The American journal of hospice & palliative care最新文献

{"title":"Translating Evidence Into Practice: Implementing Caregiver Burden Assessments in Palliative Care Clinic.","authors":"Nasreen Bagwan Malik, Sherief Ghozy, Kitty Fan, Cheryl Green, Denise Mohess","doi":"10.1177/10499091261498169","DOIUrl":"https://doi.org/10.1177/10499091261498169","url":null,"abstract":"<p><p>BackgroundCaregiver burden assessments lack clinical uniformity in palliative care. Existing evidence-based interventions often impose resource demands that are prohibitive for smaller programs.Objectives(1) Demonstrate the practical utility of routine caregiver screening paired with an interdisciplinary team (IDT) response protocol. (2) Identify patient and caregiver factors influencing burden.DesignSetting: Cross-sectional study in a US outpatient palliative care clinic.Measurements: The 12-item Zarit Burden Interview (ZBI-12) was administered by a nurse or social worker. Scores guided immediate, point-of-care IDT interventions.ResultsOf 81 approached caregivers, 74 completed the ZBI-12 (72% female; median age 56). Burden was stratified into mild (n = 37), mild-moderate (n = 22), and high (n = 15) tiers, with median scores increasing significantly (6 vs 16 vs 28; <i>P</i> < 0.001). General counseling was consistent across tiers (∼54%). However, high-intensity supportive interventions rose significantly with burden severity: social work telephone follow-ups increased (0% vs 13.6% vs 33.3%; <i>P</i> < 0.001), support group referrals rose (2.7% vs 31.8% vs 46.7%; <i>P</i> < 0.001), and psychotherapy referrals increased (0% vs 4.5% vs 13.3%; <i>P</i> = 0.030). Multivariable linear regression showed lower patient Palliative Performance Scale (PPS) scores independently predicted higher caregiver burden. Each 10-point decrease in PPS correlated with a 2.4-point increase in total ZBI-12 score (β = -0.240; 95% CI, -0.433 to -0.048; <i>P</i> = 0.015).ConclusionThis workflow provides a replicable roadmap to transition caregivers from \"invisible patients\" to actively supported extensions of the care unit, reinforcing dyadic assessments as standard practice in outpatient palliative medicine.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261498169"},"PeriodicalIF":1.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187219","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":"Emotional Experiences in Grief Over Time and Impact on Existential Dimensions of Life: A Cross-Sectional Study.","authors":"Johanna Skoglund, Stina Nyblom, Ylva Hård Af Segerstad, Daniel Enstedt, Inger Benkel","doi":"10.1177/10499091261496853","DOIUrl":"https://doi.org/10.1177/10499091261496853","url":null,"abstract":"<p><p>BackgroundGrief following the death of a significant other encompasses physical, emotional, cognitive, social, and existential dimensions. Emotions and their expressions serve important adaptive functions and may influence individuals' existential perspectives on life.ObjectiveTo examine emotional experiences over time in the bereavement process and to investigate in what ways bereavement impact grief on existential dimensions of life.MethodsA cross-sectional study was conducted using a web-based questionnaire. A total of 255 bereaved individuals in western Sweden participated, recruited through a bereavement support association and a pensioners' association. Data included self-reported emotions experienced during the past week and perceived changes in existential domains such as meaningfulness, hope, and sense of belonging.ResultsParticipants reported a wide range of negative and positive emotions including sadness, emptiness, sorrow, and melancholy, while positive emotions such as joy, hope, and peace were also present. Emotional patterns were comparable across time since loss, although frequencies declined over time. Unexpected death was associated with higher frequencies of several emotions. Gender differences were observed, particularly in guilt and shame. Participants also reported changes in existential dimensions, including increased meaningfulness, capacity for compassion, and sense of belonging. Emotional expression varies across cultures due to differing norms.ConclusionsGrief involves emotional and existential responses that persist over time. The findings support individualized, non-linear perspectives on grief and indicate that bereavement may impact existential dimensions. Bereavement support may need to be tailored to the circumstances of the death and to individual emotional and existential responses.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261496853"},"PeriodicalIF":1.