Literature Review

All posts tagged with “Research News | Journal Article.”



Telehealth use by home health agencies before, during, and after COVID-19

06/02/25 at 03:00 AM

Telehealth use by home health agencies before, during, and after COVID-19 National Institutes of Health, published by Wiley Online Library; by Dana B. Mukamel, Debra Saliba, Heather Ladd, Melissa A. Clark, Michelle L. Rogers, Cheryl Meyer Nelson, Marisa L. Roczen, Dara H. Sorkin, Jacqueline S. Zinn, Peter Huckfeldt; 5/22/25

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Provision of end-of-life care in austere environments

05/31/25 at 03:40 AM

Provision of end-of-life care in austere environmentsWilderness & Environmental Medicine; by Jason W. David, Hui Z. Feng, Danny Lammers, Russell Day; 6/25End-of-life care presents unique challenges in austere or resource-limited environments where traditional medical resources are scarce or absent. This review explores the complexities of providing end-of-life care under such constraints, including recognition of the dying patient and techniques to alleviate suffering and allow death with dignity in under-resourced or expeditionary environments. Moreover, it presents these techniques in an accessible manner for providers without formal hospice training to use. Based on a literature review of hospice and palliative medicine, insights from the body of literature in wilderness and austere medicine, and the authors’ experiences in practicing in austere environments, this paper discusses practical approaches to symptom management, ethical considerations in end-of-life decision making, and accessible interventions with limited resources.Publisher's note: An interesting article for all healthcare professionals to consider...

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A critical examination of ‘family’ caregiving at the end of life in contexts of homelessness: Key concepts and future considerations

05/31/25 at 03:35 AM

A critical examination of ‘family’ caregiving at the end of life in contexts of homelessness: Key concepts and future considerationsPalliative Care and Social Practice; Ashley Mollison, Kelli I. Stajduhar, Marilou Gagnon, Ryan McNeil; 5/25In a world that is becoming more inequitable, understanding and reducing health disparities is a key priority for palliative care. This essay has demonstrated that bio-legal assumptions and privileging may be yet one more inequity in palliative care to address and overcome. This essay has focused in on populations facing homelessness and housing vulnerability, but changing families and growing inequality suggests the potential broad applicability of this work for our collective future. Palliative care is one of the areas of the Western healthcare system that explicitly attends to the person with serious illness and their family and caregivers understanding deeply how the suffering and joys of one group impacts the other. If there is a place in the current health system that can truly make space for caregiving – in all the ways it happens – it is, and should be, palliative care.

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Granting permission: Toward embracing grief

05/31/25 at 03:30 AM

Granting permission: Toward embracing griefJournal of Social Work in End-of-Life and Palliative Care; by Rennie Bimman; 3/25Grief, unavoidable and often excruciating, is rarely sufficiently acknowledged or supported in Western society. It is not granted permission to exist without barriers. By considering and evaluating grief experiences through the lens of their access to permission, clinicians can collectively imagine and promote inclusivity in grief. Permission is presented as a conceptual framework and clinical tool, with broader micro- and macro-level applications for both professional and layperson engagement, offering a foundation for further implementation and research.

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Does family functioning matter? Understanding the relationship between family interactions and depressive symptoms for caregivers of cancer patients

05/31/25 at 03:25 AM

Does family functioning matter? Understanding the relationship between family interactions and depressive symptoms for caregivers of cancer patientsAmerican Journal of Hospice and Palliative Care; by Keisha White Makinde, Kyle A Pitzer, Jacquelyn J Benson, Maysara Mitchell, Debra Parker Oliver, George Demiris, Karla T Washington; 6/25Caregivers of cancer patients are at increased risk of depression and other health challenges. There is limited understanding of the role of the caregiver's own family members in promoting or discouraging mental wellbeing. Family caregivers with more positive family interactions are likely to have fewer depressive symptoms, suggesting family functioning may play a key role in bolstering family caregiver mental health and wellbeing.

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Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancer

05/31/25 at 03:20 AM

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancerOncology Practice; Jeremiah Bonnet, BA; Colin Cernik, MS; Hajime Uno, PhD; Lanfang Xu, MS; Cecile A. Laurent, MS; Lauren Fisher, MS; Nancy Cannizzaro, BA; Julie Munneke, BA; Robert M. Cooper, MD; Joshua R. Lakin, MD; Corey M. Schwartz, MD; Mallory Casperson, BA; Andrea Altschuler, PhD; Lawrence H. Kushi, ScD; Chun R. Chao, PhD; Lori Wiener, PhD; Jennifer W. Mack, MD, MPH; 5/25Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ... 

