Literature Review
All posts tagged with “Research News | Journal Article.”
An authentic learning experience for medical students on conducting a family meeting
11/02/24 at 03:40 AMAn authentic learning experience for medical students on conducting a family meetingAmerican Journal of Hospice and Palliative Care; by Mariana Khawand-Azoulai, Elisse Kavensky, Julia Sanchez, Ileana M Leyva, Corinne Ferrari, Marcio Soares, Khin M Zaw, Maria H van Zuilen; 9/24Medical schools often lack training for serious illness conversations with patients and caregivers. We developed a curriculum in our elective Transitioning to Residency medical student course, focused on end-of-life discussions. This paper provides an overview of the curriculum and outcomes from an advanced preparation assignment and student evaluations.
MAiD in America: A rapid review of medical assistance in dying in the United States and its implications for practice for health care professionals
11/02/24 at 03:35 AMMAiD in America: A rapid review of medical assistance in dying in the United States and its implications for practice for health care professionalsJournal of Hospice and Palliative Nursing; by Kathy Howard Grubbs, Christiana M. Keinath, Sharon E. Bigger; 10/24The evolving legal landscape associated with medical assistance in dying (MAiD) may pose significant challenges for hospice and palliative care professionals. In the United States, 10 states and 1 jurisdiction have passed legislation allowing MAiD. National organizations, such as the Hospice and Palliative Nurses Association, have created position statements to serve as guides to care. Given the clinical and ethical challenges associated with MAiD, a rapid review was conducted to provide current evidence for policymakers, health care professionals, and researchers to use when considering care management and policy initiatives. Using a systematic approach, publications related to MAiD between 2019 and 2024were extracted and synthesized. The review provides definitions of terms that differentiate between MAiD, euthanasia, physician-assisted suicide, medically assisted death of the nonterminal patient, and death with dignity. A total of 23 articles were included in the review and categorized into 4 themes: (1) legal, regulatory, and policy concerns; (2) health care professional experience of MAiD; (3) patient and caregiver experience of and communication about MAiD; and (4) disparate access to MAiD.
Six basic rules of palliative care and their Buddhist counterparts
11/02/24 at 03:30 AMSix basic rules of palliative care and their Buddhist counterpartsAmerican Journal of Hospice and Palliative Medicine; by Jonathan D. Walker, Steven Radwany; 10/24As healthcare workers in palliative care, every day brings its share of awfulness and beauty, suffering and connection, meaning and cynicism. Without a way to support ourselves, we cannot help our patients, let alone one another. But how do we cope? Despite the unpredictability inherent in our work, we can discern certain patterns that offer an approach for dealing with these stressors. These patterns can be summarized into six simple rules of palliative care—rules that are coterminous with the teachings of Buddhism... The Six Rules of Palliative Care we propose are as follows:
Dying or lying? For-profit hospices and end of life care
11/02/24 at 03:25 AMDying or lying? For-profit hospices and end of life careAmerican Economic Review; by Jonathan Gruber, David H. Howard, Jetson Leder-Luis, Theodore L. Caputi; 10/24The Medicare hospice program is intended to provide palliative care to terminal patients, but patients with long stays in hospice are highly profitable, motivating concerns about overuse among the Alzheimer’s and Dementia (ADRD) population in the rapidly growing for-profit sector. We provide the first causal estimates of the effect of for-profit hospice on patient spending using the entry of for-profit hospices over twenty years. We find hospice has saved money for Medicare by offsetting other expensive care among ADRD patients. As a result, policies limiting hospice use including revenue caps and anti-fraud lawsuits are distortionary and deter potentially cost-saving admissions.
Healthcare utilization in pediatric cancer patients near the end-of-life
11/02/24 at 03:20 AMHealthcare utilization in pediatric cancer patients near the end-of-lifeAmerican Journal of Hospice and Palliative Medicine; by James P. Kelly, Daniel V. Runco, James E. Slaven, Jason Z. Niehaus; 10/24Describe the healthcare utilization in the last 60 days of life in pediatric patients with cancer who died at home under hospice care and those that died in the hospital. Patients dying under hospice care spent a median of 44 days at home. Patients dying in the hospital spent a median of 30.5 days in the hospital, 10.5 days in the intensive care unit, and underwent 3.5 procedures requiring anesthesia. 45% of those that died in the hospital were compassionately extubated. Conclusion: For those dying with a cancer diagnosis, hospice care can allow for significant time at home with minimal healthcare while those dying in the hospital do spend a significant time in the hospital.