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187212","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":"Specialist Palliative Care Nurses' Perspectives on Spirituality and Spiritual Care at End of Life - A Quantitative Study.","authors":"Bronagh Dunning, Michael Connolly, Nicholas Nyaaba, Fiona Timmins","doi":"10.1177/10499091261495410","DOIUrl":"https://doi.org/10.1177/10499091261495410","url":null,"abstract":"<p><p>BackgroundSpirituality is an important component of holistic palliative care, but challenges remain regarding its understanding and delivery. Limited quantitative evidence exists regarding specialist palliative care nurses' perspectives in specialist palliative care settings in the Republic of Ireland (ROI).ObjectivesTo explore specialist palliative care nurses' perspectives of spirituality and spiritual care at end of life and examine associated factors.DesignA descriptive correlational, cross-sectional survey design was used.Setting/SubjectsSpecialist palliative care nurses (SPCNs) from inpatient and community services were recruited using non-probability convenience sampling. Data from 123 completed responses were analysed.MeasurementsThe Spirituality and Spiritual Care Rating Scale (SSCRS) was used. Data were analysed using descriptive statistics and multiple regression analysis.ResultsParticipants demonstrated high endorsement of spirituality and spiritual care (median = 4.2, IQR = 0.61). No significant differences were identified between nurses working in inpatient or community settings (<i>P</i> = 1.00). Spiritual needs were most commonly recognised through direct interaction, observation, and listening rather than formal assessment tools. In addition, guidance to spiritual care came from personal and spiritual experience of SPCNs.ConclusionsSpecialist palliative care nurses strongly endorsed spirituality and spiritual care as important aspects of end-of-life practice. Findings suggest that explicit undergraduate education, together with personal and spiritual experience, may strengthen nurses' understanding of spiritual care and should remain a priority within specialist palliative care education.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261495410"},"PeriodicalIF":1.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187217","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":"Family Caregivers of People Living With Glioblastoma Report Low Palliative Care Utilization and Limited Discussions About Palliative Care With Members of the Healthcare Team: A Cross-Sectional Survey Study.","authors":"Lauren Robbins, Anna Vreeling, Samantha Ennis, Elizabeth James, Marlee Wallace, Barbara J Lutz, Laurie A Minns","doi":"10.1177/10499091261498179","DOIUrl":"https://doi.org/10.1177/10499091261498179","url":null,"abstract":"<p><p>BackgroundGlioblastoma is an aggressive, incurable, primary brain cancer associated with substantial symptom burden and reliance on family care partners/caregivers (CP/CG) throughout the illness trajectory. Palliative care can improve symptom management and quality of life for people with serious illness and their families. This study examined CP/CG reported palliative care utilization, understanding of palliative care, and the discussions about palliative care with members of the healthcare team.MethodsA cross-sectional survey was administered between January and February 2024 to adult CP/CG of adults living with glioblastoma recruited through online caregiver support groups. The 38-item survey collected demographic information and caregiver-reported experiences related to palliative care utilization, discussions about palliative care, and supportive care needs. Descriptive statistics and tests of association were performed.ResultsFamily CP/CG (n = 75) reported low involvement of palliative care (28%). A significant association was observed between caregiver-reported discussions about palliative care and utilization of palliative care services (χ² = 34.31, <i>P</i> < .001). Fewer than 10% of CP/CG correctly identified all WHO-defined functions of palliative care. CP/CG also reported unmet supportive care needs, particularly related to physical and emotional support, symptom management, and treatment side effect management.ConclusionsFamily CP/CG of people living with glioblastoma reported low utilization of palliative care services, limited discussions about palliative care with members of the healthcare team, and persistent misconceptions regarding its role. These findings highlight opportunities to improve communication about palliative care and strengthen supportive care services for people living with glioblastoma and their caregivers.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261498179"},"PeriodicalIF":1.