Literature Review

Evaluation of required end-of-life (EOL) ethics content in the ten residency programs offering hospice and palliative medicine fellowshipAmerican Journal of Hospice and Palliative Care; by Sara W Youssef, Lauren E Berninger, Danielle J Doberman; 4/25Ethics training is essential to hospice and palliative medicine (HPM) training. Ten residencies can lead into HPM fellowship, but clinical ethics tested on board certification exams vary in content and weight across specialties. Our findings indicate that end-of-life ethics content tested on these board certification exams vary across specialties. Given this variance, standardizing end-of-life ethics training for HPM fellowship programs presents an opportunity for educational improvement.

Integration of palliative care into heart failure care: Consensus-based recommendations from the Heart Failure Society of AmericaJournal of Cardiac Failure; by Sarah Chuzi, Martha Abshire Saylor, Larry A Allen, Akshay S Desai, Shelli Feder, Nathan E Goldstein, Hunter Groninger, James N Kirkpatrick, James A Tulsky, Jill M Steiner, Natasha Lever, Eldrin Lewis, Joseph G Rogers, Haider J Warraich; 3/25Heart failure (HF) is characterized by significant symptoms, compromised quality of life, frequent hospital admissions, and high mortality rates; palliative care (PC) is, therefore, highly relevant for patients with HF and their clinicians. Multiple guidelines and consensus statements recommend the provision of PC alongside HF management. However, few resources exist to guide the integration of PC into HF care, for both primary PC (provided by HF clinicians in the course of HF care) and specialty PC (provided by PC specialists). Through this consensus statement, the Heart Failure Society of America aims to provide a contemporary, practical guide for clinicians and institutions about how PC should be operationalized in the context of comprehensive HF care.

Palliative and end-of-life care interventions with minoritized populations in the US with serious illness: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; by Brandon M. Varilek, Katherine Doyon, Shelie Vacek, Mary J. Isaacson; 1/25Using an equity-informed research approach is vital to improve palliative and end-of-life care interventions for minoritized communities with serious illness. There is also a need for more robust publishing guidelines related to community-based participatory research methods to ensure publication consistency among research teams that employ this complex research method.

Improving outcomes for ICU family members: The role of spiritual careJournal of Palliative Medicine; by Alexia M Torke, Shelley Varner-Perez, Emily S Burke, Amber R Comer, Susan Conrad, LaVera Crawley, Deborah Ejem, Jennifer Gabbard, Patricia E Kelly, Buddy Marterre, Ariel Modrykamien, Patrick O Monahan, Sarah Nouri, Csaba Szilagyi, Douglas White, George Fitchett; 4/25Having a family member hospitalized in the intensive care unit (ICU) can be a stressful experience for family members, encompassing both psychological and spiritual distress. While research has delved into the impact of spiritual care for ICU family members, further investigation is still needed to determine the most effective approaches for delivering such care. This narrative review will describe a conceptual model aimed at guiding future research in this endeavor. The model proposes that chaplains provide emotional, spiritual, and information support to ICU family members. This affects both their ICU experience, decision making, and outcomes for the patient and family.

Does sedation affect patients’ spiritual experience at the end of life? An intersection between medicine and spiritualityJournal of Pain and Symptom Management; by Anne L. Dalle Ave, Daniel P. Sulmasy; 1/25Spirituality, consciousness, sedation, end-of-life, end-of-life care, spiritual experiences Key Message This article explores the role of sedation with respect to the patient’s spiritual experiences at the end of life. As healers, healthcare professionals offer compassionate care to body and soul. While drugs with sedative effects may be an answer to some bodily and psychological suffering, other forms of care, such as spiritual care or counseling, may better address other forms of suffering, particularly the fear of death.

‘Losing a part of yourself’: How women grieve their close friend’s deathOmega-Journal of Death and Dying; Elizabeth W. Sauber, Karen M. O’Brien; 4/25Friendship provides women with a plethora of benefits, including reduced physiological and psychological distress. Thus, this study qualitatively described the bereavement of seven women who experienced the death of a close woman friend and tested an integrative model predicting prolonged grief and posttraumatic growth with 148 women grieving the death of a close woman friend. Findings from directed content analysis highlighted grief reactions, disenfranchising interactions related to social support, ways of coping, growth after loss, and ongoing challenges. Results from a path analysis indicated that avoidant emotional coping was a key mediator and predictor of prolonged grief, while problem-focused coping served as a key mediator and predictor of posttraumatic growth. The findings can be used to advance research, clinical practice and intervention efforts for women who are grieving the death of a woman friend.

