The American journal of hospice & palliative care最新文献_第9页

Enhancing the Quality of Hospice Shared Care for End-Stage Malignant Tumor Patients: A Structure-process-outcome Three-Dimensional Quality Evaluation Model. 提高终末期恶性肿瘤患者安宁疗护共享照护品质：结构-过程-结果三维品质评估模型。

The American journal of hospice & palliative care Pub Date : 2025-05-22 DOI: 10.1177/10499091251343216

Han Zhang, Hai-Xia Diao, Qian-Qian Wang

{"title":"Enhancing the Quality of Hospice Shared Care for End-Stage Malignant Tumor Patients: A Structure-process-outcome Three-Dimensional Quality Evaluation Model.","authors":"Han Zhang, Hai-Xia Diao, Qian-Qian Wang","doi":"10.1177/10499091251343216","DOIUrl":"https://doi.org/10.1177/10499091251343216","url":null,"abstract":"Background: The progression of end-stage malignant tumors in patients is irreversible, making high-quality hospice care especially critical. Objective: To evaluate the effectiveness of the hospice shared care guided by the structure-process-outcome three-dimensional quality evaluation model compared to the hospice shared care in patients with end-stage malignant tumors. Design: This study is a single-center, open-label, randomized controlled trial, conducted in the Department of Radiation Oncology at the Second People's Hospital of Wuhu City. Methods: The control group adopted the standard hospice shared care, while the intervention group utilized the hospice shared care guided by the structure-process-outcome three-dimensional quality evaluation model. The quality of life, spiritual well-being, psychological distress, and satisfaction of patients were compared between the two groups. Results: After two and four weeks of intervention, there was a significant improvement in quality of life and spiritual health, along with a notable reduction in psychological distress (P < 0.05). Compared with the control group, patients in the intervention group exhibited significantly better quality of life and mental health status, along with lower psychological distress scores (P < 0.05). The satisfaction rate in the intervention group was significantly higher than that in the control group (97.80% vs 92.31%, P = 0.029). Conclusions: Guided by the three-dimensional quality evaluation model of structure-process-outcome, the hospice shared care can significantly improve the quality of life and spiritual health of patients with end-stage malignant tumors, alleviate psychological distress, and enhance patient satisfaction.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251343216"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129796","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

Intensity of Care at the End-of-Life in Pediatrics: A Single Center Analysis With Implications for Advanced Care Planning in Saudi Arabia. 儿科学临终关怀的强度：沙特阿拉伯高级护理计划的单中心分析。

The American journal of hospice & palliative care Pub Date : 2025-05-19 DOI: 10.1177/10499091251339615

Kim Sadler, Lama Altarifi, Steven Callaghan, Saadiya Khan, Khaled AlGhamdi, Tareq Mohammed Alayed, Raghad Alhuthil, Abdulrahman Amer Alshehri, Maryam A Altassan, Musab Aldhari, Haifaa Hamzah Hussain, Mohammed Baragaa

{"title":"Intensity of Care at the End-of-Life in Pediatrics: A Single Center Analysis With Implications for Advanced Care Planning in Saudi Arabia.","authors":"Kim Sadler, Lama Altarifi, Steven Callaghan, Saadiya Khan, Khaled AlGhamdi, Tareq Mohammed Alayed, Raghad Alhuthil, Abdulrahman Amer Alshehri, Maryam A Altassan, Musab Aldhari, Haifaa Hamzah Hussain, Mohammed Baragaa","doi":"10.1177/10499091251339615","DOIUrl":"https://doi.org/10.1177/10499091251339615","url":null,"abstract":"Background: Advances in medicine have altered the progression of several pediatric disorders. However, this progress also comes with medical, economic, and ethical challenges, which can negatively affect children's quality of life. Objective: This study examines the quality of care of children with malignant and non-malignant conditions at the end of life. Design: A two-year cohort retrospective analysis was conducted. Setting/Subjects: The study included all children who died between December 1, 2021, and December 1, 2023, in a tertiary center in Saudi Arabia. Measurements: Data included. information on children's demographics, medical history, EOL care, and healthcare services utilization. Results: A total of 302 deaths were analyzed, 42% of infants. The most frequent conditions were cardiac diseases (30.1%) and malignancy (20.9%). Two-thirds had a Do-Not-Attempt-Resuscitation (DNAR) (66.6%), with most officialized in the Intensive Care Unit (ICU). Two-thirds had no advanced directives (66.9%). A majority of children died in the ICU (64.6%), with a significant number receiving intensive care until the very end of life. The Palliative Care Team was involved in only 27.9% of cases, with a median of 47 days between referral and death. Conclusion: These findings highlight the paucity of advanced care planning, delays in goals of care discussion at the end of life, and suboptimal use of specialized palliative care resources early in the disease trajectory. These gaps impact children's symptom burden, family psychological distress, and unattained children and families' last wishes.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251339615"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096617","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