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171130","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":"Feasibility of a Mindfulness-Based Intervention for Children With High Grade/High Risk Cancer and Their Caregivers: Lessons Learned From a Pilot Randomized Control Trial.","authors":"Taryn Allen, Paige Little, Melissa Baker, Mary Anne Toledo-Tamula, Staci Martin","doi":"10.1177/10499091261496433","DOIUrl":"https://doi.org/10.1177/10499091261496433","url":null,"abstract":"<p><p>BackgroundChildren and young adults diagnosed with a high-grade/relapsed-refractory cancer face a poor prognosis given limited curative options. Recent research has indicated that this population of children and adolescents/young adults (AYAs), alongside their parents, experience elevated stress and poorer health-related quality of life (HRQoL) relative to normative samples. Despite this, minimal research has examined supportive care interventions for these populations. The primary objective of this pilot study was to assess the feasibility (primary outcome) and acceptability of an 8-week mindfulness-based intervention (MBI) in this population.MethodsEligible participants included individuals aged 5-24 years diagnosed with a high-risk cancer characterized by poor prognosis, with an adult caregiver willing to participate in the parallel caregiver arm. A random number generator was used to assign dyads to the MBI (n = 2 dyads) or psychoeducation control group (n = 3 dyads).ResultsFive dyads (<i>N</i> = 10) enrolled in the study, with 3 dyads completing the intervention. All participants completed measures of feasibility and emotional-behavioral wellbeing at baseline and the study completers responded to follow-up measures after the 8-week intervention. Due to low enrollment, the study was discontinued and results are presented descriptively along with recommendations for future interventions with this population.ConclusionsThis pilot trial of an MBI for children with high-risk cancer and their caregivers demonstrated poor feasibility and highlights challenges in providing supportive care to children with high-risk cancer. The barriers and recommendations are provided to inform future research with this underserved population.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261496433"},"PeriodicalIF":1.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149543","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":"Laboratory Testing at the End of Life in Patients With Cancer: A Systematic Review of Utilization, Costs, Clinical Utility, and Patient Burden.","authors":"Michele Renata Zimolo Varasquim, Alberto Cardoso Martins Lima","doi":"10.1177/10499091261496863","DOIUrl":"https://doi.org/10.1177/10499091261496863","url":null,"abstract":"<p><p>BackgroundLaboratory tests can identify reversible causes of distress near the end of life, but how often they are ordered does not by itself show whether they improve care.ObjectiveTo synthesize evidence on laboratory testing near the end of life in cancer, including utilization, costs, clinical utility, patient burden, and relationships with palliative care and advance care planning.MethodsWe conducted a PRISMA 2020 systematic review registered in PROSPERO (CRD420261493528). PubMed, Virtual Health Library, SciELO, Embase, CINAHL, and Web of Science were searched from database inception through September 8, 2026, supplemented by reference-list and citation tracking. Two reviewers screened studies and resolved disagreements by consensus. Joanna Briggs Institute (JBI) tools informed methodological appraisal, and findings were synthesized narratively.ResultsOf 2667 records, 35 studies reported in 42 publications were included. Reported testing proportions ranged from 68 to 97% across end-of-life settings, although outcome definitions and units of analysis varied. Longitudinal studies in breast and gynecologic cancer showed increasing use as death approached. Associations with palliative care services varied by model and setting, whereas timely advance care planning was more consistently associated with lower utilization. Hospice and palliative models often reported lower laboratory use or costs. Few studies linked test results to management changes, symptom benefit, or patient experience.ConclusionsLaboratory testing is common near the end of life in cancer, but evidence is stronger for patterns of use and cost than for patient benefit. Testing decisions should be guided by a clear clinical question, a plausible effect on management, and the patient's goals of care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261496863"},"PeriodicalIF":1.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172176","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":"Survival Patterns Following Admission to Home-Based Palliative Care for Patients With Cancer: A 10-Year Cohort Study.","authors":"Mônica Isaura Corrêa, Igor de Oliveira Claber Siqueira, Sonia Souza, Eduardo Bruera, Ana Paula Drummond-Lage","doi":"10.1177/10499091261494205","DOIUrl":"https://doi.org/10.1177/10499091261494205","url":null,"abstract":"<p><p>BackgroundSurvival patterns at admission to home-based palliative care (HB-PC) are not well characterized, particularly in low- and middle-income countries (LMICs), where patients are often referred at advanced stages.ObjectivesTo identify population-level predictors of short-term survival and characterize survival patterns at admission to HB-PC in a real-world LMIC cohort.MethodsWe conducted a retrospective cohort study including 471 adult cancer patients enrolled in a public HB-PC program in Brazil between 2013 and 2023. Sociodemographic, clinical, and functional data were extracted from medical records. Overall survival was analyzed using Kaplan-Meier methods and Cox proportional hazards models. Short-term survival (30-180 days) was evaluated using logistic regression. Tumor-specific survival patterns were explored using a decision tree approach.ResultsFunctional status (PPS) and cancer stage were independent predictors of survival. Patients with PPS ≤30 had markedly reduced short-term survival, particularly within the first 30-60 days. Tumor type further stratified survival patterns, with liver and lung cancers associated with poorer outcomes. A simplified model combining PPS and tumor type showed similar performance to more complex models (C-index ∼0.63). Hematologic comorbidities were associated with modestly longer survival.ConclusionSurvival at admission to HB-PC is characterized by substantial heterogeneity, influenced by functional status, cancer stage, and tumor type. Simple, routinely collected variables can capture meaningful differences in population-level outcomes and may inform health service planning in resource-limited settings.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261494205"},"PeriodicalIF":1.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172267","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":"Enhancing Culturally Sensitive Care for Critically Ill Native American Patients and Families: An Educational Initiative and Resource Guide for Nursing and Medical Teams.","authors":"Rachel M Wiste, Valerie DeCora Guimaraes, Cole L Nevel, Teresa Goddard, Caila Rinker, Lindsey Randall, Callina Johnmeyer, Mei-Ean Yeow","doi":"10.1177/10499091261496824","DOIUrl":"https://doi.org/10.1177/10499091261496824","url":null,"abstract":"<p><p>BackgroundNative American (NA) patients experience persistent inequities in advance care planning (ACP) and often present to tertiary centers with critical illness; culturally respectful serious-illness communication is therefore essential in emergency and intensive care settings.InterventionWe developed and implemented a nursing-led, multidisciplinary educational initiative at a large academic medical center serving patients from >50 tribal nations. Informed by a literature review, local practice needs, and expert input from a Native American Patient Experience Ambassador, we created (1) an \"Honoring Your Choices\" (HYC) communication card with culturally sensitive prompts for serious illness conversations and (2) a quick reference guide (QRG) outlining key cultural considerations and unit-specific resources. Tools were disseminated to seven intensive care units and the emergency department through nurse leader engagement, unit rounding, and staff education, and the initiative was presented at departmental Grand Rounds/didactics with pre/post surveys to assess impact.ResultsTwenty-seven pre-session and twenty-four post-session surveys were collected from clinicians and trainees. Prior to the session, >80% of respondents reported being not or only slightly confident discussing end-of-life issues with NA patients/families; post-session surveys demonstrated increased self-reported confidence in recognizing when cultural beliefs may influence care and in conducting end-of-life discussions.ConclusionsThis initiative demonstrates how culturally congruent approaches to serious illness conversations may support more meaningful engagement with NA patients and families. Our experience suggests that developing and evaluating a brief, point-of-care communication tool like <i>Honoring Your Choices</i> may be accomplished with existing interdisciplinary partnerships, offering a practical model that other institutions can readily mirror.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261496824"},"PeriodicalIF":1.