Literature Review
All posts tagged with “Research News.”
Further psychometric evaluation of the eight-item Hospice Philosophy Scale: Results from a national sample of interdisciplinary hospice clinicians
07/27/24 at 03:00 AMFurther 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.
Palliative Medicine - June 2024 Issue
07/27/24 at 03:00 AMPalliative Medicine - June 2024 Issue
Omega - Journal of Death and Dying - June 2024
07/27/24 at 03:00 AMOmega - Journal of Death and Dying - June 2024 Sage Journals - Omega - Journal of Death and Dying; June 2024 issue Omega - Journal of Death and Dying, a peer-reviewed journal that says it brings insight into terminal illness, the process of dying, bereavement, mourning, funeral customs and suicide, published research articles on the following topics in its June 2024 edition (Vol. 89, Issue 2). [A few sample topics include the following:]
What does "palliative care" represent in research using secondary data?
07/23/24 at 03:00 AMWhat does "palliative care" represent in research using secondary data? Journal of Pain and Symptom Management; by J. Brian Cassel; 7/18/24 While much research has been done regarding "palliative care" using retrospective cohort studies of large datasets, the data sources may not be capturing specialty palliative care services. This article aims to clarify what source data are used in such studies, how specialty palliative care services are determined to have been provided or not, and mismatches between the nature of the data and the interpretation of researchers.
Assessing pediatric resident needs in grief and bereavement education
07/20/24 at 03:35 AMAssessing 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.
Bridge the gap: Addressing rural end-of-life care disparities and access to hospice services
07/20/24 at 03:30 AMBridge the gap: Addressing rural end-of-life care disparities and access to hospice services Journal of Pain and Symptom Management; by Asif Anwar, Muhammad Kashif Amin, Sherezaad Anwar, Moazzam Shahzad; 7/11/24 online ahead of print Rural hospices face many obstacles in delivering palliative and end-of-life care in the United States. We aimed to identify these barriers and their potential solutions. ... We propose several potential solutions to overcome these hurdles and improve access. ... Advanced practice providers should be considered to serve as physician heads in rural hospices, which would expand resources in areas with physician shortages. A single per diem payment model should be implemented for rural hospices, regardless of the level of care provided, to help offset the higher cost of care. he Critical Access Hospital program and offering cost-based reimbursement for swing-bed stays could improve access to post-acute care, including hospice services. Telehealth can improve the timeliness of care and reduce travel costs for patients and providers. [Continue reading for more solutions.]
Everyday ethics or deference to expertise: experiences of pediatric palliative care teams with ethics consultancy
07/20/24 at 03:25 AMEveryday 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.
Ethical challenges in the treatment of patients with severe anorexia nervosa
07/20/24 at 03:20 AMEthical challenges in the treatment of patients with severe anorexia nervosa Psychiatry Online; by Patricia Westmoreland, MD; Jole Yager, MD; Jonathan Treem, MD; and Philip S. Mehler, MD; 7/15/24 Ethical principles assist us in determining the best course of action with regard to patients with [anorexia nervosa] AN. The vast majority of patients with AN should be offered high-quality, restorative-informed care. But for a minority of patients (e.g., those with SE-AN) other treatment options need to be considered. Clinicians are obliged to realistically assess each patient’s potential for recovery or ability to engage in harm reduction and palliative care approaches, and be cognizant of the wishes of the patient, family, and treatment team. In addition, the burden on caregivers and stewardship in the expenditure of health care resources should also be considered when deciding whether involuntary treatment, harm reduction, palliative care, or end-of-life care be recommended for a particular patient.
Top ten tips palliative care clinicians should know before their patient undergoes surgery?
07/20/24 at 03:15 AMTop 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.
Utility of do-not-resuscitate orders for critically ill infants in the NICU
07/20/24 at 03:10 AMUtility of do-not-resuscitate orders for critically ill infants in the NICU Pediatric Research - the American Pediatric Society, the European Society for Paediatric Research, and the Society for Pediatric Research; by Shannon Y. Adams, Katherine Redford, Randall Li, Ana Malfa, Richard Tucker and Beatrice E. Lechner; 7/5/24 To better understand the value of DNR orders for critically ill infants in the NICU, a prospective mixed-methods approach was utilized including chart review of infants who died in a regional NICU over a twenty-six-month period and surveys of their neonatologists, neonatal fellows, and nurses. Impact:
Tools for tomorrow: a scoping review of patient-facing tools for advance care planning
07/20/24 at 03:05 AMTools for tomorrow: a scoping review of patient-facing tools for advance care planning Palliative Care and Social Practice; by Sean R. Riley, Christiane Voisin, Erin E. Stevens, Seuli Bose-Brill, Karen O. Moss; 6/24/24 first published online Our scoping review reveals an evolving landscape of ACP tools [Advanced Care Planning], marked by increasing diversity in delivery methods and a trend toward personalized, adaptable resources. The integration of technology and patient- and family-centered approaches signifies promising progress in end-of-life care, offering new paths for engagement with patients and families. Critics questioning the utility of ACP may need to revisit their perspectives in light of these innovative developments. Our findings highlight the need for further research on the effective implementation and integration of these tools as well as other unique approaches into healthcare systems and community-based settings. Ultimately, the continual advancement of these tools may reshape health services research, leading to more patient- and family-centered care and improving end-of-life decision-making processes outcomes for all people thereby promoting health equity.