Barriers and Practices of Intensivists and Nurses in Family Conferences and Ethical Climate in Intensive Care Units. 重症监护医师和护士在家庭会议中的障碍和实践与重症监护病房的道德氛围。

The American journal of hospice & palliative care Pub Date : 2025-05-15 DOI: 10.1177/10499091251343211

Tetsuharu Kawashima, Kaoru Ashida, Yasuyo Yoshino, Satomi Kinoshita

{"title":"Barriers and Practices of Intensivists and Nurses in Family Conferences and Ethical Climate in Intensive Care Units.","authors":"Tetsuharu Kawashima, Kaoru Ashida, Yasuyo Yoshino, Satomi Kinoshita","doi":"10.1177/10499091251343211","DOIUrl":"https://doi.org/10.1177/10499091251343211","url":null,"abstract":"Introduction: The death of a patient can cause families long-term psychological effects. Providing high-quality family conferences (FCs) and fostering an ethical climate are essential to reduce the psychological burden on patients, families, and health care professionals. Aim: To clarify the barriers and practices regarding FCs and the ethical climate in the intensive care unit (ICU) from the perspectives of intensivists and nurses. Methods: We conducted interviews based on an interview guide and analyzed the narrative data of participants using thematic analysis. Participants were intensivists and nurses working in ICUs in Japan who had experience in ICU practice and were involved in FCs. Results: Core themes of lack of communication, lack of education, climate where it is difficult to speak up, differences in opinion and thinking among intensivists and attending physicians, differences in opinion and thinking among professions and individuals, and ethical dilemma were found as barriers for physicians and nurses in FCs and the ethical climate in the ICU. For FC and ethical climate related practices of intensivists and nurses in the ICU, core themes were facilitating communication, promoting education, understanding and respect for other professions and individuals, and addressing ethical matters. Conclusions: This study enabled us to organize the barriers and practices of intensivists and nurses in FCs and the ethical climate in ICUs. These results allow us to consider interventions to build better FCs and ethical climate in ICUs, which may contribute to reducing the psychological burden on patients, families, and health care professionals.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251343211"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083046","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

Psychosocial Screening by Inpatient Palliative Care Teams: Patient Characteristics and Outcomes. 住院姑息治疗团队的社会心理筛查：患者特征和结果。

The American journal of hospice & palliative care Pub Date : 2025-05-14 DOI: 10.1177/10499091251343213

Chelsea K Brown, Laura A Schoenherr, Steven Z Pantilat, Cara L Wallace, Bridget Sumser, Sarah Peck, David L O'Riordan

{"title":"Psychosocial Screening by Inpatient Palliative Care Teams: Patient Characteristics and Outcomes.","authors":"Chelsea K Brown, Laura A Schoenherr, Steven Z Pantilat, Cara L Wallace, Bridget Sumser, Sarah Peck, David L O'Riordan","doi":"10.1177/10499091251343213","DOIUrl":"https://doi.org/10.1177/10499091251343213","url":null,"abstract":"Context: Palliative care (PC) teams are structured as interprofessional so that patient and caregiver distress can be assessed and treated across all bio-psychosocial-spiritual-cultural domains. The National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care call for all PC team members to be competent at screening patients for psychosocial needs so that urgent referrals can be appropriately triaged to a PC social worker for follow-up assessment and intervention. Objectives: To understand patient characteristics and PC outcomes of hospitalized patients who are screened for psychosocial needs and subsequently receive psychosocial interventions during inpatient PC consultation. Methods: We analyzed data from 44,586 inpatient palliative care consultations by 11 Palliative Care Quality Network (PCQN) teams across various states between 01/01/2017 and 12/31/2021. Results: Overall, 81.5% (n = 36,332) of consults included a screen for psychosocial needs. Of those patients with an identified psychosocial need, (n = 25,661), 91.6% (n = 23,503) received a psychosocial intervention. Patients who spoke Spanish were less likely to receive a psychosocial screen than English-speaking patients (OR = 0.62, CI = 0.54-0.71). Patients who screened positive for a psychosocial need and identified as Hispanic/Latinx were less likely than those who identified as White to receive a follow-up psychosocial intervention (OR = 0.68, 95% CI = 0.57-0.80). Conclusion: 4 out of 5 patients were screened for psychosocial needs. When a psychosocial need was identified, the majority of patients received a follow-up psychosocial intervention. There was disparate delivery of psychosocial care for patients who identify as Hispanic/Latinx and/or Spanish-speaking, indicating a key area for improvement and further exploration.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251343213"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056475","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 Single Academic Site Study of Five Years Evaluating Pharmacy Students' Palliative Care Clinical Reasoning Using Script Concordance Testing. 一项用文字一致性测试评价药学学生姑息治疗临床推理的五年单项学术研究。