Living for the moment – How important is it in the end of life?
11/02/24 at 03:15 AMLiving for the moment – How important is it in the end of life?American Journal of Hospice and Palliative Medicine; by Renuka Chintapalli; 10/24This essay investigates the role of present-moment living in end-of-life care, drawing on reflections from a personal patient encounter in a palliative care setting, Mrs. B, a 63-year-old patient with terminal squamous cell lung cancer, whose experience underscores the impact of living with a sense of fulfillment and joy despite a life-limiting diagnosis.
Person-centered care planning for people living with or at risk for multiple chronic conditions
11/02/24 at 03:10 AMPerson-centered care planning for people living with or at risk for multiple chronic conditionsJAMA Network Open; Brittany N. Watson, MD, MPH; Lilly Estenson, MSW; Aimee R. Eden, PhD, MPH; Maya T. Gerstein, DrPH; Maria Torroella Carney, MD; Vonetta M. Dotson, PhD3; Trisha Milnes, AuD, MHA; Arlene S. Bierman, MD, MS; 10/24This qualitative study identified 9 themes for strategies for, as well as facilitators and barriers to implementation of PCCP: (1) suboptimal quality of care; (2) person-centered, goal-concordant care; (3) multidisciplinary team–based care and care coordination; (4) prevention across the life course; (5) digital health solutions; (6) workflow; (7) education and self-management support; (8) payment; and (9) achieving community, health system, and payer goals. These themes identified reforms needed and components of care delivery models to support PCCP.
“I finally feel like I have help. Before, I was completely alone” : A grounded theory of community-based hospice transitions
11/02/24 at 03:05 AM“I finally feel like I have help. Before, I was completely alone” : A grounded theory of community-based hospice transitionsJournal of Hospice and Palliative Nursing; by Catherine M. Mann, Hannah Maciejewski, Suzanne S. Sullivan; 10/24Little is known about community-based transitions to home hospice care... Our results generated an emerging grounded theory of the hospice care transition processes rooted in maintaining personhood and autonomy. There were 5 contemporaneous steps: (1) recognizing futility and pursuing comfort; (2) seeking help and input as health declines; (3) shopping for the right services, overcoming obstacles, and self-referring to hospice care; (4) attending to the business of dying while living; and (5) processing and expressing emotions. Although not central to the care transition process, an additional step was identified that occurred after the transition to hospice care: planning for an uncertain future. The hospice care transition process identified in the study reveals important mechanistic targets for the development of interventions that promote patient-centered hospice care transitions in the home setting.
[Spain] Age-and gender-based social inequalities in palliative care for cancer patients: a systematic literature review
11/02/24 at 03:00 AM[Spain] Age-and gender-based social inequalities in palliative care for cancer patients: a systematic literature reviewFrontiers in Public Health; Marina Rodríguez-Gómez, Guadalupe Pastor-Moreno, Isabel Ruiz-Pérez, Vicenta Escribà-Agüir, Vivian Benítez-Hidalgo; 9/24Cancer is a major public health problem worldwide, given its magnitude and growing burden, in addition to the repercussions on health and quality of life. Palliative care can play an important role improving quality of life and it is cost-effective, but some population groups may not benefit from it or benefit less based on age and gender inequalities. This review reveals difficulties for older persons and men for access to key elements of palliative care and highlights the need to tackle access barriers for the most vulnerable population groups. Innovative collaborative services based around patient, family and wider community are needed to ensure optimal care.
Leading causes of death in the US, 2019-2023
11/02/24 at 03:00 AMLeading causes of death in the US, 2019-2023JAMA Network; by Farida B. Ahmad, Jodi A. Cisewski, Robert N. Anderson; 8/8/24The annual mortality burden, the causes of mortality, and the changes over time are key indicators of population change. In the US, mortality statistics are derived from death certificate data from the National Center for Health Statistics National Vital Statistics System. These data provide both the annual mortality burden in numbers and by cause of death. Herein, we summarize the key findings from the newly released report from the National Center for Health Statistics on the leading causes of death in the US from 2019 to 2023. [Top 10 leading causes of death in 2023, which are trended over the past five years, include: heart disease, cancer, unintentional injuries / COVID-19, chronic lower respiratory diseases, stroke, Alzheimer disease, diabetes, kidney disease, influenza and pneumonia, and suicide.]
