Literature Review

Clinician and parent perspectives on essential psychosocial care in pediatric cancerJAMA Pediatrics; by Kimberly S. Canter, Anne E. Kazak, Natalie Koskela-Staples, Michele A. Scialla, Kimberly Buff, Emily Pariseau, Victoria A. Sardi-Brown, Julia B. Tager, Lori Wiener; 10/25The Standards for Psychosocial Care for Children With Cancer and Their Families provide guidelines for evidence-based psychosocial care for children with cancer and their families. The Implementing the Standards Together: Engaging Parents and Providers in Psychosocial Care (iSTEPPP) study extends the standards through innovative collaborative research between clinicians and patient and family advocates, with the goal of widespread clinical implementation of standards that clinicians and parents or caregivers agree to be priorities. The 3 standards prioritized by parents and clinicians in this study offer insight into shared priorities for psychosocial care in pediatric cancer. However, misalignment on other priority standards (parental mental health, palliative care, and neurocognitive monitoring) highlights the differences in perception between parents and clinicians. Areas lacking agreement are a stark reminder of potential challenges when working to meet the holistic needs of children with chronic diseases and their families, as clinicians and parents may not agree on which needs are most important.

Compassionate care, measurable impact: Evaluation of embedded physician-led palliative care in a community oncology practiceJCO Oncology Practice; by Haibei Liu, Jillian Hellmann, Jessica Heintz, Geoffrey Daniel Moorer, Karen Miller; 10/25This analysis indicates that embedding palliative care physicians within a community oncology practice significantly increases hospice enrollment and LOS [length of stay] greater than 3 days. These findings support a cooperative care model as a practical strategy for integrating palliative care physicians into community-based oncology practices to improve patients’ EOL outcomes. 

Affirming healthcare experiences among older Black-and White-identifying gay men living with serious illness: A qualitative study in the Deep SouthAmerican Journal of Hospice & Palliative Care; by Korijna Valenti, Michael Barnett, Stacy Smallwood, Ronit Elk; 10/25Older gay men living with serious illness often face challenges related to identity, disclosure, and relational recognition in healthcare settings [and] these challenges are particularly acute in the Deep South, where affirming care remains inconsistent, and disparities persist. Three main themes were identified [in this study]: (1) Experiences of Inclusion and Visibility, (2) Positive Communication, and (3) Sharing Sexuality and Effect on Care. Clear communication, honesty, and opportunities to ask questions were critical in navigating medical decisions. Discussions of sexual orientation were context-dependent and often shaped by perceptions of safety. Recognition of chosen family members, particularly partners, was central to participants' sense of dignity and affirmation in care.

Live discharges of patients in hospice home settings-Relief or grief: A narrative studyThe American Journal of Hospice & Palliative Care; by Jacek T Soroka, Amanda L Paulson-Blom, Alla Blotsky, Jennifer L Derrick, Margaret T Mudroch; 10/25Approximately 20% of hospice patients in the US are discharged alive, often due to Medicare regulations. One of the caregivers described discharge as distressing and poorly coordinated; the other reported a positive experience shaped by prior knowledge and financial resources. Both emphasized the importance of clear communication, care planning (eg, to avoid loss of durable medical equipment), and interdisciplinary support. Live hospice discharge can cause emotional and practical disruption, especially when not accompanied by a care transition plan or access to durable medical equipment. This study highlights the need for team-based communication, sensitivity in language, and continued support. Assistant Editor's note: There can be immense ambivalence among patients and loved ones when one is discharged alive from hospice. Usually, these patients have been with hospice for many months or even years. Perhaps the discharge is viewed as good news-even GREAT news(!) that the patient has "graduated" from hospice. Maybe loved ones will throw a graduation party(!) as it means that the patient is no longer terminally ill (as defined by hospice regulations). On the other hand, some patients/loved ones can become very distraught, wondering how they will get along without having a nurse to call in the middle of the night, without their beloved aide who brightens their day with the TLC of the bath-hair-nail care, and without the support and guidance of their social worker and/or chaplain. Some patients/loved ones will feel angry and abandoned. Best practices dictate that hospices be proactive in discharge planning when the health of their long length-of-stay patients hits a plateau; discharge should never come as a surprise. There should be frequent and ongoing discussions with the patient/loved ones about the potential for live discharge. Discharge planning needs to include: how the patient will get their DME/medical supplies/medications?, who does the loved one call in the middle of the night if there is a medical crisis?, who can provide tangible support and spiritual guidance (if desired)?, and can palliative care ease the transition once hospice has discharged?

Hospice Research Information 10/25/25

Religious traditions and grief in the USA: When it's less about G-d and more about the peopleJournal of Religion & Health; by Emily Scheinfeld, Cassidy Taladay-Carter, Kelly Tenzek; 9/25Many turn to religion or spirituality for personal meaning, purpose, and guidance throughout our lifetime, including in the context of death and dying. Through the qualitative analysis of 159 open-ended survey responses from adults in the USA who had experienced the death of a parent, we examined the types of religious traditions, practices, and/or rituals that participants engaged in during their bereavement. We then explored how those practices were helpful, harmful to, or revealing of emergent interfaith family dynamics throughout their grief journeys. By better articulating the communicative role of religion in death and dying, we broaden the understanding of religion and grief in these important sociocultural contexts. We discuss implications for families and religious communities alike.

