Literature Review

Further psychometric evaluation of the eight-item Hospice Philosophy Scale: Results from a national sample of interdisciplinary hospice clinicians Journal of Applied Gerontology; by Todd D Becker, Sarah E Clem, Paul Sacco, John G Cagle, Joan K Davitt, Nancy Kusmaul; 7/20/24 online ahead of print This study examined the psychometric properties of the eight-item Hospice Philosophy Scale (HPS-8) through confirmatory factor analysis; differential item functioning by age, gender, race, and professional discipline; and internal consistency reliability. ... Our results support the HPS-8 as a valid and reliable measure of attitudes toward the hospice philosophy of care in hospice clinicians.

Mayo Clinic Minute: How extreme heat, humidity affect your health News Tribune; by Tribune News Service; 7/16/24 Many parts of the U.S. continue to grapple with oppressive heat and humidity. This can prevent the body from cooling down, increasing the risk of heat cramps, exhaustion and heatstroke. Dr. Jesse Bracamonte, a Mayo Clinic family medicine physician, said the extreme heat and high humidity can be a dangerous mix. "High heat and high humidity can place one at risk for serious illness if people aren't careful. The heat can affect people's bodies by increasing the core body temperature and ability to sweat, and cause dehydration that can cause further medical problems and ensuing issues, and eventually can lead to heat exhaustion, in some cases, severe heat illness, known as heatstroke," Bracamonte said. Editor's Note: What information and support are you providing for your clinicians who travel between visits and for your patients who might be affected by extreme heat and humidity? What simple, practical adaptations might you create, like disposable water bottles for staff as they leave your building (with a sign of support and basic info)?

Being present is one way to help dying friendAsk the Doctors; by Elizabeth Ko, MD and Eve Glazier, MD; 7/5/24Dear Doctors: My friend was diagnosed with multiple myeloma 10 years ago. His chemo is no longer working, and his doctors say there’s nothing else to be done. He has accepted whatever is coming. He has lost weight, and sometimes the pain is bad. How can I help him?Dear Reader: No matter how long someone has been dealing with a serious illness, the cessation of active treatment can be devastating. This is true not only for the person approaching the end of their life, but also for family and friends. The response to this transition often includes a rotating mix of grief, sorrow, fear, anxiety, dread and anger. However, people also often feel acceptance, peace, hope and even relief. Again, these are experienced not only by the individual who is ill, but also by the people around them. When spending time with someone with a terminal illness, you are looking for balance. That is, you want to be supportive and helpful, but not overwhelm them with your attentions. Hospice care professionals say this can be achieved by asking the person what they need. ... Always check with the person before starting a new task or a project. This keeps them in control of the events around them, which bolsters mental and emotional well-being. [Italics and bold are from this newsletter's editor.]Editor's Note: Calling all hospice and palliative leaders, in the midst of carrying out our professional roles most of us experience the dying and deaths of family, friends, and acquaintances. This article gives meaningful, practical ways to both be present and do simple things that can empower and support the person who is dying. We invite you to pair this article with our newsletter's "Today's Encouragement: We are human beings ..."

Anxiety and resilience in palliative medicine physicians BMJ Supportive & Palliative Care; by Cristhian Alexis Velásquez Marín, Carlos Javier Avendaño-Vásquez; 7/2/24, online ahead of printTo identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians ..., [we] included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. Results: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. ... Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.Editor's Note: Executive leaders for palliative care services, use this research to be aware of possible stress-related tolls on your palliative physicians and team members. Ask. Generate dialogue. Do not assume that this applies, but rather use it to tune into and improve the support your physicians need. While this research was in Columbia, it resonates a U.S.recurring trend of the unionization of physicians, often related to burnout and stress overload.

Palliative care nurses see us in our final hours — these are the life lessons they've learnt ABC News; by Iskhandar Razak; 6/29/24 Anne Myers was once confused and shaken by death. After more than a decade as a nurse, including in hospital ICUs, her mother died. "I'd seen a lot of deaths in my nursing life, but it was the closest human to me that had died," she said. "It kind of sent me down a 'oh my god, I don't know what's happening to me', this grief I'm experiencing." Soon afterwards, she became a palliative care nurse. "I ended up just going down the path of 'what is death, what is death and dying all about?'" she recalled. More than 15 years later, here's what she and other palliative care nurses have discovered on how to die well and live well.

171K+ clicks saved: Inside Johns Hopkins' nurse documentation revamp Becker's Clinical Leadership; by Erica Carbajal; 6/17/24 Across healthcare, efforts to advance documentation are often focused on enhancing physicians' workflow. But at Baltimore-based Johns Hopkins Hospital, leaders are equally focused on improving documentation in nursing. ... [The] American Nurses Credentialing Center recognized Johns Hopkins with 10 exemplars, one of which recognized the hospital as a leader in nursing informatics. Case in point: The hospital has saved nurses 170,620 clicks in four months, April Saathoff, DNP, RN, vice president and chief nursing information officer at Johns Hopkins Medicine, told Becker's. ... "Instead of the nurse having to go in and document on every single row on a head-to-toe reassessment for the patient, we now have some fields added to the top where the nurse can document reassessment changes noted or reassessed no changes," Dr. Saathoff said, adding that the changes are saving nurses an average of 13 minutes per reassessment. Editor's Note: What might your organization be able to streamline in your online documentation? Before IT or clinical management decides unilaterally, get input from your clinicians who make the visits and use the system. Include your psychosocial/spiritual care team members as well, as you might delete something crucial that they need.

Interdisciplinary Pain Board for managing patients with palliative care needs and substance use disorder: A pilot study Journal of Palliative Medicine; Sarah Hauke Given, Patricia Reid Ponte, Kate Lally, Isaac S Chua; 6/20/24 online ahead of print Context: Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Objectives: Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. 

‘I tried to get into their shoes and their culture’. Care worker experiences in cultural end-of-life care: Interpretative phenomenological analysis Journal of Clinical Nursing / Early View; by Elizabeth Lambert RN, BN (Hons), Jo Gibson RN, BN, PhD, MAdvNsgPrac, Kasia Bail RN, BN(Hons), GCHE, PhD Aim: What are care workers' lived experiences caring for people of culturally and linguistically diverse backgrounds during end-of-life care?What does this paper contribute to the wider global community? This study highlights the importance of understanding care workers’ experiences in providing culturally appropriate end-of-life care.

Of Mice and Meaning: Multidisciplinary perspectives on the interconnectedness of pain, stress, and suffering The Free Library; by Claire Woodward and Taylor Woodward, Indiana University Bloomington; 6/13/24 ... We are siblings and scholars from seemingly disparate disciplines (one in humanities and one in neurobiology), yet we are both engaged in work to understand--and ultimately alleviate--various facets of pain and suffering. We currently work in two different laboratories at the same institution (Indiana University). Taylor works in a lab with mice and Claire works in a lab on storytelling. Our scholarship includes interpreting reactions to pain, stress, and suffering, both felt and observed, behavioral and aesthetic. Such observations provide further insights into understanding how the mind and the brain process pain and suffering. ...

Daughter stole $25K using [dying] father's credit, debit cardsLatrobe Bulletin, Latrobe, PA; by Joseph Bell; 6/6/24 A Vandergrift woman is facing multiple felony charges after she racked up over $25,000 in credit and debit card debt using her father’s accounts. According to court records, 44-year-old Kimberly Sue Shaw of Hancock Avenue is accused of using three of her father’s credit and debit cards for unauthorized purchases, in addition to transferring a sum of money from one of his bank accounts to another while he was hospitalized and later under hospice care. The defendant’s father, Dennis Lee Barger of Washington Township, died May 2.Editor's Note: Often, we think of elder abuse as being physical harm. However, it includes much more, and your interdisciplinary team members must be trained to signs, assessments, interventions, and safety (for the patient and self). Definitions are available on the CDC's "About Abuse of Older Persons" webpage. These definitions include physical abuse, sexual abuse, emotional or psychological abuse, neglect, and financial abuse.

Design, creation, and 13-month performance of a novel, web-based activity for education in primary cardiology palliative care Journal of Pain and Symptom Management; by Jill M Steiner, Caroline L Doherty, Jill A Patton, Jadry Gruen, Sarah Godfrey, John Mulrow, Richard A Josephson, Sarah J Goodlin; 6/5/24 online ahead of print Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC).Editor's Note: Reiterating, this "free, online activity [is] for clinicians across disciplines and levels of training." The trajectories for cardiovascular diseases can elicit enormous anxiety--due to their roller-coaster changes that can result in sudden death--in contrast to the more predictable trajectories for cancer. Whether you use this resource or another, educate your interdisciplinary clinical managers and team members to the all-important disease and care factors for cardiology palliative care, relevant to the scope of professionals' different roles. 

ASCO updates Guidelines on Palliative Care Hematology Adviosor; by Jen Smith; 5/30/24 The American Society of Clinical Oncology (ASCO) has released an update to its guidelines on palliative care for cancer patients. The guidelines and related information were published in the Journal of Clinical Oncology and JCO Oncology Practice. To develop updated recommendations for integrating palliative care into cancer care, an expert panel reviewed randomized controlled trials, systematic reviews, and meta-analyses published during 2015-2023. Based on their findings, the experts recommend that patients with advanced cancer be referred to specialized interdisciplinary palliative care teams soon after diagnosis, while the patients are still receiving active cancer treatment.

The real cost of cancer: 49% of patients carry $5K+ in medical debt Becker's Hospital Review; by Ashleigh Hollowell; 5/28/24 ... Now, 47% of cancer patients accumulate debt as a result of their medical needs, The Wall Street Journal reported May 28. ... Some Americans are facing $38,000 or even more in medical debt, the Journal found. Additionally, more cancer patients are filing for bankruptcy, which one study linked to an 80% increased risk of dying. ... A 2024 survey of 1,284 cancer patients and survivors led by the American Cancer Society Cancer Action Network also found that: ...