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An intervention to increase advance care planning among older adults with advanced cancer-A randomized clinical trial

05/31/25 at 03:15 AM

An intervention to increase advance care planning among older adults with advanced cancer-A randomized clinical trialJAMA Network Open; Angelo E. Volandes, MD, MPH; Yuchiao Chang, PhD; Joshua R. Lakin, MD; Michael K. Paasche-Orlow, MD; Charlotta Lindvall, MD, PhD; Seth N. Zupanc, BA; Diana Martins-Welch, MD; Maria T. Carney, MD; Edith A. Burns, MD; Jennifer Itty, MPH; Kaitlin Emmert-Tangredi, MSW; Narda J. Martin, MSN-ED, RN; Shreya Sanghani, MS; Jon Tilburt, MD; Kathryn I. Pollak, PhD; Aretha Delight Davis, MD, JD; Cynthia Garde, MBA; Michael J. Barry, MD; Areej El-Jawahri, MD; Lisa Quintiliani, PhD; Kate Sciacca, NP; Julie Goldman, MPH; James A. Tulsky, MD; 5/25Despite accumulating evidence of the benefits of these discussions, documentation of advance care planning (ACP) activity in the electronic health record (EHR) remains low and inconsistent for most health care systems, increasing the risk that patients will not receive care that matches their goals. In this pragmatic stepped-wedge randomized clinical trial among older patients with advanced cancer, an intervention combining patient video decision aids and clinician communication skills training increased the proportion of patients with ACP documentation. This randomized clinical trial exploring a combined intervention of patient empowerment and clinician communication skills training found a significant and clinically meaningful increase in ACP documentation rates with a scalable intervention that can be rapidly implemented across large health care systems. This approach offers an innovative paradigm with a clinically meaningful increase in ACP documentation, a widely used quality metric that reflects high-quality patient-centered care delivery.

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Palliative care program characteristics and end-of-life outcomes for patients with metastatic cancer

05/31/25 at 03:10 AM

Palliative care program characteristics and end-of-life outcomes for patients with metastatic cancerJournal of Pain and Symptom Management; by May Hua, Ling Guo, Shuang Wang, R Sean Morrison; 6/25Although U.S. palliative care programs have substantial differences in their implementation, whether this heterogeneity impacts patient outcomes is unknown. Palliative care program characteristics largely were not associated with differences in end-of-life quality metrics for patients with metastatic cancer.

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The dementia care workforce: Essential to care but large research gaps exist

05/31/25 at 03:05 AM

The dementia care workforce: Essential to care but large research gaps existAlzheimer's and Dementia; Jasmine L Travers Altizer, Jennifer M Reckrey, Bianca K Frogner, David C Grabowski, Joanne Spetz; 5/25People living with dementia and their care partners benefit from services and supports from a wide variety of healthcare and social service professionals. This article provides an overview of the dementia care workforce and highlights gaps and opportunities for data collection and research to advance the workforce and its contributions to high-quality care. There are notable gaps in our ability to track career pathways, assess the impact of training, identify best practices for recruitment and retention, and understand attributes of the workforce that may affect the quality of both workers' lives and the care they provide to people living with dementia. The dementia care workforce works in multiple settings and includes many occupations. Evaluation research is needed to improve direct care worker recruitment, retention, and knowledge.

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Referral criteria for specialist palliative care for patients with dementia

05/31/25 at 03:00 AM

Referral criteria for specialist palliative care for patients with dementiaJAMA Network Open; Yuchieh Kathryn Chang, DO; Jennifer Philip, PhD, MMed, MBBS; Jenny T. van der Steen, PhD; Lieve Van den Block, PhD, MSc; Allyn Yin Mei Hum, MD; Pedro E. Pérez-Cruz, MD, MPH; Carlos Paiva, MD, PhD; Masanori Mori, MD; Ping-Jen Chen, MD; Meera R. Agar, PhD, MPC, MBBS; Laura Hanson, MD, MPH; Catherine J. Evans, PhD, MSc, BSc; David Hui, MD, MSc; 5/25Dementia is an ever-growing public health issue with currently more than 55 million people worldwide living with this disease. Due to an aging global population, this number is projected to triple by 2050. As the number of people with dementia continues to grow worldwide, there is a need and an opportunity to collaborate and provide seamless integration of specialist palliative care with the primary palliative care already delivered to enhance the care of patients with dementia. To help advance this goal, the 15 major criteria identified here represent a first step toward clarification of primary and specialist palliative care roles and consideration for systematic screening of symptom and supportive care needs.

