Literature Review

How Latine families navigate pediatric loss amid broken systems: A qualitative study with caregivers and providers using Liberation PsychologyAdvances in Nursing Science; by Patricia Buzelli, Tolu O Oyesanya, Angelli Aguilar, Rosa M Gonzalez-Guarda; 8/26This study explored the challenges and strengths shaping Latine families' experiences of pediatric loss in the United States context. Eighteen semistructured interviews with healthcare providers (n = 7) and bereaved Latine caregivers (n = 11) were carried out using an integrated qualitative descriptive and Liberation Psychology approach. Four themes emerged that are heavily shaped by individual and contextual factors: (1) Unsupportive and hegemonic systems, (2) caregiver and provider discordance regarding end-of-life care, (3) caregiver identity transcendence in the "natural distress of grief," and (4) supportive networks and their limitations. Results highlight sociocultural realities that inform needed structural, policy, and practice changes.

Timing prompts for advance care planning discussions and advance directive completionJAMA Network Open; by Neil S Wenger, Fernando Javier Sanz Vidorreta, Chi-Hong Tseng, Victor Gonzalez, Ron D Hays, Maryam Rahimi, Lisa Gibbs, Katherine Santos, Rebecca L Sudore, Anne M Walling; 8/26Objective: To compare the association of an appointment-based ACP [advance care planning] behavioral intervention delivered with the patient just before a primary care visit vs a non-appointment-based intervention. Among patients receiving appointment-based interventions, 1143 (40.2%) had ACP discussion documentation in the EHR [electronic health record] compared with 714 (27.5%) of patients receiving only non-appointment-based interventions ...  Appointment-based interventions were associated with more AD or POLST and documented ACP discussions than non-appointment-based interventions across all 3 ACP intervention groups.

Narrative review of the US specialty palliative nursing workforce 2025: Measurement for now and the futureJournal of Pain & Symptom Management; by Susan Lysaght Hurley, Morgan E Murphy, Marian Grant, Caitlin Brennan, Joanne Reifsnyder, Joan G Carpenter; 8/26A robust, expertly trained nursing workforce is needed to care for over 13 million people living with serious illness in the United States (US). Workforce data remain limited due to the diversity of nursing roles in hospice and palliative care. No comprehensive estimate exists for the broader palliative nursing workforce; however, a 2024 national survey estimated 56,619 registered nurses working in hospice. Palliative nursing education was not formally integrated into US nursing curricula until 2021 with the AACN publication of The Essentials, and only 12 healthcare organizations offer specialty nurse residency or fellowship programs. The National Board for Certification of Hospice Nurses was established in 1992 in the US and awarded the first certification to registered nurses in 1994; in 2025 nearly 12,000 nurses are certified.

[UK] A policy scoping review of how ‘Hospitals at Home’ can and could support people with dementia Age & Ageing; by Anthony Zheng Wang, Anita Wong, Nathan Davies, Sevim Hodge, Elizabeth L Sampson, Victoria Vickerstaff, Kate Walters, Catherine J Evans, Mark James Rawle, Jane Ward, Simon Conroy, Bastien Genet, Claudia Cooper; 8/26People with dementia are often hospitalised due to comorbidities and superimposed delirium and have poorer outcomes in hospital compared to people without dementia, especially among under-served groups. Hospital at Home (HaH) schemes could reduce these inequalities by facilitating care in a familiar home environment that offers similar outcomes to acute hospital care with lower risks of harms. We developed three themes: (i) benefits of HaH for people with dementia, including more person-centred care and familiar treatment environments; (ii) how HaH can be inclusively designed for people with dementia, accommodating needs and mitigating concerns over digital exclusion and safety; and (iii) the critical role of family carers in enabling HaH, including potential carer burden. Future policies should drive consistent inclusive eligibility criteria and processes for ensuring continuity with primary care, dementia care as a HaH staff core competency.

Time is of the essence: evaluating short-term prognosis tools in cancer and non-cancer patients Journal of Pain and Symptom Management; by Kayla Sheehan, Navasuja Kumar, Julia Pudar, Susan Duong, Megan Bricely, Mohamman Alhameed, Mohammed Kabeto, Donglin Zeng, Adam Marks; 8/27/26 Accurate end-of-life prognostication supports patient, family, clinician, and health system decision-making. The Palliative Prognostic Index (PPI), Palliative Performance Scale (PPS), and Short-Term Prognosis Signs (SPS) have been used in palliative care populations, particularly advanced cancer (1-3), but their utility for short-term prognostication in non-cancer patients is less established.

Inpatient palliative care utilization in gynecological malignancies: a national inpatient study Medscape; by Lydia Francis, LF and Benjamin Easow, MD; 9/3/26 Conclusions: Only 1 in 6 hospitalizations for gynecological malignancies had documented palliative care, reflecting underutilization in a population with substantial supportive care needs. Palliative care concentration among older, higher-acuity admissions suggests late referral rather than early integration. These findings support timely palliative care expansion in gynecological malignancies to improve symptom management and goal-concordant care.

Health and health care access among Afghan refugee women in the United StatesJAMA Network Open; by Nazineen Kandahari, Nilufar N. Kayhani, Fareha Moulana Zada, Zahra Kayhani, Zarin Noor, Nicholas Nelson, Susan L. Ivey; 8/26Afghans are one of the world’s largest refugee populations. Afghan women face compounded health risks due to sociocultural restrictions, low literacy, forced displacement, and limited health care access, yet little is known about their experiences with health care after resettlement in the US. In this qualitative study of 23 Afghan women residing in the US who shared their experiences accessing health care, key barriers included sociocultural constraints on women’s autonomy, inadequate interpretation services, culturally insensitive health care, intergenerational stigma surrounding sexual and reproductive health knowledge and care, and mental health challenges. Structural barriers produced mistrust in and miscommunication with clinicians and led to use of home remedies. These findings suggest a need for health care interventions that are sensitive to sociocultural contexts and immigration histories to address the needs of Afghan refugee women in the US.

The prevalence of Medical Power of Attorney documentation in a large healthcare system: A retrospective cohort studyJournal of Palliative Care; by Angeli Sirilan, Alexandria Ellershaw, Tony Gaidici, Jacob Lahti, Michael Ruta, Richard Elias, Sandeep Pagali, Kristina Balangue, Sumit Agarwal, Nimit Agarwal; 8/26Designation of a Medical Power of Attorney (MPOA) is a key component of advance care planning (ACP) that ensures patient preferences are honored when decision-making capacity is not present. This study aimed to quantify MPOA documentation rates [in adult hospitalized patients] and identify demographic and clinical factors associated with documentation presence. Male sex, White race, older age (67.0 vs 54.3 years), and unmarried status were associated with a higher MPOA documentation rate ...  Dementia ...  and malignancy ...  were associated with higher odds, while discharge against medical advice was associated with lower odds ...  of MPOA documentation. Conclusions: MPOA documentation rates were low, highlighting missed opportunities to identify alternate decision makers when a patient lacks capacity.

[Portugal] International differences in the technical qualities of place of death classifications and data: A survey of researchers' perspectivesPalliative Medicine; by Mayra Delalibera, Sílvia Lopes, Inês Dias da Silva, Barbara Gomes; 9/26Place of death is a key population-level indicator for palliative care and health services planning. However, substantial international variation in how it is recorded limits cross-country comparisons and health system evaluations. This is the first study to assess place of death classifications and data from researchers' perspectives. Findings highlight critical limitations in current classification systems and provide guidance for developing an international classification aligned with UN and WHO recommendations. This will enable more meaningful cross-country comparisons and strengthen evidence to inform palliative care and health services planning worldwide.