The American journal of hospice & palliative care Pub Date : 2025-05-12 DOI: 10.1177/10499091251342625

Florence Labrador, Kyle P Edmonds, Toluwalase A Ajayi, Rabia S Atayee

{"title":"A Single Academic Site Study of Five Years Evaluating Pharmacy Students' Palliative Care Clinical Reasoning Using Script Concordance Testing.","authors":"Florence Labrador, Kyle P Edmonds, Toluwalase A Ajayi, Rabia S Atayee","doi":"10.1177/10499091251342625","DOIUrl":"10.1177/10499091251342625","url":null,"abstract":"Introduction: This study aimed to evaluate the impact of a Pain and Palliative Care elective didactic course on enhancing clinical reasoning skills among Doctor of Pharmacy (PharmD) students using the Script Concordance Test (SCT). As palliative care education becomes increasingly vital in pharmacy training, assessing its effectiveness is essential for curriculum development. Methods: A 5-year prospective study was conducted between 2018 and 2023 at a single academic institution. The elective course was offered six times, covering various palliative care topics such as opioid management, procedural pain, and end-of-life care. A total of 130 third year PharmD candidate students, completed pre- and post-course SCT assessments. The SCT, administered via an online platform, was used to measure clinical reasoning in ambiguous scenarios, with scores compared to a panel of expert responses. Results: The study found a statistically significant improvement in SCT scores from pre- to post-course assessments (P = 0.04), with a mean score increase of 0.09. The 5-year cohort's average score (0.56) outperformed a previous multisite cohort (0.50), although the difference was not statistically significant. Item analysis highlighted areas where students struggled, such as bowel obstruction and CYP interactions, indicating potential areas for curriculum enhancement. Conclusion: This study demonstrates the effectiveness of a targeted palliative care elective in improving clinical reasoning skills among pharmacy students. The findings suggest the need for ongoing curriculum refinement to address specific areas of difficulty and ensure comprehensive palliative care education.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251342625"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016324","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

The Perspectives of Families in Decision-Making Conflicts Related to Palliative Care Patients With Mechanical Ventilation in Taiwan. 台湾安宁疗护机械通气病患决策冲突之家庭观点。

The American journal of hospice & palliative care Pub Date : 2025-05-11 DOI: 10.1177/10499091251341455

Shou-Yu Wang, Li-Wei Lin, Jiun-Long Wang, Chao-Jung Chen

{"title":"The Perspectives of Families in Decision-Making Conflicts Related to Palliative Care Patients With Mechanical Ventilation in Taiwan.","authors":"Shou-Yu Wang, Li-Wei Lin, Jiun-Long Wang, Chao-Jung Chen","doi":"10.1177/10499091251341455","DOIUrl":"10.1177/10499091251341455","url":null,"abstract":"BackgroundFamily members experience decision-making conflicts regarding changes in patient care. If the medical team does not attempt to understand the family members' awareness of palliative care, family members may experience medical decision-making stress and dilemmas. This study examined the decision-making conflicts of the family members of patients dependent on prolonged mechanical ventilator regarding palliative care in Taiwan.MethodsA cross-sectional design was used in this study. Family members of such patients in the subacute respiratory care ward and the respiratory intensive care unit of a medical center in Taiwan were recruited. A structured questionnaire was used to collect data.ResultsAmong the family members of the 127 patients included, 57.5% hesitated to make palliative medical decisions and 61.4% experienced palliative medical decision conflicts. The absence of other chronic diseases, family members' inability to accept the movement of patients to palliative care, and family members' hesitation in palliative care medical decision-making resulted in decision-making conflicts. In this study, 127 prolonged mechanical ventilation-dependent patients (PMVDP) and their family members were examined. The results revealed that family members experienced palliative care medical decision-making difficulties (61.40% = <2.5). Predictors of palliative care decision-making conflict for PMVDP and their family members included the following: absence of other comorbid chronic diseases, the inability of family to accept palliative care on behalf of patients, and hesitation in palliative care medical decision-making by family members.ConclusionThe study results are able to help Taiwanese medical staff in evaluating such conflicts and palliative care medical decisions of PMVDP.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251341455"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060096","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