Perspectives on artificial intelligence–generated responses to patient messages
10/26/24 at 03:55 AMPerspectives on artificial intelligence–generated responses to patient messagesJAMA Network Open; Jiyeong Kim, PhD, MPH; Michael L. Chen, BA; Shawheen J. Rezaei, MPhil; April S. Liang, MD; Susan M. Seav, MD; Sonia Onyeka, MD; Julie J. Lee, MD, MPH; Shivam C. Vedak, MD, MBA; David Mui, MD, MBA; Rayhan A. Lal, MD; Michael A. Pfeffer, MD; Christopher Sharp, MD; Natalie M. Pageler, MD, MEd; Steven M. Asch, MD, MPH; Eleni Linos, MD, DrPH; 10/24Generative artificial intelligence (AI) has the potential to assist clinicians in responding to patients’ messages. Satisfaction was consistently higher with AI-generated responses than with clinicians overall and by specialty. However, satisfaction was not necessarily concordant with the clinician-determined information quality and empathy. For example, satisfaction was highest with AI responses to cardiology questions while information quality and empathy were highest in endocrinology questions. Interestingly, clinicians’ response length was associated with satisfaction while AI’s response length was not. The findings suggest that the extreme brevity of responses could be a factor that lowers satisfaction in patient-clinician communication in EHR.
Virtual reality videos for symptom management in hospice and palliative care
10/26/24 at 03:50 AMVirtual reality videos for symptom management in hospice and palliative careMayo Clinic Proceedings - Digital Health; by James R Deming, Kassie J Dunbar, Joshua F Lueck, Yoonsin Oh; 8/24Nature scenes significantly improved total symptom scores, as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved. Patients with lower functional status tended to have more symptoms beforehand and improve the most.
"Hospice care could be a compassionate choice": ChatGPT responses to questions about decision making in advanced cancer
10/26/24 at 03:45 AM"Hospice Care Could Be a Compassionate Choice": ChatGPT Responses to Questions About Decision Making in Advanced CancerJournal of Palliative Medicine; by Meghan McDarby, Emily L Mroz, Jessica Hahne, Charlotte D Malling, Brian D Carpenter, Patricia A Parker; 9/24Objective: To examine the content of ChatGPT responses to a hypothetical patient question about decision making in advanced cancer... ChatGPT responses (N= 96) were coded for mentions of: hospice care, palliative care, financial implications of treatment, second opinions, clinical trials, discussing the decision with loved ones, and discussing the decision with care providers... Responses more frequently mentioned clinical trials for vignettes describing 45-year-old patients compared with 65- and 85-year-old patients. When vignettes mentioned a preexisting recommendation for hospice, responses more frequently mentioned seeking a second opinion and hospice care... ChatGPT responses to questions about advanced cancer decision making can be heterogeneous based on demographic and clinical characteristics. Findings underscore the possible impact of this heterogeneity on treatment decision making in patients with cancer.
Ethics roundtable state-erected barriers to end-of-life care
10/26/24 at 03:40 AMEthics roundtable state-erected barriers to end-of-life careAmerican Journal of Hospice and Palliative Medicine; by Saima Rashid, Scott P Broyles, Andrew Wampler, Matthew Stolick, Steven J Baumrucker; 10/24[An interesting ethics case study discussed from physician, spiritual care, legal, and ethics perspectives. Discussion focused on conflicts between healthcare ethics and state law.]
Roles of pediatric surgeons in palliative pediatric oncology
10/26/24 at 03:35 AMRoles of pediatric surgeons in palliative pediatric oncologyPediatric Blood and Cancer; by Hau D Le, Sarah Braungart, Jaime Shalkow-Klincovstein, Nelson Piché; 10/24Pediatric surgeons engaged in oncology will inevitably treat patients receiving palliative care, but their role in this context is poorly described. This article identifies some of the challenges and opportunities of surgical involvement in pediatric oncology palliative care, underscoring how the surgeon's expertise can be exploited to significantly benefit children with cancer. Specific examples of skills (procedural, communication, and coordination) that surgeons can provide to the multidisciplinary palliative care teams are described and the importance of collaboration is highlighted.
"Grief explodes all relationships": Experiences of grief and coping among parents and siblings following the death of a child
10/26/24 at 03:30 AM"Grief explodes all relationships": Experiences of grief and coping among parents and siblings following the death of a childOmega (Westport); by Katy A Tenhulzen, Amy M Claridge, Abigail McCarthy, Meredith Craven, Libby Faith McClendon; 10/24The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family... Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium... Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.
