Literature Review

A wish to remember: Penn Medicine program fulfills patients’ last requests Penn Medicine News, by Meredith Mann; 4/9/24 The patient was dying of cancer. All options for saving or prolonging their life had been exhausted. Now, the patient most wanted to spend one more carefree, joyous day with their grandchild. ... This is just one example of the last requests granted through Princeton Health’s Three Wishes Project. On paper, it’s about performing small gestures that bring comfort and meaning to patients at the end of their lives. In practice, it’s about so much more—providing a sense of hope and closure, not only to these patients and their families, but also to staff.

The Sunday Read: 'What deathbed visions teach us about living' New York Times Podcasts, 4/7/24 Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. ... Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. ... Kerr followed his father into medicine, and in the last 10 years he has hired a permanent research team that expanded studies on deathbed visions to include interviews with patients receiving hospice care at home and with their families, deepening researchers’ understanding of the variety and profundity of these visions.

Translation and validation of the Chinese version of Palliative Care Self-Efficacy ScalePalliative & Supportive Care; by Junchen Guo, Yongyi Chen, Boyong Shen, Wei Peng , Lianjun Wang, Yunyun Dai; 4/8/24[This] study aimed to translate, adapt, and validate the Palliative Care Self-Efficacy Scale (PCSS) among Chinese palliative care professionals. ...Significance of results: The findings from this study affirmed good validity and reliability of the C-PCSS [Chinese-PCSS]. It can be emerged as a valuable and reliable instrument for assessing the self-efficacy levels of palliative care professionals in China.

Medicine—Both a Science (Care) and an Art (CARE) JAMA Network - Viewpoint; by Theodore J. Strange, MD and Mario R. Castellanos, MD; 4/3/24In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment. Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care ... The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. ... In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.

Study shows strong social ties may ease the way for older adults in life's final chapter Medical & Life Sciences, by Vijay Kumar Maleus; 4/4/24  Study Results: ... The analysis revealed that higher levels of loneliness were significantly associated with increased odds of experiencing anxiety, sadness, and pain in the last month of life, suggesting a pivotal link between social isolation and end-of-life symptomatology. Furthermore, marital status and the receipt of personal care were predictors of dying in a hospital, pointing to the influence of social support structures on the location of death. Interestingly, a larger social network was correlated with a higher likelihood of receiving hospice or palliative care, highlighting the potential benefits of broader social connections. 

Qualitative analysis of initial palliative care consultations in amyotrophic lateral sclerosis Journal of Pain and Symptom Management; by Christine L Watt, Ian C Smith, Jill Rice, Rebekah Murphy, Ari Breiner, Maria Duff, Danica Nogo, Shirley H Bush, Susan McNeely, Usha Buenger, Belinda Zehrt, Jocelyn Zwicker; 4/2/24, online ahead of print Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

Neuropsychiatric effects associated with opioid-based management for palliative care patients

Integration of palliative care across the spectrum of heart failure care and therapies: considerations, contemporary data, and challengesCurrent Opinion in Cardiology, by Sarah Chuzi and Katharine Manning; online ahead of May 1, 2024 printRecent findings: Patients with chronic heart failure [HF], as well as those who are being evaluated for or who have undergone advanced HF surgical therapies such as left ventricular assist device or heart transplantation, have a number of palliative care [PC] needs, including decision-making, symptoms and quality of life, caregiver support, and end-of-life care. ... PC skills and teams may also help address preparedness planning, adverse events, and psychosocial barriers in patients who have had HF surgeries, but more data are needed to determine association with outcomes.

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

A pilot of a Telehealth-Hospice transition intervention for children and young adults with cancer Journal of Pain and Symptom Management; by Nicholas P DeGroote, Ebonee Harris, Anna Lange, Karen Wasilewski-Masker, James L Klosky, Joanne Wolfe, Dio Kavalieratos, Katharine E Brock; 3/31/24, online ahead of printConclusions: Participants found coordinated telehealth visits to be feasible, acceptable, and satisfactory. Telehealth may be utilized as an acceptable alternative to clinic visits and fosters hospital-hospice collaboration.

Interruptions: Bad for hospitalists and their patientsThe Hospitalist, by Larry Beresford; 4/1/24More than 10 years ago this magazine published an article by Winthrop Whitcomb, MD, MHM, a pioneer of hospital medicine and co-founder of the Society of Hospital Medicine, warning of the hazards of workflow interruptions for hospitalists, which he labeled a career satisfaction issue for clinicians but a safety and quality risk for their patients. A decade later, the problem has surely gotten worse as hospital financial pressures and staff shortfalls push caseloads higher and job stresses drive burnout and premature retirement for doctors who have been pulled in too many directions in their work. 

Integrating palliative care screening in the intensive care unit: A quality improvement projectCritical Care Nurse; by Traci N. Phillips, DNP, APRN, ACNP-BC, CCRN; Denise K. Gormley, PhD, RN; Sherry Donaworth, DNP, APRN, ACNP-BC, FNP-BC; 4/1/24Background: Patients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years ...  Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Conclusion: The screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.

Expanding the use of continuous sedation until death and physician-assisted suicide  The Journal of Medicine & Philosophy: A Forum for Bioethics and Philosophy of Medicine; by Samuel H Lipuma and Joesph P Demarco; 3/27/24 The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD.