Literature Review

Virtual reality for pain management in hospitalized patients with cancer: A randomized controlled trialCancer; by Hunter Groninger, Diana Violanti, Mihriye Mete; 4/24Among hospitalized adult patients with moderate-severe pain related to cancer and cancer therapies, VR provided more nonpharmacologic pain relief than active control and this benefit sustained long after conclusion of the intervention.

Advance Care Planning: Perspectives of People Living in PrisonJournal of Hospice and Palliative Nursing; by Erin Kitt-Lewis, Nanda Zheng, Susan J Loeb; 8/24A person-centered approach to advance care planning is recognized as a fundamental need, yet its routine implementation remains a challenge across disparate settings, such as prisons. The purpose of this study was to gain the perspectives of people who are incarcerated about advance care planning... Findings contribute to identifying best practices for infusing advance care planning into prisons.

Providing clarity: communicating the benefits of palliative care beyond end-of-life supportPalliative Care and Social Practice; by Julie L Masters, Patrick W Josh, Amanda J Kirkpatrick, Mariya A Kovaleva, Harlan R Sayles; 6/24Palliative care affords numerous benefits, including improvements in symptom management, mental health, and quality of life, financial savings, and decreased mortality. Yet palliative care is poorly understood and often erroneously viewed as end-of-life care and hospice. Barriers for better education of the public about palliative care and its benefits include shortage of healthcare providers specializing in palliative care and generalist clinicians' lack of knowledge and confidence to discuss this topic and time constraints in busy clinical settings. This study offers insight into the knowledge and attitudes about palliative care among community-dwelling adults, 19 years and older living in Nebraska. More effort is needed to communicate what palliative care is, who can receive help from it, and why it is not only for people at end of life.

The Tandem VR™ protocol: Synchronized nature-based and other outdoor experiences in virtual reality for hospice patients and their caregiversContemporary Clinical Trials Communications; by O McAnirlin, J Thrift, F Li, J K Pope, M H E M Browning, P P Moutogiannis, G Thomas, E Farrell, M M Evatt, T Fasolino; 6/24Nature-based and other outdoor virtual reality (VR) experiences in head-mounted displays (HMDs) offer powerful, non-pharmacological tools for hospice teams to help patients undergoing end-of-life (EOL) transitions. However, the psychological distress of the patient-caregiver dyad is interconnected and highlights the interdependence and responsiveness to distress as a unit. Using personalized, nature-based and other outdoor VR content, the patient-caregiver dyads can simultaneously engage in an immersive encounter may help alleviate symptoms associated with declining health and EOL phases for the patient and the often overburdened caregiver. This protocol focuses on meeting the need for person-centered, non-pharmacological interventions to reduce physical, psychological, and spiritual distress.

Prognostication in hospice care: Challenges, opportunities, and the importance of functional statusFederal Practitioner - Case Reports; by David B. Brecher, MD and Heather J. Sabol, MSN, ARNP; 7/24 Predicting life expectancy and providing an end-of-life diagnosis in hospice and palliative care is a challenge for most clinicians. Lack of training, limited communication skills, and relationships with patients are all contributing factors. These skills can improve with the use of functional scoring tools in conjunction with the patient’s comorbidities and physical/psychological symptoms. The Palliative Performance Scale (PPS), Karnofsky Performance Scale (KPS), and Eastern Cooperative Oncology Group Performance Status Scale (ECOG) are commonly used functional scoring tools.

Pain Management at the End of LifeJournal of Hospice and Palliative Nursing; HPNA position statement; 8/24.Pain management is essential from the time of diagnosis of a serious illness and throughout the disease trajectory. Unfortunately, the prevalence of pain in those with serious illness remains unacceptably high. In most cases, pain experienced by people with advanced disease can be prevented or relieved through optimal care, yet studies reveal that patients continue to experience uncontrolled pain in the final weeks, days, and hours of their lives...