Tailoring hospice care to the Veteran population
10/26/24 at 03:25 AMTailoring hospice care to the Veteran populationAmerican Journal of Hospice and Palliative Medicine; by Curtis G Kommer, Autumn Nadolny; 10/24United States Military Veterans are an increasingly elderly population, and more and more veterans are choosing hospice care at the end of life. These veterans, particularly if they served in combat, can bring unique management challenges and opportunities to a hospice team. This review highlights the physical and psychosocial traumas experienced by many veterans, and discusses how these issues can affect their hospice care. Traumatic injury-related issues such as chronic pain, neuropathic pain, insomnia, and chronic headaches can worsen for veterans at the end of life, and the psychological sequelae of these traumatic events such as Post-Traumatic Stress Disorder (PTSD), Chronic Anxiety, Substance Abuse, and increased risk of suicide can also be magnified during this time.
Beyond infection: Mortality and end-of-life care associated with infectious disease consultation in an academic health system
10/26/24 at 03:20 AMBeyond infection: Mortality and end-of-life care associated with infectious disease consultation in an academic health systemClinical Infectious Diseases; by Alison G. C. Smith, Michael E. Yarrington, Rasha Raslan, Wil L. Santivasi, Arthur W. Baker, Nicholas A. Turner, Gary M. Cox, Kristen V. Dicks, John J. Engemann, Patricia Kohler, Ahmad Mourad, Rebekah H. Wrenn, Sofia Zavala, Jason E. Stout; 10/24Infectious diseases (ID) physicians are increasingly faced with the challenge of caring for patients with terminal illnesses or incurable infections. This was a retrospective cohort of all patients with an ID consult within an academic health system from 1 January 2014 through 31 December 2023, including community, general, and transplant ID consult services. There were 60,820 inpatient ID consults involving 37,848 unique patients... In total, [2898] 7.5% of patients receiving an ID consult died during admission and 1006 (2.6%) of patients were discharged to hospice... In total 2866 (7.6%) of all patients receiving ID consultation also received palliative care consultation during the same hospitalization... Patients receiving ID consultation were increasingly complex and more likely to die soon after consultation. These results provide a framework for ID clinicians to consider their role in end-of-life care.Publisher's note: How often does your hospice work with infectious disease physicians and patients?
Clinician perspectives on palliative care for older adults with serious mental illnesses: A multisite qualitative study
10/26/24 at 03:15 AMClinician perspectives on palliative care for older adults with serious mental illnesses: A multisite qualitative studyThe American Journal of Geriatric Psychiatry; by Daniel Shalev, Maureen Ekwebelem, Lilla Brody, Karolina Sadowska, Sanam Bhatia, Dania Alvarez, Catherine Riffin, M Carrington Reid; 9/24Approximately 5.5% of the population live with serious mental illnesses (SMI). Older adults with SMI experience a high burden of serious medical illnesses and disparities in advance care planning, symptom management, and caregiver support. The objectives of this study are to explore interdisciplinary clinician perspectives on the palliative care needs of older adults with SMI and serious medical illnesses... Major themes identified were: (1) Current paradigms of palliative care do not meet the needs of patients with SMI; (2) Clinicians are motivated to care for this population but require more training and interdisciplinary practice; (3) There is a need for structural integration of psychiatric and palliative care services. The study underscores the inadequacy of current palliative care models in meeting the unique needs of older adults with SMI. Models of integrated psychiatric and serious illness care and enhanced training are needed to improve the delivery of palliative care. Integrated care models and workforce development at the interface of serious illness care and psychiatric have the potential to improve outcomes for this vulnerable population.
A comprehensive perspective on educational and economic barriers for utilization of palliative radiation therapy in hospice: A narrative review
10/26/24 at 03:10 AMA comprehensive perspective on educational and economic barriers for utilization of palliative radiation therapy in hospice: A narrative reviewAdvances in Radiation Oncology; by Sarah J Hendee, Kareem Fakhoury, Sana D Karam; 10/24Despite the agreed-on efficacy and benefits of palliative radiation therapy (PRT) to alleviate end-of-life complications related to cancer progression, PRT remains an underused treatment in the hospice-care setting. Common barriers for hospice patient use of PRT include educational and economic limitations. This paper discussed these barriers and ways to eliminate them based on previously published interventions.
[Netherlands] The spiritual dimension of parents' experiences caring for a seriously ill child: An interview study
10/26/24 at 03:05 AM[Netherlands] The spiritual dimension of parents' experiences caring for a seriously ill child: An interview studyJournal of Pain and Symptom Management; by Marije A Brouwer, Marijanne Engel, Saskia C C M Teunissen, Carlo Leget, Marijke C Kars; 10/24The spiritual dimension plays a central role in the experiences of parents who care for children with life-threatening conditions, but they receive little support in this dimension, and care needs often go unnoticed. If we want to provide high-quality pediatric palliative care including adequate spiritual support for parents, we should focus on the wide range of their spiritual experiences, and provide support that focuses both on loss of meaning as well as on where parents find growth, joy or meaning.
Mortality and function after widowhood among older adults with dementia, cancer, or organ failure
10/26/24 at 03:05 AMMortality and function after widowhood among older adults with dementia, cancer, or organ failureJAMA Network Open; Rebecca Rodin, MD, MSc; Alexander K. Smith, MD, MS, MPH; Edie Espejo, MPH; Siqi Gan, MPH; W. John Boscardin, PhD; Lauren J. Hunt, PhD, RN; Katherine A. Ornstein, PhD, MPH; R. Sean Morrison, MD; 9/24In this cohort study including 13,824 participants in the Health and Retirement Study, widowhood was associated with functional decline and increased 1-year mortality in functionally impaired older adults with dementia and cancer. The study findings suggest that older adults with functional impairment and cancer or dementia are at risk of adverse outcomes following widowhood, including functional decline and a marked elevation in the risk of death, in the year after widowhood.
[UK] Symptom management for people with advanced dementia who are receiving end of life care
10/26/24 at 03:00 AM[UK] Symptom management for people with advanced dementia who are receiving end of life careCurrent Opinion in Supportive and Palliative Care; Maria Drummond , Bridget Johnston; 10/24Recent studies indicate that people with advanced dementia often experience significant unmet palliative care needs, particularly regarding symptom management. Palliative care for people with advanced dementia is currently inadequate due to a lack of tailored interventions, poor symptom management, and disjointed care systems. Enhancing training for caregivers, fostering interdisciplinary collaboration, and focusing on integrated care approaches across home and institutional settings are crucial to improving quality of life and symptom control for people with advanced dementia.
Patterns of migration following dementia diagnosis
10/26/24 at 03:00 AMPatterns of migration following dementia diagnosisJAMA Network Open; Momotazur Rahman, PhD; Bishnu Bahadur Thapa, PhD; Christopher Santostefano, MPH, RN; Pedro Gozalo, PhD; Ulrike Muench, RN, PhD; Cyrus M. Kosar, PhD; Hyesung Oh, PhD; Elizabeth White, APRN, PhD; Vincent Mor, PhD; 10/24In this cohort study of more than 1 million Medicare fee-for-service beneficiaries, individuals with a diagnosis of dementia were almost twice as likely to migrate to another county or state compared with those with diagnoses of myocardial infarction, chronic obstructive pulmonary disease, or colon cancer. Of the excess migrations resulting from dementia diagnosis, 55% occurred in community settings, and 45% occurred in institutional settings. The marked increase in migration among patients following a dementia diagnosis highlights a distinctive need for policy and support interventions tailored to their unique migration patterns and care requirements.
Research synthesis related to oncology family caregiver spirituality in palliative care
10/23/24 at 03:00 AMResearch synthesis related to oncology family caregiver spirituality in palliative care Journal of Palliative Medicine; by Betty R. Ferrell, Tami Borneman, Marianna Koczywas, and Paul Galchutt; 10/21/24 online ahead of print Family caregivers are central to the delivery of serious illness care and also have needs related to their role and experience. One aspect of the family caregiver quality of life (QOL) that has received less attention is caregiver spirituality. The research objectives for this analysis were (1) Describe spirituality in oncology family caregivers. (2) Determine the impact of palliative care interventions on spirituality and related variables in oncology family caregivers. (3) Describe findings from the research literature related to spirituality in family caregivers. The authors include two nurse researchers (BF, TB) and a physician (MK) who conducted these studies and a board-certified chaplain (PG) who contributed his expertise in chaplaincy. ... The authors' research synthesis and the literature support the importance of additional research and clinical focus in family caregiver spirituality in serious illness care.