Self-Care for Psychosocial and Palliative Care Clinicians: Stakeholder-Informed Recommendations for Medical Education and Clinical Training. 心理社会和姑息治疗临床医生的自我保健：利益相关者知情的医学教育和临床培训建议。

The American journal of hospice & palliative care Pub Date : 2025-05-09 DOI: 10.1177/10499091251339745

Greta J Khanna, Timothy S Sannes, Douglas E Brandoff, Jane deLima Thomas, Richard E Leiter, Sue E Morris

{"title":"Self-Care for Psychosocial and Palliative Care Clinicians: Stakeholder-Informed Recommendations for Medical Education and Clinical Training.","authors":"Greta J Khanna, Timothy S Sannes, Douglas E Brandoff, Jane deLima Thomas, Richard E Leiter, Sue E Morris","doi":"10.1177/10499091251339745","DOIUrl":"https://doi.org/10.1177/10499091251339745","url":null,"abstract":"BackgroundDespite overwhelming evidence for work-related stress and burnout, health care clinicians receive little training in self-care.ObjectivesWe explored training and current self-care satisfaction of psychosocial and palliative care clinicians.DesignForty-one psychosocial and palliative care clinicians (18 physicians, 16 social workers, and 7 others [nurse practitioners, psychologists, pharmacists, and physician assistants]) who care for adult oncology patients at a large U.S. academic cancer center, completed an online survey about well-being, including their prior training, current satisfaction, and barriers to self-care.ResultsThis cross-sectional mixed-methods study found that clinicians felt that their graduate training did not prepare them very well to look after themselves in their professional roles (m = 1.71 [SD = 1.25]), where zero corresponded to \"not well at all\" and 4 to \"extremely well.\" Open-ended responses highlighted potential gaps in self-care training: (1) Institutional support; (2) Information and education; (3) Self-care techniques and support; (4) Expectations; and (5) Managing boundaries. Clinicians rated their satisfaction with their current self-care practices as \"moderately satisfied\" (m = 2.10 [SD = 0.92]). Participants also noted barriers to self-care: (1) Time; (2) Competing demands and priorities between work and home; (3) Work culture, including pace and load; (4) Energy, motivation, and awareness; and (5) New methods and tools.ConclusionsThe findings highlight gaps in clinical education and training about self-care practices for health care clinicians, especially for those who care for seriously ill and dying patients. We discuss training implications and propose possible interventions, to strengthen the existing models of self-care for health care clinicians.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251339745"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036361","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

An Analysis of the Clinical Burden and Economic Costs of Venous Thromboembolism During Inpatient Admissions for Pancreatic Cancer in the United States. 美国胰腺癌住院期间静脉血栓栓塞的临床负担和经济成本分析。

The American journal of hospice & palliative care Pub Date : 2025-05-09 DOI: 10.1177/10499091251341453

Osayande Osagiede, Wafa Aldhaleei, Massimo Raimondo, Michael B Wallace, Yan Bi, Frank J Lukens

{"title":"An Analysis of the Clinical Burden and Economic Costs of Venous Thromboembolism During Inpatient Admissions for Pancreatic Cancer in the United States.","authors":"Osayande Osagiede, Wafa Aldhaleei, Massimo Raimondo, Michael B Wallace, Yan Bi, Frank J Lukens","doi":"10.1177/10499091251341453","DOIUrl":"https://doi.org/10.1177/10499091251341453","url":null,"abstract":"Objectives: VTE is a frequent complication of pancreatic cancer, but it is often under-reported. VTE is associated with a shorter overall survival and poor quality of life in ambulatory settings. This study aims to examine the clinical burden and costs of newly diagnosed VTE during inpatient admissions for pancreatic cancer. Methods: We conducted a retrospective study of 108,690 pancreatic cancers using the National Inpatient Sample (NIS) database (January 2016 - December 2020). Patient and hospital characteristics, mortality, discharge disposition, length of stay (LOS), hospital costs and charges were compared between pancreatic cancer patients based on VTE occurrence. Multivariate regression was used to evaluate patient outcomes associated with VTE occurrence. Results: A total number of 4520 (4.2%) patients had VTE. Patients with VTE were more likely to have a high comorbidity index ≥3. Patients with VTE displayed higher odds of prolonged hospitalization, discharge to home hospice, and palliative care use, but no difference in in-hospital deaths. The adjusted additional mean hospital charge and cost were higher in patients with VTE by $10,293 (P < 0.001) and $2966 (P < 0.001), respectively. Conclusions: VTE occurrence during acute hospitalizations for pancreatic cancer is associated with significant morbidity, increased resource utilization and economic burden without additional risk for in-hospital mortality.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251341453"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056472","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

Improving Comfort With Palliative Care Concepts: A Longitudinal Didactic Curriculum for Internal Medicine Residents. 改善姑息治疗概念的舒适度：内科住院医师的纵向教学课程。

The American journal of hospice & palliative care Pub Date : 2025-05-08 DOI: 10.1177/10499091251341810

Michael Petterson, Harini Pallerla, Michelle Atallah, Joshua Jameson

{"title":"Improving Comfort With Palliative Care Concepts: A Longitudinal Didactic Curriculum for Internal Medicine Residents.","authors":"Michael Petterson, Harini Pallerla, Michelle Atallah, Joshua Jameson","doi":"10.1177/10499091251341810","DOIUrl":"https://doi.org/10.1177/10499091251341810","url":null,"abstract":"The steady increase in the number of older, chronically ill patients and resultant need for improved access to palliative care demonstrates the importance of equipping trainees from all medical specialties with essential palliative care skills. There is a specific need for this sort of education among internal medicine providers who manage a broad range of diseases and stages of disease. To improve acumen with palliative care principles, we developed a three-part noontime lecture series for internal medicine interns, the first of its kind at our institution. These lectures equipped trainees with basic understanding of the scope and makeup of a palliative care consult team, and instilled basic palliative care-focused skills in goal-of-care conversations, discussing code status, opioid pain management in the setting of serious illness, hospice, and prognostication. Before each lecture, interns indicated their comfortability in performing certain skills via an online survey with Likert-style responses (1 = not at all comfortable, 5 = very comfortable). At the conclusion, interns were re-administered the online survey and asked to rate their comfort level after the educational intervention. Bivariant and descriptive analysis and effect size tests compared the responses between the pre- and post-lecture surveys. Our results indicated a statistically significant improvement in comfort across almost all domains. These findings suggest that longitudinal curricula in palliative care may be beneficial in equipping internal medicine interns with essential palliative care skills.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251341810"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063790","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

Equity of Access to Palliative Care Through Telehealth: Experience Report. 通过远程医疗公平获得姑息治疗：经验报告。

The American journal of hospice & palliative care Pub Date : 2025-05-08 DOI: 10.1177/10499091251340676

Raquel Prado Thomaz, Mônica Rossatti Molina, Bruno Belo Lima, Desireé Souza Filizzola, Mariana Setanni Grecco, Marcus Vinicius Dutra Zuanazzi, Rafael Saad Fernandez, Soraya Camargo Ito Süffert

{"title":"Equity of Access to Palliative Care Through Telehealth: Experience Report.","authors":"Raquel Prado Thomaz, Mônica Rossatti Molina, Bruno Belo Lima, Desireé Souza Filizzola, Mariana Setanni Grecco, Marcus Vinicius Dutra Zuanazzi, Rafael Saad Fernandez, Soraya Camargo Ito Süffert","doi":"10.1177/10499091251340676","DOIUrl":"https://doi.org/10.1177/10499091251340676","url":null,"abstract":"ObjectiveTo describe the process of conception and articulation of the Care Pathways in Palliative Care in Primary Health Care in the locations served by BP's TeleNordeste project in the interior of the Brazilian Northeast.MethodsExperience report on the process of designing and articulating Care Pathways in Palliative Care for regions far from urban centers in 3 states in Brazil: Alagoas, Maranhão and Piauí, through the TeleNordeste Project of Hospital Beneficência Portuguesa in São Paulo through the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (SUS) in the 2021-2023 period. After pre-operational alignments with health representatives, processes were defined and training was carried out for local teams on the flows and modalities of care available through telehealth, connecting the patient, doctor from the Basic Health Unit and palliative doctor to establish a care plan timely to the needs of patients.ResultsA total 178 teleconsultations were carried out in the specialty of Palliative Care, 124 (69.7%) were teleinterconsultations and 54 (30.3%) were teleconsulting. The median age was 75 years with an interquartile range of 16. Approximately 74,699 miles and 1845 hours of patient time in palliative care were saved. Approximately 29,880 kg of CO2 emissions were avoided.DiscussionThe development of Care Pathways presented an innovative proposal for access to specialized Palliative Care in the SUS, considering the sustainability of the health system and promoting better equity in access to palliative care for regions far from reference centers.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251340676"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032210","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