Literature Review

Palliative care intervention for patients with end-stage liver disease-A cluster randomized clinical trialJAMA Internal Medicine; by Manisha Verma, Victor Navarro, Andrzej Kosinski, Tamar Taddei, Richard Kalman, A. Sidney Barritt, Simona Jakab, Marina Serper, Eric Orman, Maya Balakrishnan, Mina Rakoski, Don Rockey, Kristel Hunt, Roniel Cabrera, Ayse Aytaman, Binu John, Gyorgy Baffy, Rohit Nathan, Elliot Tapper, Marina Roytman, Brendan McGuire, Nicholas Hoppmann, Christopher Woodrell, Marie Bakitas, Yang Yue, Bryce Reeve, Li Lin, Rebecca Tantala, Michael Volk; 4/26Palliative care improves quality of life (QoL) in advanced illnesses, but data in end-stage liver disease (ESLD) are limited. It is unknown whether palliative care delivered by hepatologists is effective when compared with palliative care specialists. This cluster trial found that palliative care delivered by trained hepatologists was comparable with palliative care delivered by palliative care specialists in improving QoL in patients with ESLD and was associated with greater improvement in patient satisfaction, demonstrating the effectiveness among enrolled patients.Assistant Editor's note: That's the beauty of palliative care. It can be layered upon many other specialties and sub-specialties and utilized by a variety of health care disciplines. The science of palliative care, the skill and knowledge base involved, is adaptable and valuable for almost anyone working in direct patient care in many different health care settings.

Trends in preferred place of death among patients with bladder cancer in the United States, 2000 to 2020Palliative & Supportive Care; by Manas Pustake, Atharva Railkar, Mohammad Arfat Ganiyani, Atulya Aman Khosla, Avi Harisingani, Hanzala Jehangir, Mostafa Eysha, Divya Samat, Taha Hassan, Rohan Garje; 4/26Understanding trends in end-of-life care for bladder cancer patients is essential in improving palliative care planning. This study analyzes trends in preferred place of death among bladder cancer patients in the United States from year 2000 to 2020. Black individuals had significantly lower odds of hospice use than White patients ... and hospice use increased annually by an average of 13.4% ...  Interestingly, younger individuals were more likely to die in hospice compared to those aged 85 years or older, though the odds decreased with age. The results indicate that utilization of hospice care and home-based end-of-life care have risen in prominence though disparities are present across racial and regional groups.

Assessing PA student interest in hospice and palliative medicineThe American Journal of Hospice & Palliative Care; by Ryan Baldeo, Rachael Broder; 4/26While hospice and palliative medicine (HPM) is a critical and growing field, Physician Associates (PAs) are underrepresented. This study sought to assess PA student interest in HPM and identify strategies to increase engagement with the Physician Associates in Hospice and Palliative Medicine (PAHPM) organization. The survey assessed attitudes toward HPM and identified barriers to organizational involvement. Lack of awareness was the primary barrier to involvement (75.8%). Students expressed interest in educational resources (63.6%), job opportunities (57.6%), and mentorship (51.5%). Most respondents (81.8%) do not currently follow PAHPM on social media, but 72.7% indicated they would follow an Instagram account.

The professional guest: Ethical challenges in home-based end-of-life care among interprofessional teamsNursing Ethics; Inbal Halevi Hochwald, Gila Yakov, Moran Weiss, Liron Inchi, Inbal Mayan, Ron Sabar; 4/26Home-based end-of-life palliative care presents unique ethical challenges that differ fundamentally from those in institutional settings. Healthcare professionals navigate the complex role of being both clinical experts and guests in patients' domestic environments, operating in a context where professional authority is continuously negotiated rather than institutionally established. Home-based palliative care places professionals at the intersection of clinical responsibility and domestic sovereignty, a position for which existing frameworks offer insufficient guidance. Addressing these structural and relational challenges requires both individual-level preparation, including training in ethical decision-making in low-control environments, and systemic policy reform.

Enhancing psychosocial care at end of life: A novel simulation training programPalliative & Supportive Care; by Emilia Crnjak, Michelle Kerns, Mariah Stevens, Brianna O'Connell, Lauren Mednick; 4/26Providing psychosocial support to pediatric patients and their families at the end of life represents one of the most challenging yet vital aspects of healthcare practice. This study explored the use of simulation-based training to enhance the self-reported knowledge, skills, and comfort levels of child life specialists in providing psychosocial care during end-of-life situations. Forty-three child life specialists participated in the simulation-based training, which was combined with traditional didactic instruction, and the associated research study. Pre- and post-training surveys were used to assess impact of the training on child life specialists' self-reported knowledge of end-of-life care and comfort in providing this care. A statistically significant increase was seen in all measured aspects of self-reported knowledge and comfort in providing end-of-life care following the training.

Losing a close person to death in ICU: A thematic analysis of bereaved family members' experiences of end-of-life careIntensive and Critical Care Nursing; by Lena Palmryd, Anette Alvariza, Asa Rejno, Tove Godskesen; 6/26This study aims to describe bereaved family members experiences of end-of-life care following the death of a close person in ICU... In ICUs, family members are in great need of compassionate support, characterized by the presence of ICU nurses and their emotionally attuned communication. This support helps family members navigate the complexity in care, fostering trust, meaning-making, and a sense of dignity.