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148329","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":"Outcomes of Percutaneous Transhepatic Biliary Drainage in Patients With Malignant Biliary Obstruction Receiving Palliative Care.","authors":"María Angélica Rodríguez-Calderon, Johana Benavides-Cruz, Lina Andrea Mejía-Pérez, Diana Catalina Borda-Restrepo","doi":"10.1177/10499091261495075","DOIUrl":"https://doi.org/10.1177/10499091261495075","url":null,"abstract":"<p><p>IntroductionMalignant biliary obstruction (MBO) is a common complication of advanced hepatopancreaticobiliary cancers, often presenting with jaundice, functional decline, and high symptom burden that significantly impairs quality of life. Percutaneous transhepatic biliary drainage (PTBD) is frequently used to relieve MBO when endoscopic drainage is not feasible, including patients receiving palliative care. However, evidence on clinical outcomes in palliative care populations remains limited.AimTo evaluate short-term clinical outcomes of PTBD in patients with advanced MBO receiving palliative care, focusing on 90-day mortality, clinical success, symptom control, functional status, procedure-related complications, reintervention, and access to chemotherapy.MethodsThis single-cohort, descriptive observational study included patients with MBO who underwent PTBD between 2022 and 2024. Patients were followed for 90 days after the procedure. Functional status was assessed using the Karnofsky Performance Status (KPS), and symptom burden was evaluated using the Edmonton Symptom Assessment System (ESAS).ResultsSeventy-four patients were included (mean age: 65.5 years; 55.4% male). The most frequent malignancies were pancreatic cancer and cholangiocarcinoma. 90 days mortality after the procedure was 74.3%. Clinical success was achieved in 55.4% of cases. Symptomatic relief was observed for pruritus (95%) and pain (89%), although functional decline was noted. Procedure-related complications occurred in 23.0% of patients, and 43.2% required reintervention.ConclusionsPTBD provided symptomatic relief; however, functional status declined and short-term mortality was high, consistent with the advanced disease stage of this cohort. These findings underscore the importance of individualized, comfort-focused decision-making aimed at optimizing symptom control and quality of life in palliative care patients.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261495075"},"PeriodicalIF":1.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140105","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":"Identifying Palliative Care Needs Using the Double Surprise Question: Intuitive Knowledge of General Practitioners in Six European Countries is not Influenced by Their Characteristics. A Vignette Study.","authors":"Carel Veldhoven, Veronie Versteeg, Christina Avgerinou, Guido Biasco, Ewald Bronkhorst, Rabih Chattat, Steffen Eychmueller, Christina Gerlach, Bert Leysen, Maud Maessen, Linda Oostendorp, Giovanni Ottoboni, Henk Schers, Paddy Stone, Christopher Tomlinson, Victoria Vickerstaff, Kris Vissers, Johan Wens, Sofia Zambrano, Nicola White, Yvonne Engels","doi":"10.1177/10499091261489538","DOIUrl":"https://doi.org/10.1177/10499091261489538","url":null,"abstract":"<p><p>IntroductionThe Surprise Question (\"Would I be surprised if this patient were to die in the next 12 months?\") helps to identify patients' who may need palliative care, but its accuracy is limited. Adding a Second Surprise Question (\"Would I be surprised if this patient were still alive after 12 months?\"), together called the Double Surprise Question, appeared promising.AimTo determine which patient - and GP-characteristics influence responses to the Double Surprise Question.DesignA cross-sectional study of participants, who were invited to complete an online survey with 20 case vignettes. Outcome was what characteristics of the vignettes and of the GPs influence the answers to the Double Surprise Question, using the association between the answers and the estimated chance of dying within one year as a reference. One-way ANOVA and multilevel logistic regression were used. Trial registration: NCT03697213.Setting/participantsGPs from six European countries.Results250 GPs completed the survey. GPs were more likely to answer 'yes' to the Second Surprise Question when the estimated chance of dying was higher, the Australian Modified Karnofsky Performance Scale was lower and for patients with cancer compared to organ-failure. GP characteristics did not influence the answer.ConclusionsThis study indicates that the Double Surprise Question is broadly applicable by GPs as no associations were found between measured GP characteristics and responses to the Double Surprise Question. We recommend prospective studies in real-world populations to relate the answers to the Double Surprise Question to actual death to further demonstrate its clinical efficacy.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091261489538"},"PeriodicalIF":1.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140074","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}