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[Sweden / Australia / UK] Harms of morphine for chronic breathlessness in relation to dose, duration and titration phase

05/31/25 at 03:00 AM

[Sweden / Australia / UK] Harms of morphine for chronic breathlessness in relation to dose, duration and titration phaseJournal of Pain and Symptom Management; by Magnus Ekström, Fatima Alameri, Sungwon Chang, Diana Ferreira, Miriam J Johnson, David C Currow; 6/25In people with COPD and severe chronic breathlessness, the risk of adverse events was highest during the first week of treatment in a dose-related fashion but did not differ by titration phase or by dose of once-daily SR morphine between 8 and 32 mg/day.

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[UK] An exploration of perceived impact of receiving complementary therapies on service users during the palliative and end-of-life care phase

05/24/25 at 03:55 AM

[UK] An exploration of perceived impact of receiving complementary therapies on service users during the palliative and end-of-life care phaseInternational Journal of Palliative Nursing; Jason Vickers, Brian Nyatanga, Hayley Holden; 4/25Background: To explore and understand the narratives of service users in the hospice setting regarding the value they place on complementary therapies and their perceived impact on overall wellbeing. The benefits derived from complementary therapy sessions include managing anxiety and stress, developing better sleep strategies and devising coping techniques for personal situations and contexts through guided discussions and personal reflection. 

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A practice model for palliative radiotherapy

05/24/25 at 03:45 AM

A practice model for palliative radiotherapyCureus; Alina Zheng, Alec Zheng, Alan Zheng, Xiaodong Wu, Beatriz Amendola; 5/25Despite well-recognized challenges in implementing palliative radiation therapy (PRT), progress remains slow, and conventional approaches have yielded limited success. A specialized certification track within radiation oncology residency programs is proposed, enabling palliative care physicians to obtain limited PRT licenses under the supervision of fully licensed radiation oncologists. Dedicated PRT facilities-affiliated with comprehensive radiation therapy centers (CRTCs) and integrated into hospice settings-will enhance accessibility by reducing logistical and financial burdens. These facilities will utilize cost-effective infrastructure, including refurbished linear accelerators, modular construction, and remote physics and dosimetry support, ensuring operational costs remain significantly lower than those of conventional radiotherapy centers. Systematic studies with a PRT-oriented mindset should establish PRT-specific treatment recommendations and recommendations, moving away from conventional radiation therapy protocols. While requiring initial investment and regulatory adjustments, it has the potential to improve end-of-life care for terminally ill cancer patients, ensuring greater dignity and comfort while establishing a robust foundation for future reimbursement models.

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Care transformation in palliative care: Leveraging a payor-provider partnership to fast-track growth of a palliative program

05/24/25 at 03:40 AM

Care transformation in palliative care: Leveraging a payor-provider partnership to fast-track growth of a palliative programJournal of Palliative Medicine; Emily Jaffe, Emily Hobart, Alexandra Aiello, Amber Shergill, Amanda Harpster-Hagen, Tyson S. Barrett; 5/25This study describes a unique partnership between an insurer and a provider to enhance the quality, availability, and access to palliative services. A retrospective cohort analysis of insurance claims data for patients receiving palliative care compared to a matched cohort not receiving palliative care services from 2019 through 2022. Outcomes demonstrated a total savings of $4,526,408 through reductions in costs for the treatment group compared to the control group for total cost of care ...., inpatient stays ($5,672 ... ) , outpatient visits ($229 ... ), professional claims ($1,243 ... ), and pharmacy fills ($17 ... ). The treatment group had lower skilled nursing facility ($1,049 ... ) and inpatient rehabilitation facility ($216 ... ) costs. The treatment group had higher rates of hospice care (83.7% in the treatment compared to 50.2% ... ) but had lower lengths of stay (four days compared to five ... ).Conclusions: Collaborative investment in a palliative program by a payor and provider system shows significant financial savings for an insurer when patients receive evidence-based palliative care near the end of life.

