Literature Review

Suicide deaths among adolescent and young adult patients with cancerJAMA Network Open; Koji Matsuo, MD, PhD; Christina J. Duval, BA; Briana A. Nanton, BS; Jennifer A. Yao, BA; Erin Yu, BS; Christian Pino, MD; Jason D. Wright, MD; 11/24The overall cancer incidence among adolescent and young adult (AYA) patients is increasing at an alarming rate in the US largely driven by thyroid cancer. Although cancer mortality continues to decrease among AYA patients, those who survive cancer are at elevated risk for emotional distress, mental health problems, and suicide. Together with the population-level increase in the US suicide death rate, the results of this assessment call for attention focused on the increasing suicide death rate among AYA patients with cancer, particularly male individuals. The proportion of AYA patients with cancer of thyroid, testis, or cutaneous melanoma who had a suicide death was greater than 2%, and they most benefit from a psychosocial and mental health evaluation. Because this study noted that many suicide deaths among these AYA patients with cancer occur years after the cancer diagnosis, long-term care and support for cancer survivors is recommended.

He who is not everyday conquering some fear has not learned the secret of life. ~Ralph Waldo Emerson

The greatest glory in living lies not in never falling, but in rising every time we fall. ~ Nelson Mandela

Goals of surgical interventions in youths receiving palliative careJAMA Network Open; Danielle I. Ellis, MD, MTS; Li Chen, MS; Samara Gordon Wexler, BA; Madeline Avery, MPH; Tommy D. Kim, MD; Amy J. Kaplan, BS; Emanuele Mazzola, PhD; Cassandra Kelleher, MD; Joanne Wolfe, MD, MPH; 11/24In this cohort study of 197 youths receiving palliative care, interventions were performed with goals of helping youths feel better and live longer and for the purposes of diagnosis, cure and repair, and assistive technology more so than for symptom support or as a temporizing measure. Youths with more acute illnesses underwent the most curative and repair interventions (particularly in the early postdiagnosis period), whereas those with more chronic illnesses underwent most of the supportive interventions. These findings suggest that conversations using the proposed framework concerning goals and purposes of surgical intervention may facilitate goal-concordant, high-quality care for youths with serious illness.

Analysis of mortality causes and locations in veterans with ALS: A decade reviewMedical Science Monitor; Meheroz H Rabadi, Kimberly A Russell, Chao Xu; 11/24Amyotrophic lateral sclerosis (ALS) is a motor neuron disease that leads to rapid degeneration of nerves in the brain and spinal cord, with eventual loss of voluntary movements, including breathing. This retrospective study of medical record data from 105 US veterans diagnosed with ALS at the Oklahoma City VA Medical Center between 2010 and 2021 aimed to identify patient demographics, and the causes and places of death for these veterans. This study's findings are that in veterans with ALS, the main cause of death is respiratory disease (failure). The main location of death was the home, with their family members. The all-cause mortality rate among veterans with ALS was 26 times greater than for the general Oklahoma population.

Nurse burnout and patient safety, satisfaction, and quality of care-A systematic review and meta-analysisJAMA Network Open; Lambert Zixin Li, MPhil; Peilin Yang, BS; Sara J. Singer, PhD, MBA; Jeffrey Pfeffer, PhD; Maya B. Mathur, PhD; Tait Shanafelt, MD; 11/24Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. In this systematic review and meta-analysis of 85 studies including 288,581 nurses, nurse burnout was associated with a lower patient safety climate and patient safety grade; more nosocomial infections, patient falls, medication errors, and adverse events; lower patient satisfaction ratings; and lower nurse-assessed quality of care. The associations were consistent across nurse age, sex, work experience, and geography. These findings suggest that systems-level interventions for nurse burnout may improve patient outcomes.

Caregiver policies in the United States: A systematic reviewJournal of Public Health Policy; By Makenna R Green, M Courtney Hughes, Sadia Afrin, Erin VernonIn the United States, there are nearly 53 million informal or unpaid caregivers, many of whom experience mental and physical stress related to their caregiving duties and increased financial responsibility. We identified federal and state informal caregiver support policies authorized by specific legislation along with their key provisions and conducted a systematic review of the academic literature related to quantitative evaluations of these policies... Increased legislation to support informal caregivers may be warranted. The limited academic research examining existing caregiver policies identifies mixed outcomes for caregivers. Prioritizing vulnerable populations in such policy research examining outcomes could help improve caregiver support efforts.