Psychiatric manifestations of neurological diseases: a narrative reviewCureus Journal of Medical Science; Anthony J. Maristany, Brianna C. Sa, Cameron Murray, Ashwin B. Subramaniam, Sean E. Oldak; 7/24Neurological diseases like Alzheimer's, FTD [frontotemporal dementia], Parkinson's, MS [multiple sclerosis], stroke, epilepsy, Huntington's, ALS [amyotrophic lateral sclerosis], TBI [traumatic brain injury], andMSA [multiple system atrophy] are not only characterized by neurological symptoms but also by various psychiatric manifestations, complicating diagnosis and treatment. For instance, Alzheimer's induces cognitive decline and emotionaldistress, Parkinson's leads to motor impairments and mood disorders, and MS intertwines physicalsymptoms with emotional disturbances. Understanding these complex relationships is crucial forcomprehensive care. Collaboration, innovation, and ethical commitment are essential for improvingoutcomes.

Palliative Medicine - June 2024 Issue

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.

The home-based experiences of palliative and hospice care for children and caregivers (EXPERIENCE) Measure: evaluation of psychometric propertiesJournal of Pain and Symptom Management; by Jackelyn Y Boyden, Mary Ersek, Kimberley A Widger, Judy A Shea, Chris Feudtner; 6/24Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received.

Assessing pediatric resident needs in grief and bereavement educationJournal of Pain and Symptom Management; Hannah Reuman, Scott H Maurer, Kelly Harris, Amanda W Brown; July 2024Pediatric [medical] residents care for dying children during training. Few educational efforts focus on helping trainees better understand their own grief process and the supports available to them and their patients' families. This work aims to assess pediatric residents' needs and preferences for content included in a curriculum on grief and bereavement. Conclusion: Pediatric residents indicate a strong desire for structured curricula on grief and bereavement focusing on resources that exist for families, approaches to grieving as a healthcare professional, and better understanding the experiences of bereaved families. These data may inform educators on priorities in training and support of pediatric residents on grief and bereavement.

Everyday ethics or deference to expertise: experiences of pediatric palliative care teams with ethics consultancyJournal of Palliative Medicine; Anessa M Foxwell, Connie M Ulrich, Jennifer K Walter, Meaghann S Weaver; 7/24Little is known about the extent to which pediatric palliative care (PPC) clinicians are engaged in ethics consults or how they perceive interactions with ethics consultants. Online survey distributed to members of the American Academy of Pediatrics and American Academy of Hospice and Palliative Care pediatric and ethics section and special interest groups in the United States. Eighty-six responses were obtained (response rate 45%) from PPC teams in 70 different children's hospitals located in 34 states. Almost all (97%) reported a functional ethics consult service such that PPC is not expected to meet the ethics need of the institution. A person involved on the PPC team also performed ethics consults in half (49%) of the settings, predominantly the PPC physician. Most respondents who perceive PPC teams engage in ethics-relevant work as part of their everyday PPC work. Formal ethics training was lacking among PPC members involved in ethics consults with few ethics degrees (15%), certifications (6%), or fellowships (2%). Discord (67%), conflict (49%), limitations to treatment (48%), and distress (41%) were cited as the most frequent reasons for which PPC teams consult ethics. PPC respondents identified role clarity, coordinated engagement, timely presence, and open communication as strong PHCE consultant practices. Conclusions: PPC team members performing ethics consults may benefit from additional ethics education and training.

Top ten tips palliative care clinicians should know before their patient undergoes surgery? Journal of Palliative Medicine; by Rachel Hadler, Lara India, Angela M Bader, Orly N Farber, Melanie L Fritz, Fabian M Johnston, Nader N Massarweh, Ravi Pathak, Sandra H Sacks, Margaret L Schwarze, Jocelyn Streid, William E Rosa, Rebecca A Aslakson; 7/15/24 online ahead of print Many seriously ill patients undergo surgical interventions. Palliative care clinicians may not be familiar with the nuances involved in perioperative care, however they can play a valuable role in enabling the delivery of patient-centered and goal-concordant perioperative care. ... This article, written by a team of surgeons and anesthesiologists, many with subspecialty training in palliative medicine and/or ethics, offers ten tips to support palliative care clinicians and facilitate comprehensive discussion as they engage with patients and clinicians considering surgical interventions.