patient service coordinator (PSC) telephone calls. This study aims to determine the no-show rates for automated methods of confirmation, in-person and virtual visits, and patients living in underserved areas.MethodsData was gathered retrospectively through electronic medical record review. Completed, canceled and no-show visits for in-person and virtual (telehealth) visits from January to June 2023 were collected along with automated and PSC reminders, and whether patients resided within community outreach zones (COZ), areas of healthcare underutilization.ResultsOf 8054 scheduled appointments with 2161 unique patients, there were 4563 (57%) completed, 3036 (38%) canceled, and 455 (6%) no-shows. Overall no-show rate was 6% (CI: 5%-6%). No-show rate for in-person visits was 5% (CI: 4%-6%); 9% (CI: 8%-11%) for virtual visits. Patients who confirmed by PSC telephone call had a significantly higher chance of no-show compared to those who did not confirm by other means (OR 1.57; 95% CI 1.23-2.01; P = 0.0003). Patients living within COZ had a significantly higher chance of no-show compared to patients living outside (OR 1.88; 95% CI 1.51-2.34; P < 0.0001). For virtual appointments, patients living within COZ had a significantly higher chance of no-show compared to patients living outside (OR 1.65; 95% CI 1.11-2.46; P = 0.0141).ConclusionPSC telephone calls, individuals living within COZ and virtual visits had higher no-show rates.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251329924"},"PeriodicalIF":0.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695046","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

Quality Measure Considerations for Pediatric Palliative and End-of-Life Care.

The American journal of hospice & palliative care Pub Date : 2025-03-20 DOI: 10.1177/10499091251326586

Hannah Hommes, Diane Forsyth, April Rowe Neal

{"title":"Quality Measure Considerations for Pediatric Palliative and End-of-Life Care.","authors":"Hannah Hommes, Diane Forsyth, April Rowe Neal","doi":"10.1177/10499091251326586","DOIUrl":"https://doi.org/10.1177/10499091251326586","url":null,"abstract":"There is an emerging need to provide high-quality pediatric palliative care and end-of-life care to children, adolescents, and young adults with life-limiting illnesses. Currently, there are no standardized quality measures supporting pediatric palliative care and end-of-life care patient outcomes. The aim of this literature review was to explore current quality measures utilized in pediatric palliative care and end-of-life care among pediatric patients with life-limiting illnesses within the conceptual framework of Comfort Theory. A comprehensive review of relevant articles resulted in 15 articles that met criteria and were evaluated. Included studies focused on pediatric patients with life-limiting illnesses receiving palliative care or end-of-life care. Articles related to children with acute illness, trauma, or accidental death were excluded. Emergent themes among quality measures were categorized into 7 domains: (a) Alleviation of distressing symptoms, (b) Structures and processes of care, (c) Health care utilization, (d) Location of death and bereavement care, (e) Patient and family experiences, (f) Psychological and spiritual care, and (g) Cultural, ethical, and legal considerations. These domains support the physical, psychospiritual, sociocultural, and environmental contexts of Comfort Theory. Quality measure research, development, and standardization should focus within the 7 domains identified for the promotion of comfort, equity, and accessible care.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251326586"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671959","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

Advance Care Planning Before and After In-Hospital Cardiac Arrest.

The American journal of hospice & palliative care Pub Date : 2025-03-19 DOI: 10.1177/10499091251328019

Alexander Polyak, Phillip Ryan Tacon, Zachary Krom, Oren Friedman, James Mirocha, Yuri Matusov

{"title":"Advance Care Planning Before and After In-Hospital Cardiac Arrest.","authors":"Alexander Polyak, Phillip Ryan Tacon, Zachary Krom, Oren Friedman, James Mirocha, Yuri Matusov","doi":"10.1177/10499091251328019","DOIUrl":"https://doi.org/10.1177/10499091251328019","url":null,"abstract":"Objective: In-hospital cardiac arrest (IHCA) is a common event with high morbidity and mortality. This study seeks to evaluate advance care planning (ACP) among hospitalized patients who experienced IHCA. Design: Single center retrospective cohort study. Measurement and Main Results: The primary objective was to compare whether certain clinical characteristics are associated with a physician's likelihood of having an ACP discussion with patients who subsequently have IHCA. We found that older age, White race, and higher GO-FAR score were associated with increased ACP documentation. In multivariate regression modeling, numerically higher GO-FAR score, ICU patients, hospitalization for ≥7 days, and having a normal mental status were consistently associated with ACP documentation (OR ∼2 for all). There was a persistent trend, significant in some models, to lower likelihood of ACP documentation for non-White patients. Among patients who had predicted low-to-very low likelihood of IHCA survival, most (56%) had no ACP documentation prior to IHCA. Conclusions: We found that the factors associated with an increased likelihood of ACP were age, ICU location, longer LOS prior to IHCA, higher GO-FAR score and normal mental status before IHCA. There was a worrying trend toward lower rates of ACP documentation among non-White patients. The overall rate of completion of ACP was low in patients with poor predicted IHCA outcomes. Ongoing efforts should continue to engage all patients in ACP irrespective of demographics, and there may be a role for utilizing standardized prognostication models to encourage ACP.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251328019"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665686","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

Disparities in End-of-Life Care: A Retrospective Study on Intensive Care Utilization and Advance Care Planning in the Colorado All-Payer Claims Database.

The American journal of hospice & palliative care Pub Date : 2025-03-18 DOI: 10.1177/10499091251327191

Darcy Holladay Ford, Kimberly Landry, Megha Jha, Martha Meyer

{"title":"Disparities in End-of-Life Care: A Retrospective Study on Intensive Care Utilization and Advance Care Planning in the Colorado All-Payer Claims Database.","authors":"Darcy Holladay Ford, Kimberly Landry, Megha Jha, Martha Meyer","doi":"10.1177/10499091251327191","DOIUrl":"https://doi.org/10.1177/10499091251327191","url":null,"abstract":"BackgroundIntensive end-of-life (EOL) care is emotionally and financially burdensome, disproportionally negatively impacting racial and ethnic minorities, rural residents, and lower socioeconomic seniors.ObjectivesTo evaluate the impact of race, ethnicity, and rural residency on EOL Intensive Care Unit (ICU) stays, emergency department (ED) visits, 30-day readmissions, and Advanced Care Planning (ACP) in Colorado residents when controlling for comorbidities.MethodsThis retrospective cohort study analyzed data from the Colorado All-Payer Claims Database for 92,975 severely or chronically ill individuals (2018-2021). It used logistic regression models to evaluate associations between demographic variables and EOL health care utilization outcomes.ResultsICU Stays: Hispanic/Latino, Asian, and Black members had increased ICU stays compared to Whites (Adj. OR: 1.24;1.34;1.28: 95% CI). However, members without ACP and rural residents had lower ICU stays (Adj. OR: 0.67; 0.89: 95% CI). ED Visits: Hispanic/Latino, Asian, Black members, non-dually eligible members (Medicare Fee for Service (MFFS) + Medicaid), and rural residents had increased ED visits (Adj. OR: 1.29; 1.39; 1.19; 1.17; 2.04: 95% CI). Meanwhile, members without ACP or hospice care had lower ED visits (Adj. OR: 0.70; 0.75: 95% CI). 30-day Readmissions: Asian members and rural residents had increased 30-day readmissions (Adjusted OR: 2.42; 1.06: 95% CI). In contrast, those on MFFS and not on Medicaid, members without ACP, and those not in hospice care had decreased 30-day readmissions (Adj. OR: 0.69; 0.47; 0.83: 95% CI).ConclusionEOL racial, geographic, and socioeconomic disparities exist in Colorado, requiring urgent interventions for a more equitable health care system.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251327191"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660176","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

Homelessness and Cancer: A Multi-Site, Mixed Methods Study of Delayed or No Cancer Therapy.

The American journal of hospice & palliative care Pub Date : 2025-03-18 DOI: 10.1177/10499091251325231

Robert J Haemmerle, Kelliann Fee-Schroeder, Lynn Phelan, Aminah Jatoi, Elizabeth Cathcart-Rake

{"title":"Homelessness and Cancer: A Multi-Site, Mixed Methods Study of Delayed or No Cancer Therapy.","authors":"Robert J Haemmerle, Kelliann Fee-Schroeder, Lynn Phelan, Aminah Jatoi, Elizabeth Cathcart-Rake","doi":"10.1177/10499091251325231","DOIUrl":"https://doi.org/10.1177/10499091251325231","url":null,"abstract":"Background: Patients who experience homelessness manifest poor cancer outcomes, often because of treatment delays. Few studies have used mixed methods to learn what happens at the patient and health care staff level to explain these delays. Methods: This single-institution, multi-site study interrogated the entire medical record system (thousands of patients annually) for homelessness and cancer diagnoses from January 1, 2019, through October 10, 2023. Records were abstracted for relevant quantitative and qualitative data; rigorous methods were used to analyze, integrate, and report findings. Results: Forty-three patients with a median age of 58 years (range: 32, 73 years) and 34 (79%) assigned male sex at birth are the focus of this report. The most common cancers include hematologic (n = 8), gastrointestinal (n = 8), and genitourinary (n = 8). Thirty-five patients (81%) initiated cancer therapy, and 27 (63%) manifested treatment delay (>4 weeks post-diagnosis). The median time to cancer therapy was 9 weeks (95% confidence interval: 4.6, 12 weeks). Qualitative themes that explain delays are as follows: (1) logistical challenges in communication between the patient and health care team (\"lack of a cell phone\"); (2) patient reluctance to receive care (\"patient elected to leave Against Medical Advice\"); and (3) medical challenges in providing care (\"he was hospitalized after being found down and hypotensive\"). Conclusions: This study confirms that initiation of cancer therapy is often delayed in patients who experience homelessness. It sheds light on reasons for delay - for example, lack of phone access, an observation which suggests that perhaps provision of a burner phone might help some patients.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251325231"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660180","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