It starts with a story: A four-step narrative-based framework for serious illness conversations
07/20/24 at 03:00 AMIt starts with a story: A four-step narrative-based framework for serious illness conversations Journal of Palliative Medicine; by Natalie Lanocha, Sara Taub, Jason N Webb, Mary Wood, Tyler Tate; 7/5/24 online ahead of print An original and innovative identity-centered conceptual framework for serious illness conversations was developed. The framework consists of a four-step, reproducible approach: (1) attend to patient narrative identity, (2) identify values, (3) cocreate goals, and (4) actively promote choices. In short: attend, identify, create, and promote (AICP). ... By using this conceptual framework and four-step approach, clinicians can accomplish goal-concordant serious illness care and build rich clinical relationships that foster trust and goodwill.
Hospice enrollment and central nervous system–active medication prescribing to Medicare decedents with dementia
07/20/24 at 02:00 AMHospice enrollment and central nervous system–active medication prescribing to Medicare decedents with dementia JAMA Psychiatry; by Lauren B. Gerlach, DO, MS; Lan Zhang, PhD; Joan Teno, MD, MS; Donovan T. Maust, MD, MS; 7/17/24 Central nervous system (CNS)–active medications, including benzodiazepines and antipsychotics, are commonly prescribed in hospice for behavioral and physical symptom management.1 Such medications are not without risks, especially among patients living with Alzheimer disease and related dementias (ADRD), where potential harms may outweigh benefits for some patients.2 We explored the extent to which hospice enrollment is associated with CNS–active medication exposure among Medicare decedents with ADRD.
Report shows substantial financial opportunity in prioritizing research, education on women’s heart health
07/16/24 at 03:00 AMReport shows substantial financial opportunity in prioritizing research, education on women’s heart health Pharmacy Times; by Alexandra Gerlach; 7/13/24 A report published by authors from the American Heart Association (AHA) and the McKinsey Health Institute showed that addressing the gender gaps prevalent in the treatment of cardiovascular disease (CVD) could boost the US economy by $28 billion annually by 2040 and potentially address the 1.6 million years of life lost due to barriers to care experienced by women. The paper identifies multiple pathways to addressing the lack of representation and access to care for women with CVD... CVD is the leading cause of death in women in the United States, affecting nearly 60 million individuals, and it makes up over a third of the health gap between men and women.
Characterizing disparities in receipt of palliative care for Asian Americans, Native Hawaiians, and Pacific Islanders with metastatic cancer in the United States
07/13/24 at 03:40 AMCharacterizing disparities in receipt of palliative care for Asian Americans, Native Hawaiians, and Pacific Islanders with metastatic cancer in the United States Supportive Care in Cancer: Official journal of the Multinational Association of Supportive Care in Cancer; by Khushi Kohli, Mahi Kohli, Bhav Jain, Nishwant Swami, Sruthi Ranganathan, Fumiko Chino, Puneeth Iyengar, Divya Yerramilli, Edward Christopher Dee; 7/9/24 Palliative care plays essential roles in cancer care. However, differences in receipt among individuals identifying as Asian American, Native Hawaiian, and Other Pacific Islanders (AA&NHPI) with cancer are not well-characterized, especially when these diverse groups are disaggregated. We characterized disparities in receipt of palliative care among AA&NHPI patients with AJCC Stage IV prostate, breast, or lung cancer. Conclusions and relevance: Our findings demonstrate disparities in receipt of palliative care upon disaggregation of diverse AA&NHPI groups, the need for disaggregated research and targeted interventions that address the unique cultural, socioeconomic, and healthcare system barriers to palliative care receipt.