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Impact of an inpatient telepalliative care consult service in rural hospitals: One state story

05/24/25 at 03:30 AM

Impact of an inpatient telepalliative care consult service in rural hospitals: One state storyJournal of Hospice and Palliative Nursing; by Anup Bhushan, Scott D Hurley, Patrick J Coyne; 2/25Palliative care has become a standard of care for patients with serious illnesses. However, many rural hospitals do not have access to specialized palliative care consultation. This article describes the journey taken by a palliative care team to improve access to palliative care and overall patient outcomes at rural hospitals throughout the state of South Carolina by using the telehealth modality. The impact, challenges, and benefits of the program are discussed.

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Palliative care in acute care surgery: research challenges and opportunities

05/24/25 at 03:25 AM

Palliative care in acute care surgery: research challenges and opportunitiesTrauma Surgery Acute Care Open; by Amelia W Maiga, Vanessa Ho, Rachel S Morris, Lisa M Kodadek, Thaddeus J Puzio, Gail T Tominaga, Masami Tabata-Kelly, Zara Cooper; 3/25Acute care surgeons routinely care for individuals who may benefit from palliative care. Patients exposed to traumatic injury, emergency surgical conditions, major burns and/or critical surgical illness are more likely to be experiencing a serious illness than other hospitalized patients. This narrative review summarizes the current state of research challenges and opportunities to address palliative care in acute care surgery.

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Palliative care consults in the Southeast: Lower readmissions despite increased length of stay

05/24/25 at 03:20 AM

Palliative care consults in the Southeast: Lower readmissions despite increased length of stayJournal of Palliative Medicine; by Hillary E Davis, Heather Reed-Day, Erin W Jackson, R Eric Heidel, Justin Wolfe, Adam J Tyson; 3/25We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. Our cohort study using MS-DRG matching indicates that despite increased LOS, PC consultations were associated with significantly lower readmission rates. This suggests their potential to improve resource utilization, especially in regions affected by pandemic-deferred care.

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Trends in the use of advance care planning and cognitive assessment and care planning service visits: Moving toward a palliative-informed approach for ambulatory care of community-dwelling persons with dementia and their caregivers

05/24/25 at 03:15 AM

Trends in the use of advance care planning and cognitive assessment and care planning service visits: Moving toward a palliative-informed approach for ambulatory care of community-dwelling persons with dementia and their caregiversAlzheimer's & Dementia; by Jennifer B Seaman, Yurun Cai, Dianxu Ren; 4/25Both the advance care planning (ACP) visit and cognitive assessment and care planning service (CAACPS) visit offer palliative-oriented care for persons with Alzheimer's disease and related dementias (ADRD); however, the rate of ACP visits remains low, and little has been reported regarding CAACPS visits. Furthermore, few reports describe use of either visit among Medicare Advantage (MA) beneficiaries. Discussion: Few MA beneficiaries with ADRD received ACP or CAACPS visits, and the delivery of CAACPs visits is similar to that reported for non-MA beneficiaries.

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Perspectives on the challenges of planning for and accessing long-term dementia care services through Medicaid and Medicaid Waivers

05/24/25 at 03:10 AM

Perspectives on the challenges of planning for and accessing long-term dementia care services through Medicaid and Medicaid WaiversJournal of Applied Gerontology; Justine Scattarelli, Kelly Moeller, Dana Urbanski, Marguerite DeLiema; 4/25 Formal long-term services and supports (LTSS) are essential to support older Americans with chronic conditions, such as Alzheimer’s disease and related dementias (ADRD). However, few older adults have saved enough to pay for LTSS, and navigating Medicaid eligibility criteria presents significant challenges. We conducted semi-structured, in-depth interviews with aging services professionals and caregivers of older adults with ADRD to assess challenges to planning for and accessing LTSS coverage through Medicaid and Medicaid waivers. Using concept mapping, three main themes were identified: (1) Proactive planning, (2) decision points, and (3) the application process. Participants described misconceptions about LTSS coverage, challenges with enrollment, and lack of information about eligibility affecting the LTSS planning trajectory. Results demonstrate a critical need for resources that help caregivers estimate costs and guide them through the eligibility determination, application, and spend down processes for Medicaid programs.

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The 2016 CDC Opioid Guideline and analgesic prescribing patterns in older adults with cancer

05/24/25 at 03:05 AM

The 2016 CDC Opioid Guideline and analgesic prescribing patterns in older adults with cancerJAMA Network Open; Rebecca Rodin, MD, MSc; Lihua Li, PhD; Karen McKendrick, MPH; Krista Harrison, PhD; Lauren J. Hunt, PhD, RN; Ulrike Muench, PhD, RN; Cardinale B. Smith, MD, PhD; Melissa D. Aldridge, PhD, MPH, MBA; R. Sean Morrison, MD; 5/25In 2016, the Centers for Disease Control and Prevention (CDC) published guidelines cautioning against prescribing opioids for chronic noncancer pain. In this cohort study of older adults with cancer, the 2016 CDC guideline was associated with a decline in first-line opioids while less-safe tramadol and less-effective gabapentinoid prescribing continued to rise. Further revision of the recent 2022 CDC guideline and oncology pain management guidelines may be needed to help address these potentially inappropriate analgesic shifts.

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Exploring the impact of acquisition on quality of care among US home health agencies

05/24/25 at 03:00 AM

Exploring the impact of acquisition on quality of care among US home health agenciesHealth Services Management Research; by Debra Winberg, Jillian Torres; 5/25Throughout the United States and Europe, the home health care industry is rapidly consolidating, with merger and acquisition (M&A) activity on the rise. The consolidation of the industry raises questions about the impact that diminished competition may have on the quality of care being delivered. This study examines the impact of home health agency acquisition on quality of care among a sample of 10,184 home health agencies across the United States. Utilizing publicly available data from the Outcome and Assessment Information Set (OASIS) and the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) from 2018 to 2022, this study investigates changes in clinical outcomes, organizational process measures, and patient experience. The findings suggest there is a modest 1.07 percentage point improvement in process measures post-acquisition, but no significant changes in outcome or patient experience measures among the 169 agencies that were acquired during the study period. These findings suggest that, while integration has the potential to modestly improve home health process efficiency, there is very little benefit to patients.

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[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approach

05/24/25 at 03:00 AM

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

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Successful strategies for operationalizing goals-of-care documentation

05/24/25 at 02:00 AM

Successful strategies for operationalizing goals-of-care documentationNEJM Catalyst: Innovations in Care Delivery; by Matthew J. Gonzales, Nusha Safabakhsh, Suzanne Engelder, Deborah Unger, Ira Byock; 5/25Goals-of-care (GOC) conversations are critically important to ensure that clinical teams and health systems know what matters to their patients, enabling treatment plans to be aligned with patients’ goals. However, because many conversations are ad hoc and clinician dependent, patients with serious medical conditions often do not have GOC conversations documented in their health record... [In 2024], 2024, 8,533 out of 10,063 (84.8%) of patients who were in an ICU for 5 or more days had a documented GOC conversation in the electronic health record at some point between hospital admission and prior to the fifth ICU day. This compares with a preintervention rate of just 555 out of 8,143 (6.8%) of patients who were in an ICU for 5 or more days having a documented GOC conversation [in 2016]. Essential strategies included centering efforts within the organization’s mission and vision, partnering with clinical leaders to set strong quality standards and corresponding metrics, easing documentation within the electronic health record, and designing and implementing effective communication skills–building workshops.

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Evaluation of required end-of-life (EOL) ethics content in the ten residency programs offering hospice and palliative medicine fellowship

05/17/25 at 03:45 AM

Evaluation of required end-of-life (EOL) ethics content in the ten residency programs offering hospice and palliative medicine fellowshipAmerican Journal of Hospice and Palliative Care; by Sara W Youssef, Lauren E Berninger, Danielle J Doberman; 4/25Ethics training is essential to hospice and palliative medicine (HPM) training. Ten residencies can lead into HPM fellowship, but clinical ethics tested on board certification exams vary in content and weight across specialties. Our findings indicate that end-of-life ethics content tested on these board certification exams vary across specialties. Given this variance, standardizing end-of-life ethics training for HPM fellowship programs presents an opportunity for educational improvement.

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A narrative review—Characterizing palliative care curriculum aimed at high school adolescents and young adults

05/17/25 at 03:40 AM

A narrative review—Characterizing palliative care curriculum aimed at high school adolescents and young adultsIllness, Crisis and Loss; Austin B. Elder; 4/25The aim of this narrative review is to explore the characteristics of palliative care curriculum developed for high school adolescent and young adults (AYAs). Characteristics including a variety of designs, methods, and strategies were all identified to have positive participation, feedback, and experiences from high school AYA being provided palliative care curriculum. Conclusions: The literature indicates that the use of subject matter experts within palliative care curriculum for high school students is a core characteristic in meeting the World Health Organizations recommendation to embed palliative care curriculum into public awareness strategies.

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