Advance care planning and unlimited treatment preferences in dementia scenarios: Insights from community-dwelling adultsAmerican Journal of Hospice and Palliative Care; Yuchi Young, Yichun Liu, Yufang Tu, Wan-Yu Chiu, Ashley Shayya, Thomas O'Grady; 4/25Dementia leads to progressive cognitive decline, impairing self-care and decision making. Advance directives (AdvDirs) enable individuals to document healthcare preferences while cognitively capable, ensuring value-aligned care and reducing caregiver burden. In the dementia scenario, 26.9% of participants preferred unlimited medical treatment. This preference was strongly associated with a pre-existing attitude favoring life-sustaining treatments ... and religious beliefs ... Conversely, an interest in learning about quality of life at the end of life was negatively associated with preferring unlimited treatment ... Our findings highlight the need to align advance care planning with individuals' values, beliefs, and religious practices. 

Theories and concepts about society, dying, and bereavement commonly discussed in education about death, dying, and bereavementDeath Studies; Charles A Corr, Kenneth J Doka; 4/25This article describes and offers some evaluations of fifteen prominent theories and concepts in the field of death, dying, and bereavement. These theories and concepts range from claims about "death-denying societies" and the concept of "societal death systems" to theories about coping with dying and coping with loss, grief, and bereavement. Also examined are the concept of disenfranchised grief and theories about contrasting grief styles. Because each of these theories and concepts is often discussed in education about death, dying, and bereavement, it is important that instructors and students understand both their strengths and limitations. The goal of this analysis is twofold: (1) To help guide educators as they explain these theories and concepts to their students and readers, and (2) To assist educators in commenting on the soundness and usefulness of these theoretical frameworks.

Barriers to perioperative palliative care across Veterans Health Administration hospitals: A qualitative evaluationAmerican Journal of Surgery; by Emily E Evans, Sarah E Bradley, C Ann Vitous, Cara Ferguson, R Evey Aslanian, Shukri H A Dualeh, Christina L Shabet, M Andrew Millis, Pasithorn A Suwanabol; 3/25While providers recognize the importance of palliative care and end-of-life care, obstacles to its use exist at various levels. Identification of these barriers highlights areas to focus future efforts to improve the quality of palliative and end-of-life care for Veterans.

The real-world effect of early screening for palliative care criteria in a medical intensive care unit: An instrumental variable analysisAnnals of the American Thoracic Society; by Chad H Hochberg, Rebecca A Gersten, Khyzer B Aziz, Margaret D Krasne, Li Yan, Alison E Turnbull, Daniel Brodie, Michelle Churchill, Danielle J Doberman, Theodore J Iwashyna, David N Hager; 2/25Early identification of intensive care unit (ICU) patients likely to benefit from specialist palliative care could reduce the time such patients spend in the ICU receiving care inconsistent with their goals. Conclusions: Despite significantly increased specialty palliative care consultation, there was no evidence that early screening for palliative care criteria affected time to DNR/ICU discharge or other secondary outcomes.

Systemic functioning of Puerto Rican families with a cancer patient: A qualitative-oriented mixed-methods studyJournal of Health Psychology; Nicole M. Vélez Agosto; 4/25Puerto Ricans are part of marginalized communities that are impacted by health disparities, such as lifestyles, health behaviors and access to care (Simmons et al., 2011). The purpose of study was to assess systemic functioning in Puerto Rican families with a cancer patient using the Spanish translated version of the Family Genogram Interview (FGI) that measures Bowen’s four emotional processes in nuclear family and family of origin. Results suggested an acceptable reliability for the FGI-Spanish and higher presence of symptoms in a spouse or partner, symptoms in family of origin, focus on a child and emotional cutoff in family of origin. Qualitative findings suggested that main concerns for participants were related to family changes surrounding illness and familial roles, consistent with Bowen’s theory and clinical implications for designing systemic interventions for Puerto Rican families.

Research disrupted at the NIH Clinical Center STAT - Morning Rounds; by Theresa Gaffney; 5/6/25 The NIH Clinical Center — the nation’s largest hospital devoted solely to medical research — is in crisis. In 2023, the hospital ran around 1,500 studies with a permanent staff of more than 1,800 federal workers. But amid continued disruptions from the Trump administration, researchers are leaving, technicians have been let go, studies are facing major delays, and some patients are deciding to drop out of the hospital’s research.

Increasing timely code status discussions in hospitalized children with medical complexityJournal of Hospital Medicine; James Bowen MD; Laura Brower MD, MSc; Daniel Kadden MD; Jasmine Parker BS; Alexandra Delvalle BSN; Andrew Krueger MD; Kristin Todd MSW; Rachel Peterson MD; 4/25Children with medical complexity (CMC) have an increased risk of hospitalization and clinical deterioration. Documentation of code statuses concordant with family goals is rare, increasing the risk of serious unintended consequences. We aimed to increase the percentage of patients with documentation of timely code status orders (CSOs) from 5% to 80% over 6 months. Multiple plan-do-study-act cycles were performed focusing on interventions aimed at key drivers, including increasing knowledge in performing code status discussions (CSDs) and improving understanding of institutional policies. The average percentage of patients who received a CSO placed in their chart within 72 h of admission to the CCT [complex care team] increased from 5% to 61% over 6 months.