Literature Review

[Philippines] Virtual mourning: How Filipinos utilize Facebook to express grief and seek support – A hermeneutic phenomenological studyMarc Kenneth F. Cabañero, Ma. Teresa Tricia Guison-Bautista; 4/25This study explores how grieving Filipinos use Facebook to cope with loss and seek support, integrating traditional mourning practices with digital expressions of grief. Using a hermeneutic phenomenological approach, in-depth interviews were conducted with ten bereaved Filipinos to examine their online grieving experiences. Thematic analysis identified three key themes: the blending of traditional mourning rituals with Facebook for emotional support, the validation and relief provided by online interactions, and the role of digital mourning in fostering healing. Findings suggest that social media enhances Filipino bereavement practices by strengthening community connections and preserving cultural traditions. The study emphasizes the need for culturally sensitive digital spaces and grief support services that integrate both online and offline mourning.

‘Losing a part of yourself’: How women grieve their close friend’s deathOmega-Journal of Death and Dying; Elizabeth W. Sauber, Karen M. O’Brien; 4/25Friendship provides women with a plethora of benefits, including reduced physiological and psychological distress. Thus, this study qualitatively described the bereavement of seven women who experienced the death of a close woman friend and tested an integrative model predicting prolonged grief and posttraumatic growth with 148 women grieving the death of a close woman friend. Findings from directed content analysis highlighted grief reactions, disenfranchising interactions related to social support, ways of coping, growth after loss, and ongoing challenges. Results from a path analysis indicated that avoidant emotional coping was a key mediator and predictor of prolonged grief, while problem-focused coping served as a key mediator and predictor of posttraumatic growth. The findings can be used to advance research, clinical practice and intervention efforts for women who are grieving the death of a woman friend.

Theories and concepts about society, dying, and bereavement commonly discussed in education about death, dying, and bereavementDeath Studies; Charles A Corr, Kenneth J Doka; 4/25This article describes and offers some evaluations of fifteen prominent theories and concepts in the field of death, dying, and bereavement. These theories and concepts range from claims about "death-denying societies" and the concept of "societal death systems" to theories about coping with dying and coping with loss, grief, and bereavement. Also examined are the concept of disenfranchised grief and theories about contrasting grief styles. Because each of these theories and concepts is often discussed in education about death, dying, and bereavement, it is important that instructors and students understand both their strengths and limitations. The goal of this analysis is twofold: (1) To help guide educators as they explain these theories and concepts to their students and readers, and (2) To assist educators in commenting on the soundness and usefulness of these theoretical frameworks.

Increasing timely code status discussions in hospitalized children with medical complexityJournal of Hospital Medicine; James Bowen MD; Laura Brower MD, MSc; Daniel Kadden MD; Jasmine Parker BS; Alexandra Delvalle BSN; Andrew Krueger MD; Kristin Todd MSW; Rachel Peterson MD; 4/25Children with medical complexity (CMC) have an increased risk of hospitalization and clinical deterioration. Documentation of code statuses concordant with family goals is rare, increasing the risk of serious unintended consequences. We aimed to increase the percentage of patients with documentation of timely code status orders (CSOs) from 5% to 80% over 6 months. Multiple plan-do-study-act cycles were performed focusing on interventions aimed at key drivers, including increasing knowledge in performing code status discussions (CSDs) and improving understanding of institutional policies. The average percentage of patients who received a CSO placed in their chart within 72 h of admission to the CCT [complex care team] increased from 5% to 61% over 6 months.

Family caregiving for older persons with dementia at end-of-life: A comprehensive overviewInternational Perspectives on Family Caregiving; Cynthia A. Hovland; 4/25 Family caregiving for older persons with dementia at the end of life is a perplexing, challenging, and growing concern across the United States and other developing countries. This overview looks at these epidemiological forecasts, scope, and impact of dementia on the family and caregiver. Using a bio-psycho-social theoretical framework helps to understand identified problems and issues for the caregiver and implications for the older adult with dementia. Caregiver issues include the burdens as well as positive aspects of this role, but the unknown trajectory of dementia poses significant challenges. Caregivers' responses are impacted by their individual resilience and supports, and recommendations for approaches, strategies, and interventions for caregivers and health professionals are provided.

Location of terminal care in pulmonary hypertensionCJC Open; Ramzi Ibrahim MD; Adam Habib MD; April Olson MD; Farah Shrourou; Hoang Nhat Pham MD; Mahmoud Abdelnabi MBBCh MSc; Maryam Emami Neyestanak PhD; Sabrina Soin DO; See-Wei Low MD; Bhupinder Natt MD; Mamas A. Mamas BMBCh MA DPhil FRCP; Timothy Barry MB BCh BAO; Chadi Ayoub MBBS PhD; Reza Arsanjani MD; Franz P. Rischard MD; Kwan Lee MD; 4/25Palliative care services have seen an increase in utilization in recent years, yet this uptrend has not been observed uniformly across all groups. The recent decline in mortality within inpatient facilities, despite the persistently high mortality rates of PH [pulmonary hypertension], depicts better coordinated patient-centered care, including hospice and at-home services. Nonetheless, place-of-death disparities remain, linked to demographic variables. Specifically, minority ethnic groups in the US have not experienced this increase. These populations often harbor misconceptions and unconscious biases about the nature of palliative care. The Pulmonary Hypertension Association, recognizing this gap, has advocated for the integration of palliative care into the treatment regimen for patients with PH.

[Taiwan] Palliative care with negative pressure wound therapy application in malignant wounds: a systematic reviewJournal of Wound Care; Xiao-Feng Yao, Yen-Jen Wang, Yang-Sheng Lin; 4/25Of 765 articles screened, 14 eligible studies were included in the review. The location of the hard-to-heal wounds was widely distributed: five wounds on the scalp; three wounds over the anogenital area; and the remaining wounds on the trunk and extremities. The reported outcomes included: improvement of wound healing; decreased exudation and malodour of the wound; decreased pain sensation; eligibility for further treatment; and a shift to the homecare system. The findings of this study suggested NPWT [negative pressure wound therapy] could be a choice in palliative care for patients with malignant wounds. However, more studies are needed to evaluate the efficacy of NPWT in these wounds.

Opening the door to wholistic patient care: Results from a nationally representative database on the use of spiritual and religious counselingHealth Services Insights; Peter J. Mallow, Pierson Savarino; 4/25The introduction of the International Classification of Diseases 10th Revision (ICD-10) code Z71.81 in 2015 enabled the systematic documentation of spiritual and religious counseling (SRC) in hospital settings, opening avenues for research into its effect on patient outcomes and healthcare resource utilization. Religion and spirituality are integral to many patients’ lives, influencing their well-being, recovery and health outcomes. SRC is primarily utilized in complex, high-mortality cases, underscoring its role in holistic care for severely ill patients. The disparities observed highlight the need for standardized SRC documentation and equitable access to SRC. Future research should investigate the clinical and economic impacts of SRC to enhance patient-centered care in alignment with value-based care practices.

Assuring the provision of palliative care as an ethical duty for all physiciansJournal of Pain and Symptom Management; Amber R Comer,Daniel Sulmasy; 4/25Although palliative care is an evidence-based, essential component of care for patients with serious or critical illness and at the end-of-life, access to palliative care continues to be limited by inaccurate definitions, misrepresentation, stigma, and neglect. To help physicians and patients to overcome barriers limiting the provision of palliative care, the American Medical Association (AMA) has recently adopted policy and a new opinion in the Code of Medical Ethics which establishes an ethical duty for all physicians, in all specialties, to assure the provision of palliative care to patients who stand to benefit. Additionally, the new policy and Code opinion expand the depth and breadth of what palliative care access and delivery entail and address misconceptions that have resulted in barriers to the delivery of palliative care.

Medical aid in dying in the state of Colorado: Perspectives, data, and lessons learned in the first years of a uniquely centralized programJournal of Palliative Medicine; Melanie Mandell, Katie Sue Van Valkenburg, Skye O’Neil, Genie E. Roosevelt, Kerri Mason; 4/25 In 2016, Colorado voters approved Proposition 106, “Access to Medical Aid in Dying,” which amended Colorado statutes to include the Colorado End-of-life Options Act. In 2018, Denver Health and Hospital Authority, an urban, county safety-net hospital established a program to provide comprehensive medical aid in dying care via a centralized clinic with a dedicated team including a medical director, social worker, and a network of volunteer consultants. As the program has developed and matured, it has grown exponentially. This is due to its ease of accessibility, statewide educational efforts, and the relatively low cost and need-based, free services it provides. In six and a half years, our centralized program assisted over 650 Colorado patients in their quest for accessing medical aid in dying care, providing a wide continuum of services from initial intake and counseling, visits, and financial aid to specific grief counseling for loved ones. We believe our centralized system may function as a model for other hospitals considering the need to improve aid in dying access and care.

Prevention of opioid misuse and abuse through effective pain management in patients with chronic pain: An umbrella systematic reviewCureus: Sana Sultana, Safeera Khan; 3/25Chronic pain is a condition that affects physical well-being as well as emotional well-being, has mental impacts on patients, and diminishes their quality of life. There is also growing evidence that opioids have only limited effectiveness in the management of CNCP [chronic non-cancer pain], and the increased availability of prescription opioids has contributed to an increase in opioid addiction cases and overdose deaths. This review was conducted to determine if adequate pain management would decrease opioid use and prevent misuse. We discussed the different pain management methods in the paper, including the different pharmacotherapy options, nerve blocks, and spinal cord stimulation. We also talk about multidisciplinary treatment with the involvement of various departments (physician, pharmacy for pill counting, physical therapy, psychological care, etc.) in managing pain; good outcomes were observed with improvement in function.

Dying at home: A family guide for caregivingJohn Hopkins University Press; by Andrea Sankar with CM Cassady; 2/24A comprehensive guide for those caring for a loved one nearing the end of life. Many people seek the comfort and dignity of dying at home. Advances in pharmacology and hospice care allow the dying to remain at home relatively free of pain and symptoms, but navigating professional services, insurance coverage, and family dynamics often compounds the complexity of this process. Extensively updated and revised, this third edition of Andrea Sankar's Dying at Home: A Family Guide for Caregiving provides essential information that caregivers and dying persons need to navigate this journey.

[Scotland] Palliative care-based arguments against assisted dyingBioethics; Ben Colburn; 10/24Opponents of legalised assisted dying often assert that palliative care is worse in countries where assisted dying has been legalised, and imply that legalised assisted dying makes palliative care worse. This study considers five versions of this claim: that it is difficulty to access expert palliative care in countries where assisted dying has been legalised, that those countries rank low in their quality of end-of-life care; that legalising assisted dying doesn't expand patient choice in respect of palliative care; that growth in palliative care services has stalled in countries where assisted dying has been legalised; and that legalised assisted dying impedes the growth of palliative care or causes it to decline. In each case, it concludes that neither argumentation nor evidence supports these claims.