[Netherlands] Electronic health in the palliative care pathway for patients with head and neck cancerJAMA Otolaryngology- Head & Neck Surgery; Boyd N. van den Besselaar, MD; Kira S. van Hof, MD; Aniel Sewnaik, PhD; Robert. J. Baatenburg de Jong, PhD; Marinella P. J. Offerman, PhD; 11/24Head and neck cancer (HNC) generally has a poor prognosis, with more than 40% disease-specific mortality, ... with a median survival of 4 to 5 months. Given the unique nature of HNC, with a wide range of specific cancer-related symptoms, special consideration should be given to end-of-life care. In this quality improvement study, patients and next of kin were satisfied with most aspects of the hybrid palliative care pathway, and remote care seemed to be a promising means of delivery. These insights represent the initial steps toward gaining a deeper understanding of patients’ needs during specific moments in a hybrid palliative trajectory. They may support health care professionals in optimizing personalized and value-based palliative care delivery.

Symptom screening for hospitalized pediatric patients with cancer-A randomized clinical trialJAMA Pediatrics; L. Lee Dupuis, RPh, PhD; Donna L. Johnston, MD; David Dix, MBChB; Sarah McKillop, MD, MSC; Sadie Cook, BA; Nicole Crellin-Parsons, BMSc; Ketan Kulkarni, MD; Serina Patel, MD; Magimairajan lssai Vanan, MD, MPH; Paul Gibson, MD; Dilip Soman, PhD; Susan Kuczynski, HBSc; George A. Tomlinson, PhD; Lillian Sung, MD, PhD; 11/24Pediatric cancer survival outcomes are excellent, but patients often require intensive therapies to achieve a cure. Pediatric patients with cancer experience severely bothersome symptoms during treatment. It was hypothesized that symptom screening and provision of symptom reports to the health care team would reduce symptom burden in pediatric patients with cancer. In this randomized clinical trial, among pediatric patients with cancer admitted to a hospital or seen in a clinic daily for at least 5 days, symptom screening with Symptom Screening in Pediatrics Tool (SSPedi) improved total symptom scores compared to usual care.

Blue Ridge Hospice eyes N. Va. expansion, breaks into preventative care Washington Business Journal; by Sara Gilgor; 11/27/24 Winchester nonprofit Blue Ridge Hospice is heading into 2025 with plans to accelerate its regional expansion - by broadening its services, beefing up its headcount, teaming up with other local health systems and employers, and penetrating new pockets within Northern Virginia. The organization has provided hospice and palliative care in Virginia for patients with terminal illnesses from cancer to dementia for 43 years, only recently breaking into Greater Washington via Loudoun County. But now, increasing demand in the market and challenges within the larger health care landscape have led the business to rethink both its own structure and how it delivers care to the elderly patients it serves, often not until the ends of their lives. That's why the parent organization is rebranding as Blue Ridge Care. Its patients often regret not seeking its help earlier, President and CEO Jason Parsons told me in an interview, so it's repositioning itself to care for patients well before they would ever need hospice. ... Blue Ridge, now with nearly 400 employees, is looking to add another 50 to 60 people - including doctors and nurses - to its headcount in 2025, Parsons told me. And it plans to invest between $3 million and $5 million into next year's expansion, after putting in $10 million over the last two years, he said.

From grief to giving: Volunteer Jules Sebek finds her way to Hospice of the Western Reserve The News-Herald, Ohio; by Jean Bonchak; 11/28/24 After retiring from a lengthy and successful career at a local company, Jules Sebek was inspired by her past positive experiences with Hospice of the Western Reserve to pursue a volunteer position with the agency. ... “I truly get more than I give,” she said. Sebek’s introduction to hospice came about when the agency supported her parents during their end-of-life journeys and also provided care for her husband, who died eight years ago. ... A year after his death, Sebek joined hospice volunteers as a receptionist and found the experience helpful in terms of becoming familiar with the staff and other aspects of the agency. Throughout the years, she has supported a wide range of situations and finds working with married couples particularly relatable because of her own experiences. ... “I can say ‘I know what you’re going through. I’ve been there,’” she said. “If there’s a wedding picture I’ll look at the spouse and ask them to tell me their love story. Their eyes light up.” ... “I’m constantly inspired,” she said. ... Over time she has come to realize that her work with hospice holds significant importance in her life. “I can’t not do it. It’s a calling,” she said.

Hospice staff packs Thanksgiving meals for families Coosa Valley News, Rome, GA; by Staff; 11/27/24 It was a labor of love on Wednesday morning as teammates, volunteers and family members gathered again to provide Thanksgiving meals for families served by Atrium Health Floyd Medical Center Heyman Hospice Care. The meals, made or donated by Hospice teammates, volunteers and family members, included turkey, ham, dressing, mashed potatoes, macaroni and cheese, green beans, sweet potatoes, potato salad and corn. A variety of pies and cakes were baked for dessert. Nearly 150 meals were packed up and delivered personally to the families. Melissa Washington, a social worker with Hospice, once again served as the onsite director as the food boxes were assembled and sent out. She and others were also there late Tuesday night getting things ready. “We can do this!” exclaimed Washington as she encouraged the workers lined up behind tables as the assembly line began its work. Casey Blankenship, program director for Heyman Hospice Care, said the annual event started in the 1990s.