Disparities in end-of-life care for minoritized racial and ethnic patients during terminal hospitalizations in New York State
07/13/24 at 03:35 AMDisparities in end-of-life care for minoritized racial and ethnic patients during terminal hospitalizations in New York StateJournal of the American Geriatrics Society; Miguel Cid, Main Lin Quan Vega, Zhixin Yang, Jean Guglielminotti, Guohua Li, May Hua; 7/24Racial and ethnic minorities often receive care at different hospitals than non-Hispanic white patients, but how hospital characteristics influence the occurrence of disparities at the end of life is unknown. ... During terminal hospitalizations, Black patients were less likely than non-Hispanic White patients to have documented end-of-life care. This disparity appears to be more pronounced in non-teaching hospitals than in teaching hospitals.
The promise and challenge of value-based payment
07/13/24 at 03:30 AMThe promise and challenge of value-based paymentJAMA Internal Medicine; by Daniel K Shenfeld, Amol S Navathe, Ezekiel J Emanuel; 7/24Fee-for-service (FFS) systems pay physicians and health care institutions based on the number of services provided, whereas value-based payment (VBP) links payment to quality and outcomes. In 2021, the Centers for Medicare & Medicaid Services (CMS) announced the goal to use VBP for all Medicare beneficiaries’ health care by 2030. Some commercial insurers are also aligning their contracts to VBP. This broad alignment stems from increasing recognition that to reduce health care costs, incentives must be realigned to change practice patterns, prioritizing quality and cost lowering over quantity of services... Paying for value rather than more health care is without any question a wise approach. VBP fits with the intrinsic motivation of doing good, which led most physicians to medicine. Yet, achieving this is difficult due to operational and financial challenges inherently associated with the transition to VBP. A more efficient, economical method of assessing the underlying risk of a population and measuring the value and quality of care is needed. Various stakeholders across the public and private sectors are working to realize this vision.
The unintended and anticompetitive consequences of laws to control health care costs [CON implications]
07/13/24 at 03:25 AMThe unintended and anticompetitive consequences of laws to control health care costsJAMA Forum; by Lanhee J. Chen; 6/24An array of federal and state laws, and accompanying regulations, restrict the supply of health care, driving up costs and making health care less affordable and accessible for many in the US. Too few health policy analysts and commentators have paid attention to these supply-side limitations that play a significant role in limiting the number of clinicians and health care facilities. Even though some of these policies were well-intentioned and designed to control costs, they have, in practice, undermined competition and ironically led to higher prices in the long run... Together, CON and COPA laws, as well as the ACA restrictions on POHs, have been associated with a host of unintended consequences, such as the aggregation of market power in increasingly larger health care facilities, limited access to care, and higher costs for patients. Indeed, these supply-side restrictions have been critiqued by analysts across the ideological spectrum. Policymakers at both the state and federal level should take note of the unintended effects of these laws and their accompanying regulatory provisions and consider whether their repeal or modification would benefit patients and the communities where they live.
Career impact of palliative care fellowship training for nurse practitioners
07/13/24 at 03:20 AMCareer impact of palliative care fellowship training for nurse practitioners Journal of Palliative Medicine; by Hilary Carroll McGuire, Jennifer Costa, Barbara Reville; 7/8/24 online ahead of print Postgraduate fellowship training for nurse practitioners (NP) in palliative care can ameliorate workforce shortages; however, currently there are few NP fellowships and little evidence about outcomes, such as retention in hospice and palliative nursing, job satisfaction, or professional contributions. Conclusions: NP palliative care fellowship alumni reported multiple career benefits including job satisfaction, professional accomplishment, and ongoing employment at their training institutions.
A hospice transitions program for patients in the Emergency Department
07/13/24 at 03:15 AMA Hospice Transitions Program for patients in the Emergency Department JAMA Network Open; by Christopher W. Baugh, MD, MBA; Kei Ouchi, MD, MPH; Jason K. Bowman, MD; Ayal A. Aizer, MD; Alexander W. Zirulnik, MD, MPH; Martha Wadleigh, MD; Angela Wise, MHA; Paula Remón Baranda, MEM; Richard E. Leiter, MD, MA; Bradley J. Molyneaux, MD, PhD; Andrea McCabe, RN; Panupong Hansrivijit, MD; Kate Lally, MD; Melissa Littlefield, MBA; Alexei M. Wagner, MD, MBA; Katherine H. Walker, MD, MSc; Hojjat Salmasian, MD, MPH, PhD; Kourosh Ravvaz, MD, PhD; Jada A. Devlin, BSN; Karen Lewis Brownell, RN, BSN, CEN; Matthew P. Vitale, MD; Frantzie C. Firmin, MS, RN; Nelia Jain, MD; Jane deLima Thomas, MD; James A. Tulsky, MD; Soumi Ray, PhD; Lynne M. O’Mara, MPAS, PA-C; Elizabeth M. Rickerson, MD; Mallika L. Mendu, MD, MBA; 7/8/24Patients often visit the emergency department (ED) near the end of life. Their common disposition is inpatient hospital admission, which can result in a delayed transition to hospice care and, ultimately, an inpatient hospital death that may be misaligned with their goals of care. Conclusions and relevance: In this quality improvement study, a multidisciplinary program to facilitate ED patient transitions was associated with hospice use. Further investigation is needed to examine the generalizability and sustainability of the program.Editor's Note: We posted an article on 7/10/24 that describes the significance of this research,"Study finds new program streamlined hospice transitions from the emergency department."