End-of-life care in the austere military environmentMilitary Medicine; by Jason David, Stevan Fairburn, Hayden Fogle, Nicholas Dulin, Russell Day; 9/25Throughout the Global War on Terror (GWOT), the U.S. military built a revolutionary capacity to deliver life-saving care-even in austere environments-through rapid evacuation, far-forward providers and resources, and advances in prehospital and trauma-critical care. However, the operational reality of future Large Scale Combat Operations (LSCO), as evidenced by wars in Ukraine, Sudan, and Gaza, will be marked by high casualty rates and limited medical resources. [This review] ... explores how medical providers must shift from curative to comfort-focused care, often without formal palliative training, and how end-of-life care protocols must be integrated into doctrine, triage systems, and commander education. We offer pragmatic guidance on clinical decision-making, communication strategies with both medical and non-medical leaders, and the delivery of pain relief, emotional support, and dignity at the end of life-even in forward-deployed, under-resourced settings.

Hospice social worker and nurse perceptions of the usability of a hospice live discharge protocol (LDP)American Journal of Hospice & Palliative Medicine; by Stephanie P. Wladkowski, Susan Enguídanos, Tracy A. Schroepfer; 9/25Live discharges from hospice are often distressing for patients, caregivers, and hospice providers alike, disrupting care continuity and leading to emotional and logistical challenges. Despite Medicare’s discharge planning requirement, no standardized process currently exists for hospice-initiated discharges, resulting in variable quality of care transitions.  An explicit Live Discharge Protocol has strong potential to enhance the quality and consistency of a live discharge from hospice care. The LDP provides a framework to help smooth the transition from hospice care and provides patients and families with post-discharge support. Feedback from hospice professionals affirmed the relevance and usability of each step within the LDP, while also identifying opportunities for refinement for future implementation.

Correctional health and oncologist perspectives on strategies to improve cancer care in US prisons-A qualitative studyJAMA Network Open; by Christopher R. Manz, Brett Nava-Coulter, Emma Voligny, Daniel A. Gundersen, Alexi A. Wright; 10/25Individuals diagnosed with cancer while incarcerated in US prisons have worse mortality than nonincarcerated individuals. In this qualitative study of clinicians delivering cancer care for incarcerated individuals, participants identified pragmatic strategies to improve cancer screening and treatment that address most identified barriers to care in US prisons. Application of these strategies may be associated with mitigation of disparities in cancer survival for incarcerated individuals. Participants identified strategies to improve care addressing nearly all previously identified barrier themes, including strategies for (1) conducting screening in prisons; (2) bringing cancer treatment into prisons and centralizing care; (3) using telehealth, navigators, and early oncologist involvement to improve care coordination; (4) improving communication and social support; (5) improving symptom management, access to palliative medicine, and end-of-life care; and (6) delivering patient-centered care. Strategies require implementation by prisons, prison clinicians, oncologists, oncology practices, and policymakers.

FSU launches first Clinical Catalyst to unite providers and researchers to solve problemsFlorida State University News; by Kathleen Haughney; 10/21/25FSU held the first ever Clinical Catalyst as part of the 2025 Discovery Days, an event to bring together local clinical providers with researchers to find evidence-based solutions to pressing challenges in health and health care... Topics included mastectomy garments, pregnancy misinformation in social media, pacemaker complications, post-surgery stroke complications, trauma referral from rural areas, ER visits, same-day triage, team-based care, Parkinson’s disease and driving, and end-of-life care.

Hospital - and private equity – affiliated specialty physicians negotiate higher prices than independent physiciansHealth Affairs; by Alexander P. Philips, Nandita Radhakrishnan, Christopher M. Whaley, Yashaswini Singh; 10/25Hospital and private equity (PE) consolidation in health care is altering the physician practice landscape, with more than three-quarters of physicians employed by these corporate entities as of 2023. We examined practice affiliation patterns for specialist physicians and those patterns’ association with commercial prices for cardiology and gastroenterology services... Hospital-affiliated specialists negotiated prices that were 16.3 percent higher for cardiology procedures and 20.7 percent higher for gastroenterology procedures compared with specialists in independent practices. PE-affiliated specialists negotiated prices that were 6.0 percent higher for cardiology and 10.0 percent higher for gastroenterology procedures.

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of lifeNutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.

The essential role of Speech-Language Pathologists in end-of-life swallowing intervention: A narrative reviewASHA Perspectives; by Sanora Yonan; 9/25Speech-language pathologists (SLPs) are essential in the intervention of dysphagia, particularly at the end of life (EoL), where their guidance can significantly improve patients' comfort and quality of life. However, despite a growing recognition of their importance in this palliative setting, SLPs continue to face obstacles for consistent involvement on the palliative care team. Three primary themes emerged [from this study]: diet texture adjustment, compensatory swallowing strategies, and patient and caregiver education. The review also identified significant barriers to SLP involvement, including inconsistent practices, limited resources, legal concerns, and a lack of interdisciplinary integration.Assistant Editor's note: In my experience, SLPs were rarely, if ever, utilized with hospice patients. However, this article clearly describes ways that SLPs could be helpful for patients with swallowing difficulties. SLPs can also be very useful for patients with speech difficulties. I think the IDT simply does not think of it-does not think of how a SLP could be helpful. Maybe it is also partly due to lack of knowledge of their value. Perhaps, both hospice and palliative care teams might consider arranging for an inservice from a SLP so that team members can learn more about how such therapy could be helpful in improving the quality of life of patients.