Literature Review

An exploration of gratitude on well-being in hospice and palliative care familial caregiversJournal of Palliative Medicine; by Kathryn Levy, Pei C Grant, Hannah Rachiele, Gina Schuster, Jonathan L Rossi, Sheila Conboy, Andrew Gasper, Christopher W Kerr; 7/26Familial caregivers (FCGs) play a critical role in health care by providing unpaid care to loved ones with serious illness. Although caregiving is often associated with emotional and physical burden, increasing attention has been directed toward potential sources of meaning and psychological growth, including gratitude. Higher levels of gratitude were associated with greater flourishing and recognition of positive caregiving experiences and were inversely associated with caregiver strain among FCGs of hospice and palliative care patients. Future longitudinal and intervention-based research is needed to determine whether gratitude-focused approaches can improve resilience, psychological well-being, and relational connection in end-of-life caregiving.

Nonreporting of race and ethnicity in medical research harms us all JAMA Internal Medicine | Editorial | Health Equity; by Sharon K. Inouye, MD, MPH, Jerard Kneifati-Hayek, MD, MS, Annette Flanagin, RN, MA, Kirsten Bibbins-Domingo, PhD, MD, MAS; Raegan W. Durant, MD, MPH; 8/24/26 At JAMA Internal Medicine, we have become increasingly aware that some US researchers are unable to report on race or ethnicity as demographic variables to describe their sample or to conduct stratified analyses by these variables. In some cases, we have been informed that based on 3 recent US federal executive orders, the stewards of federal databases, such as those responsible for distributing data from the Centers for Medicaid and Medicare Services (CMS), are unable to release any race or ethnicity data for research purposes. The restrictions may be particularly prohibitive when study investigators are US federal employees. We have been informed of similar concerns occurring at other biomedical journals. Editor's Note: This theme recurs throughout our American history. Stark examples repeatedly emerged when I was researching and writing my recent e-book: A History of Care: 250 Years of Need, Service and Hope.

Family caregivers' understanding, expectations, and emotional responses during transition to a palliative care unit: a qualitative study Empirical Research Qualitative; by Filipa Vieira-Matos and Paulo Reis-\Pina; 8/2/26 Aim: To explore how family caregivers interpret palliative care and respond to admission to a palliative care unit as a critical transition in care. ... Results: Admission was experienced as a critical transition. Three interrelated themes were identified: understanding of palliative care, expectations regarding care, and emotional responses. Participants described partial familiarity with palliative care but frequently associated referral with terminal illness. Expectations focused on comfort and clear communication. Emotional responses included fear, uncertainty, and ambivalence, particularly when referral occurred abruptly. ... Impact: Admission was experienced as a transition involving meaning-making, expectation formation, and emotional adjustment. Findings may inform nursing practice in inpatient palliative care by supporting caregiver-centered transition support.

Advance care planning in sickle cell disease: A scoping reviewJournal of Palliative Medicine; by Megan R Marshall, Miranda Ravicz Adelmann, Miriam A Osei, Sharl S Azar, Stephanie Kiser, Richard Newcomb; 7/26Sickle cell disease (SCD) is an inherited hemoglobinopathy characterized by abnormal red blood cell sickling, leading to pain, organ dysfunction, and early mortality. Its severe, unpredictable course and the emergence of complex decisions surrounding transformative therapies have prompted recommendations to integrate palliative care (PC) to support patients and families. The limited available evidence suggests that patients are open to ACP discussions with trusted clinicians, but few patients had participated in formal or informal ACP. Personal and environmental factors may influence ACP engagement, including patient-clinician trust, patient and clinician understanding of ACP in SCD, timing of ACP conversations, and previous experiences with critical illness or end-of-life care. Proposed steps for advancing ACP in SCD include education, early PC integration, and strengthened patient-clinician communication and relationships.

Palliative care physicians' perceptions about using artificial intelligence for prognosticationJournal of Pain & Symptom Management; by Stacy M Fischer, Regina M Fink, Ahmed Y Alasmar, Eric G Campbell, Matthew DeCamp; 7/26Statistical and artificial intelligence (AI)-based methods have informed clinical prognostication for decades, evolving into machine learning models integrated into electronic health records. We conducted a national survey of n=2,500 Hospice and Palliative Medicine physicians in the United States (January 2024-March 2025) to assess current prognostic practices, AI knowledge, and perceived benefits and risks of AI-based prognostication. Conclusions: Palliative care physicians report limited current use of AI-based prognostic tools but generally favorable attitudes toward potential benefits, especially among current AI tool users.

[Israel] Existential suffering at the end of life in long-term care: A critical essay on recognition, dignity, and witnessPalliative Care & Social Practice; by Anat Romem, Rachel Bardach; 7/26Existential suffering is widely acknowledged in palliative care, but it remains inconsistently recognized and unevenly addressed in long-term care. This critical essay argues that the gap is not caused by clinician indifference, but by a persistent mismatch between whole-person ideals and care systems organized around measurable symptoms, risk management, task completion, and professional uncertainty. [This] ... essay identifies three interrelated shortcomings: the reduction of suffering to medically actionable symptoms; the depersonalizing effects of institutional routines on frail older adults; and the absence of shared existential literacy across interdisciplinary teams. The essay also cautions against romanticizing suffering or treating meaning-making as a clinical expectation. It proposes a practical framework of recognition, dignity, and witness: recognizing biography and identity as clinically relevant; protecting dignity in the ordinary details of care; and enacting witness ... Long-term care cannot resolve every existential wound, but it can reduce existential neglect by treating personhood as a core quality indicator of palliative care.

In a recent study, most oncologists chose not to assist patients in dying Cancer Therapy Advisor; by Jason L. Harris; 8/19/26 Most oncologists asked to consult with a terminally ill patient seeking medical aid in dying (MAID) choose to opt out, according to research published in JAMA Network Open. In a California-based study, researchers found high rates of oncologists opting out, forcing many patients to pursue MAID with physicians they did not know. Further, a small number of physicians were responsible for most MAID-related prescriptions. “Our dataset likely underestimates these challenges, as it only includes patients who successfully found an attending physician and does not capture instances when opt-out was not documented,” the researchers added.

Reports from Duke University describe recent advances in managed care (the South had the lowest rates of hospice and palliative medicine-certified providers in the Us, 2024): managed care Insurance Newsnet; by Staff; 8/13/26 A new study on Managed Care is now available. According to news reporting originating in Durham, North Carolina, by NewsRx journalists, research stated, “To improve access to care for serious illness, policy makers need evidence on how workforce capacity aligns with the need for palliative care. This study evaluated the palliative care workforce and policy environments at the state level, using a new data source: the 2024 Center to Advance Palliative Care’s comprehensive Serious Illness Scorecard.” Funders for this research include US Department of Veterans Affairs, Duke University, US Department of Veterans Affairs, Durham Center of Innovation to Accelerate Discover and Practice Transformation (ADAPT) at the Durham Veterans Affairs Health Care System. Read the study here.

Medical aid in dying: Bridging ethical guidance and bedside communication in nursing practiceJournal of Hospice & Palliative Nursing; by Jeanna Ford, Phyllis Whitehead; 7/26As MAiD [Medical aid in dying] becomes more integrated into serious illness care, nurses, particularly those in hospice and palliative care, are increasingly the first clinicians to receive patient questions about this option. These inquiries are often embedded in broader concerns related to suffering, loss of autonomy, fear of prolonged dying, and desire for control rather than solely requests for hastened death. The Hospice and Palliative Nurses Association’s recent position statement on medical aid in dying emphasizes compassionate, nonjudgmental care, respect for autonomy, professional integrity, and the ethical obligation of nonabandonment while recognizing the complexities of conscientious objection. This manuscript examines the evolving legal and ethical landscape of MAiD, explores the professional implications for nursing practice, and introduces the EXPLORE (Elicit, Explore, Probe Suffering, Learn Values, Observe Pressures, Review Support, Evaluate Next Steps) communication framework, a practice-based model developed to provide nurses with a structured, evidence-informed approach for responding to patient-initiated MAiD discussions. 

[Sweden] Effects and user-reported experiences of a self-management mobile health app for grieving adolescents: Randomized controlled trialJournal of Medical Internet Research; by Rebecca Rhodin, Rakel Eklund, Anneli Silvén Hagström, Rolf Gjestad, Atle Dyregrov, Josefin Sveen; 7/26Adolescents who experience the loss of a family member are at increased risk of adverse mental health outcomes, yet many face barriers or may be reluctant to access in-person or group-based support. This study evaluated the short- and long-term mental health effects of Alba - Youth in Grief, a preventive self-management mobile app for bereaved adolescents. Intention-to-treat analyses showed moderate reductions in prolonged grief symptoms at 12 months among adolescents randomized to Alba compared with the control group, with no significant effects at the 2- and 6-month follow-ups. The app group also demonstrated greater reductions in grief reactions, posttraumatic stress symptoms, and depressive symptoms compared with controls, with the strongest effects observed at long-term follow-up.