End-of-life symptoms and symptom management in older adults with stroke versus cancer
07/13/24 at 03:10 AMEnd-of-life symptoms and symptom management in older adults with stroke versus cancerAmerican Journal of Hospice & Palliative Medicine; Hanna Ramsburg, Meredith MacKenzie Greenle, Janice L Hinkle; 6/24Little is known about the end-of-life (EOL) experience in older adults with stroke or how similar the EOL experience is in older adults with stroke when compared to those with cancer. Older adults with stroke are at risk for inadequate symptom assessment and documentation, as well as poorer symptom management and poorer overall care quality.
Prognoses associated with Palliative Performance Scale scores in modern palliative care practice
07/13/24 at 03:05 AMPrognoses associated with Palliative Performance Scale scores in modern palliative care practiceJAMA Network Open; by Kara E Bischoff, Kanan Patel, W John Boscardin, David L O'Riordan, Steven Z Pantilat, Alexander K Smith; 7/1/24The Palliative Performance Scale (PPS) is one of the most widely used prognostic tools for patients with serious illness. However, current prognostic estimates associated with PPS scores are based on data that are over a decade old. ... Conclusions and relevance: In this prognostic study, prognostic estimates associated with PPS scores were substantially longer than previous estimates commonly used by clinicians. Based on these findings, an online calculator was updated to assist clinicians in reaching prognostic estimates that are more consistent with modern palliative care practice and specific to the patient's setting and diagnosis group.
Integrative oncology for patients with lung cancer: A prospective pragmatic controlled trial
07/13/24 at 03:00 AMIntegrative oncology for patients with lung cancer: A prospective pragmatic controlled trial Lung Cancer; by Eran Ben-Arye, Orit Gressel, Shahar Lifshitz, Nir Peled, Shoshana Keren, Noah Samuels; 6/25/24 Complementary medicine and integrative oncology modalities (IOM) have been included in the clinical practice guidelines of the American College of Chest Physicians in the treatments of patients with lung cancer. The present study examined the impact of a patient-tailored IOM treatment program on quality of life (QoL)-related concerns among patients with non-small and small lung cancer undergoing active oncology treatment. ... High adherence to a 6-week IOM program within supportive/palliative care for patients with lung cancer was found to alleviate pain and emotional concerns, improving overall QoL. Further research is needed to confirm the findings in real-life IOM practice for patients with lung cancer.
Veteran Honored: 101-year-old recognized for bravery on the battlefield
07/09/24 at 03:00 AMVeteran Honored: 101-year-old recognized for bravery on the battlefieldThe Glendale Star, Tempe AZ; by Lin Sue Flood; 7/5/24 At the tender age of 18, Ned Kent joined the Army. That was January 1940 ... and he served faithfully through July 1945 ... [Kent] fought on the front lines of the Battle of the Bulge in Belgium. He and his troop won a Bronze Heart for their heroic actions in storming Normandy while under German bombardment on D-Day, now over 80 years ago. His daughter Debi is enormously proud of his courage. “My dad is a hero, but my dad is also a humble man,” she said. Proving her point, the 101-year-old was quick to add, “I’m no hero. I just served in the Army.” But those five years of service were difficult to talk about. It took Kent decades to open up about what he experienced, including the horrors witnessed while liberating a concentration camp. One of the people he shared openly with was Hospice of the Valley social worker Roberta Fellows. Once she learned about his time in the service, she was determined to give him some much-needed recognition for all he endured. [Click on the title's link to continue reading.]
Ethics at the end of life
07/06/24 at 03:30 AMEthics at the end of lifeMedicine; by John Idris Baker; 7/24End-of-life care has always been prominent in discussions of clinical ethics. Almost 30% of hospital inpatients are in their last year of life. Doctors frequently encounter people with end-of-life care needs and should to be equipped to respond... Key points: