Literature Review

Incurable but not hopeless: How hope shapes patients’ awareness of their advanced cancer prognosis The Conversation, by Jean Mathews and Michael Brundage; 3/24/24Hope is defined as the expectation of achieving a future good. Patients with cancer, whether it is curable or not, prioritize cure as their highest hope. ... Previous research indicates that less than half of patients with incurable cancer are aware of their prognosis. This is often attributed to a failure of communication. ... In the context of advanced cancer, the relationship between hope and hopelessness is balanced by acceptance, which can re-direct hope to new goals beyond cure, such as hope for connection with others and enjoyment of daily pleasures. 

"A strong reason why I enjoy coming to work": Clinician acceptability of a palliative and supportive care intervention (PACT) for older adults with acute myeloid leukemia and their care partners Journal of Geriatric Oncology; by Ayomide Okanlawon Bankole, Natasha Renee Burse, Victoria Crowder, Ya-Ning Chan, Rachel Hirschey, Ahrang Jung, Kelly R Tan, Susan Coppola, Mackenzi Pergolotti, Daniel R Richardson, Ashley Leak Bryant; 3/20/24 Introduction: ... In this study, we examined clinician acceptability of a NIH-funded interdisciplinary PAlliative and Supportive Care inTervention (PACT) for older adults with acute myeloid leukemia (AML) and their care partners that transcends both inpatient and outpatient settings. Results: ... Five themes were identified in the thematic analysis: (1) Emotions and affect towards the intervention, (2) Intervention coherence and self-efficacy, (3) Barriers, burden, and opportunity costs of delivering the intervention, (4) Usefulness and effectiveness of the intervention, and (5) Recommendations to improve intervention delivery.

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Student-run Arizona non-profit uses origami to connect with hospital [and hospice] patients The State Press, by Pippa Fung; 3/19/24The Wishing Crane Project, founded by Arizona student Charles Zhang, serves hospice and hospital patients through art. In the story of Sadako and the Thousand Paper Cranes, a young girl tried to fold 1,000 paper cranes in the hopes that it would help her push through a terminal illness. Years later, students across Arizona and at ASU are folding their own cranes [and writing hopeful messages] to support others through their difficult journeys. 

Frailty needs to be a factor in drug development, proposed guidelines suggest McKnights Long-Term Care News, by Kristen Fischer; 3/20/24A new report on strategies for geriatric drug development and assessment determined that drugs need to consider age as well as other factors that older adults face such as cognitive impairment, frailty and polypharmacy. This is according to the International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee, which published the report. The strategies specifically focused on integrating frailty as a factor in drug development. The report, published in the Journal of the American Geriatrics Society earlier this month, includes 12 principles pertaining to frailty in reference to drug development. The recommendations include measuring frailty at the start of when a person goes on a drug they’ll likely take regularly.

Reducing adverse events with clinical audit Healthcare Connection; by Annette Schandl, George Bezzerides, Erin Meyer; 3/19/24 Patient safety is at the core of healthcare. Yet, clinical audits remain underrepresented on many healthcare organizations’ internal audit plans. ... Planning clinical audits: A checklist ...

Health care utilization and opioid use in patients receiving an integrated palliative care intervention for treatment of head and neck cancer compared to a historical control Elsevier, International Journal of Radiation; by F. Rizwan. C. D'Avella, M. Albert, T. King, B. Egleston, T.J. Galloway, M. Chwistek, C. Fang, A. El-jawahri, J.R. Bauman; online access for 4/1/24 release Patients receiving chemoradiation therapy (CRT) for head and neck cancer (HNC) can develop significant symptomology (odynophagia, malnutrition) resulting in frequent hospitalizations and decreased quality of life (QOL) and continue to have chronic symptoms such as dysphagia and/or pain. The integration of a palliative care (PC) team during CRT has the potential to address the high symptom burden and improve QOL.

Improvements in Interdisciplinary Communication Following the implementation of a standardized Handoff Curriculum: SAFETIPS (Statistics, Assessment, Focused Plan, Pertinent Exam findings, to Dos, If/Thens, Pointers/Pitfalls, and Severity of Illness) Cureus, by Shaefali Shandilya and Justen M. Aprile; 3/18/24 Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions. ...Results: Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment.

Hospice prepares to thank Vietnam era vetsMid Hudson News; 3/17/24In early 2017, Congress passed the Vietnam War Veterans Recognition Act, establishing March 29 as National Vietnam War Veterans Day.  The holiday is also known as “Welcome Home Vietnam Veterans Day” and in honor of those who served during the Vietnam era, the Hospice of Orange & Sullivan Counties will host its fourth annual “Thank You” and Memorial Ceremony on March 29 at 10 a.m. at the Cornwall Yacht Club. Hospice of Orange & Sullivan Counties is a community partner of “We Honor Veterans,” a campaign developed by the National Hospice and Palliative Care Organization in collaboration with the Department of Veterans Affairs.Editor's Note: Click here for information about March 29th, National Vietnam War Veterans Day.   

Tensions between grieving hearts and Western mind: Brave spaces for grief literacy and mystical experiences

Clinician perspectives on integrating neuro-oncology and palliative care for patients with high-grade glioma  Oxford Academic Neuro-Oncology Practice; by Rita C Crooms, MD MPH; Jeannys F Nnemnbeng, MD MS RRT; Jennie W Taylor, MD MPH; Nathan E Goldstein, MD; Ksenia Gorbenko, PhD; Barbara G Vickrey, MD MPH; 3/14/24  Background/objectives: Patients with high-grade glioma have high palliative care needs, yet few receive palliative care consultation. This study aims to explore themes on 1) benefits of primary (delivered by neuro-oncologists) and specialty (SPC) palliative care and 2) barriers to SPC referral, according to a diverse sample of clinicians.

Preventing adverse drug events in hospice care Hospice News, by Holly Vossel; 3/15/24 Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. ... Evaluating these risks involves having solid medication reconciliation processes in place — both at the time of a patient’s admission and throughout their end-of life care experience, according to Mary Lynn McPherson, professor and executive program director of advanced post-graduate education in palliative care at the University of Maryland’s School of Pharmacy. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM).