Literature Review
All posts tagged with “Research News.”
Integrating the clinical nurse specialist into a multi-state hospice in a large healthcare system
09/27/25 at 03:25 AMIntegrating the clinical nurse specialist into a multi-state hospice in a large healthcare systemJournal of Hospice and Palliative Nursing; by Jennifer Jarrett Lee, Melissa Robinson; 8/25Advanced Practice Registered Nurses are increasingly recognized for their role and impact in hospice and palliative care. The integration of a CNS into the practice of a large, multistate Hospice and Palliative Care program is discussed in this article. A timeline is provided with 4 phases of integration with priorities identified and specific strategies that were implemented to overcome challenges during the process. The value of CNS practice to the organization is highlighted in 3 practice exemplars, showing return on investment in terms of increased patient safety and implementation of evidence-based practice for home infusions, developing nurse confidence through complex case reviews, and reducing staff injuries through developing a Safe Patient Handling program.
Initiation of pregabalin vs gabapentin and development of heart failure
09/27/25 at 03:20 AMInitiation of pregabalin vs gabapentin and development of heart failureJAMA Network Open; by Elizabeth E. Park, Laura L. Daniel, Alyson L. Dickson, Meghan Corriere, Puran Nepal, Kathi Hall, W. Dale Plummer, William D. Dupont, Katherine T. Murray, C. Michael Stein, Wayne A. Ray, Cecilia P. Chung; 8/25Both pregabalin and gabapentin are common nonopioid medications used to treat chronic pain, which affects up to 30% of patients. Because pregabalin has greater potency than gabapentin in binding to the α2δ subunit of the L-type calcium channel, pregabalin may be associated with an increased risk for heart failure (HF). The findings suggest that pregabalin should be prescribed with caution in older patients with noncancer chronic pain.
A decade of interactive educational exchange: Impacting interprofessional palliative care education
09/27/25 at 03:15 AMA decade of interactive educational exchange: Impacting interprofessional palliative care educationJournal of Pain and Symptom Management; by Laura J Morrison, Shirley Otis-Green, Julie Bruno, Pamela N Fordham, Elise C Carey; 9/25The interprofessional clinical practice model is arguably the most impactful and generative aspect of hospice and palliative care (HPC) clinical practice. This article describes the innovative shared interprofessional leadership model, andragogical infrastructure, program development, educational impact, and critical lessons from the Interactive Educational Exchange (IEE). In response to a deficit in interprofessional HPC educational opportunities for rapid scholarship dissemination and mentorship, interprofessional leaders from medicine, social work and nursing proposed and implemented the IEE at the Annual Assembly of Hospice and Palliative Care presented by the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association from 2010-2020. The reported outcome measures for interprofessional scholarship and engagement, session evaluations, and attendance demonstrate why this successful innovation was repeated annually for over a decade pre-COVID.
Differences in after-death communications: A comparative analysis of unexpected vs. expected deaths and their impact on survivors' grief and perception of death
09/27/25 at 03:10 AMDifferences in after-death communications: A comparative analysis of unexpected vs. expected deaths and their impact on survivors' grief and perception of deathOmega; by Tess H McCormick, Gwen Grams, Fatma A Wise, Madeline Burns, Ashna Charania, Noelle St Germain-Sehr, Chris Roe, Callum E Cooper, David Lorimer, Evelyn Elsaesser, Jennifer Kim Penberthy; 9/25This study explores changes in grief and fear of death in individuals who reported after death communications (ADC) from people who died unexpectedly or whose death was expected. We found that those bereaved by unexpected loss reported significantly higher levels of uncertainty regarding changes in their fear of death compared to those bereaved by an expected loss. However, no significant differences were found in grief between the two groups. Most participants reported a positive impact of ADC on their bereavement, regardless of the type of loss they experienced.
The silent grief of grandmothers after an out-of-order death-An interpretative phenomenological analysis
09/27/25 at 03:05 AMThe silent grief of grandmothers after an out-of-order death-An interpretative phenomenological analysisDeath Studies; by Jordan Robertson, Elizabeth A Cutrer-Párraga, Paul Caldarella, Jeremy B Yorgason, Terrell Young, Erjola Gjini, Sarah Stuart, Savannah Tueller; 9/25This study delves into the lived experiences of grandmothers grappling with grief following the "out-of-order" death of a child, child-in-law, or grandchild ... Findings reveal three key themes: navigating personal grief, intergenerational support dynamics, and reconstructing family identity. Grandmothers oscillate between loss-oriented and restoration-oriented coping, with grief intensity varying by relational proximity-most profound when losing their own child. They provide emotional and practical support to surviving grandchildren, yet their own sorrow is frequently overlooked, fostering isolation. The study suggests the need for enhanced recognition and tailored support for grandmothers, integrating life course theory to address the disruption of off-time deaths, ultimately advocating for a balanced approach to their bereavement process.
Rehab and death: Improving end-of-life care for Medicare skilled nursing facility beneficiaries
09/27/25 at 03:00 AMRehab and death: Improving end-of-life care for Medicare skilled nursing facility beneficiariesJournal of the American Geriatrics Society; by Sarguni Singh, Christian Davis Furman, Lynn A. Flint, Joan Teno; 8/25Hospitalized older adults with serious illness may be discharged to a skilled nursing facility (SNF) [and] ... for those that do not improve, discharge to a SNF can begin a cycle of costly care transitions between hospital, home with home health care, SNFs, and long-term care facilities, leading to fragmented care and missed opportunities for discussions about preferences for care, illness understanding, and to address distressing symptoms. In this article, we describe key policies that contribute to high-cost, low-value care near the end of life for older adults using the Medicare SNF benefit.
Driving innovation: Healthsperien launches Center for Health Research, Policy & Strategy led by seasoned experts
09/24/25 at 03:00 AMDriving innovation: Healthsperien launches Center for Health Research, Policy & Strategy led by seasoned experts PR Newswire, Washginton, DC; by Healthsperien; 9/23/25 Healthsperien announces the official launch of its Center for Health Research, Policy & Strategy, marking the third in a series of new Centers of Expertise designed to provide clients with specialized, high-quality services and reinforce Healthsperien as a comprehensive partner and integrated hub for health policy, government relations, and research strategies. ... The Center will be led by Dianne Munevar, Partner, who joins Healthsperien after serving as Vice President of Health Care Strategy at NORC at the University of Chicago. She will lead a seasoned team of 5 research, policy, and strategy experts, who also come from NORC at the University of Chicago, ...
The new clinician-scholars—dual training in medicine and humanities drives health research innovation
09/22/25 at 03:00 AMThe new clinician-scholars—dual training in medicine and humanities drives health research innovation JAMA; by Vinayak Jain, MD; Kayla Zamanian, MS; Lakshmi Krishnan, MD, PhD; 9/18/25 Clinicians and researchers operate in an evolving landscape that demands innovative approaches to knowledge production and dissemination. Emerging technologies like artificial intelligence are transforming health care, public trust in scientific institutions is deteriorating, and major centers of biomedical research are grappling with programmatic and funding disruptions. In response, a new paradigm of clinician-scholar must emerge—one equipped not only with scientific fluency, but also the conceptual, analytical, and structural tools of humanities and social sciences.
A rapid review of states' Portable Medical Order forms and the National POLST Paradigm for Advance Care Planning
09/20/25 at 03:35 AMA rapid review of states' Portable Medical Order forms and the National POLST Paradigm for Advanced Care PlanningJournal of Hospice and Palliative Nursing; by Tracy Fasolino, Megan Pate, Nancy Dias, Rikki Hooper, Lena Burgess, Megan Golden, Savannah Horvick, Jamie Rouse, Elizabeth Snyder; 8/25Hospice and palliative care nurses initiate goals of care conversations with patients and family members while advocating for the completion of advance directives. As leaders in these conversations, nurses must have a working knowledge of the various forms, such as portable medical orders. The National Physician Orders for Life-Sustaining Treatment (POLST) Paradigm calls for the standardization of portable medical orders to ensure goal-concordant care that can cross all healthcare settings. This rapid review provides an overview of state-level portable medical order forms, compares and contrasts them with the National POLST form, and proposes policy recommendations for hospice and palliative care nurses to advocate within their state, territory, or tribal nation.
Beyond grief: Quantifying bereavement needs of rural family caregivers
09/20/25 at 03:30 AMBeyond grief: Quantifying bereavement needs of rural family caregiversPalliative and Supportive Care; by Catherine Vanderboom, Diane Holland, Cory Ingram, Brystana G Kaufman, Allison Gustavson, Jay Mandrekar, Ann Marie Dose, Ellen Wild, Carole Stiles, Joan M Griffin; 9/25Family caregivers (FCGs) may experience numerous psychosocial and practical challenges with interpersonal relationships, mental health, and finances both before and after their care recipient (CR) dies. The specific challenges affecting rural FCGs who often have limited access to palliative care services, transitional care, and other community resources are not well understood... Bereavement support should extend beyond a focus on grief to include practical challenges experienced by FCGs. Because challenges experienced in the bereavement period often begin before a CR's death, there is benefit in continuity of FCG support provided by a known clinician from pre- to post-death. When given an option, many rural FCGs are open to bereavement support as early as a week after the death of a CR.
Serious illness communication in homecare nursing: A concept analysis
09/20/25 at 03:25 AMSerious illness communication in homecare nursing: A concept analysisJournal of Hospice and Palliative Nursing; by Christine S Davidson, Olga Ehrlich, Toni L Glover; 8/25Many seriously ill patients receive nursing care at home to manage their illness [and] there is a growing overlap between homecare and palliative or hospice care. In the homecare setting, nurses may be uncertain about their role and responsibility for engaging in "serious illness communication." The term "serious illness communication" is sometimes used ambiguously, overlapping with other terms such as goals of care discussions or end-of-life conversations. Proponents of serious illness communication emphasize the need for a shift from traditional advance care planning toward a real-time, patient-centered dialogue adaptive to the evolving nature of serious illness.
Suicide bereavement among Black-Americans: Evidence from the General Social Survey
09/20/25 at 03:20 AMSuicide bereavement among Black-Americans: Evidence from the General Social SurveyOmega-Journal of Death and Dying; by William Feigelman, Julie Cerel, John McIntosh, Nina Gutin, Alice C. Edwards; 8/25Limited research attention has focused on examining the diverging adaptations of American Blacks and Whites to suicide losses. We utilized the 2016 General Social Survey, which included questions related to experiencing suicide bereavement, investigating hypotheses past studies suggested predicting Blacks face more grieving difficulties than their White counterparts. This data did not confirm any evidence of heightened grief or mental health problems among the Black respondents. Owing to the limited number of measurements of mental health assessments more research will be needed to confirm these findings.
Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adults
09/20/25 at 03:15 AMAssociations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.
“I know you didn’t want to stay”: Emergency Department conversations about disposition for people living with dementia
09/20/25 at 03:10 AM“I know you didn’t want to stay”: Emergency Department conversations about disposition for people living with dementia The Gerontologist; Justine Seidenfeld, Matthew Tucker, Melissa Harris-Gersten, Gemmae M Fix, Nina R Sperber, Susan N Hastings; 8/25When people living with dementia present to the emergency department (ED), the disposition decision- to admit them to the hospital or discharge them home- can be difficult for providers. Major themes included 1) disposition conversations had significant variation in depth and content, 2) patient and care partner participation varied with disposition, and 3) satisfaction was driven by alignment of disposition preferences. Our study suggests that there are no consistent formats of disposition conversations for people living with dementia. Improving quality may be most needed when preferences are misaligned, and this should be identified early in the encounter.
The best end-of-life care begins with TRUTH
09/20/25 at 03:05 AMThe best end-of-life care begins with TRUTHProfessional Case Management; by Julie-Kathryn E Graham, Christina Kelley, Gabriella Malagon-Maldonado; 9/25For decades, research has recommended truth and transparency in end-of-life care discussions with patients, families, and family-centered care. This study demonstrated that, in practice, this is often not done, resulting in further traumatization to families at the end of life ... [which] makes information processing and decision-making very difficult. At end-of-life, person-centered care is family-centered care. A person's individuality is inextricable from who they are to their family. If we do not care for the family, we do not care for our patients.
Hospice Research Information 9/20/25
09/20/25 at 03:00 AMHospice Research Information 9/20/25
Research digs into costs, opportunities in hospice, palliative care
09/15/25 at 03:00 AMResearch digs into costs, opportunities in hospice, palliative care Hospice News; by Jim Parker; 9/9/25 Researchers have recently uncovered significant financial trends taking shape in hospice and palliative care. Issues examined relate to cost-effectiveness, Medicare Advantage spending patterns, caregivers’ financial challenges and the cost-effectiveness of palliative care.
Developing competencies to advance health care access and quality for Latino, Hispanic, and Spanish origin populations-A consensus statement
09/13/25 at 03:45 AMDeveloping competencies to advance health care access and quality for Latino, Hispanic, and Spanish origin populations-A consensus statementJAMA Network Open; by Débora H. Silva, John A. Davis Rodríguez, Hector Rasgado-Flores, Pilar Ortega, Deion Ellis, Fernando Sánchez Mendoza, Victor Cueto, Fabiola Quintero-Rivera, Norma Iris Poll-Hunter, Minerva Romero Arenas, Kenneth Lee Dominguez, Juan Emilio Carrillo, José E. Rodríguez, John Paul Sánchez; 8/25Question: What competencies and milestones are essential for advancing health equity for Latina, Latino, Latinx, Latine, Hispanic, and Spanish Origin (LHS+) populations? Since the 1970s, the LHS+ population has increased 6-fold and grown to be the largest ethnic or racial group in the US and accounts for approximately 20% of the US population. The LHS+ health equity competencies and milestones resulting from this study add to prior work by creating a blueprint for standardization and broader application of such educational experiences on a national level. As a tool to enhance CBME [competency-based medical education ] efforts aligned with care for LHS+ populations, the competencies may aid educators and institutions through an LHS+–informed lens in conducting gap analyses for the development of local curricula, developing teaching and assessment materials, supporting the professional development of learners and faculty, and facilitating educational scholarship.
Are we growing leaders? Exploring leadership training in hospice and palliative medicine fellowship
09/13/25 at 03:40 AMAre we growing leaders? Exploring leadership training in hospice and palliative medicine fellowshipJournal of Pain & Symptom Management; by Lynn A Flint, Greg Wallingford, Paul Tatum, Julie Bruno, Helen Fernandez, Elise C Carey; 8/25The purpose of this study was to characterize the current state of leadership curricula in HPM fellowships and understand which leadership topics fellowship program directors (PDs) consider to be most important to include in a leadership curriculum for fellows. Respondents rated leadership topics as important for training, yet many topics are not included in fellowship curricula. Six topic areas related to communication and self-management were rated as having great need or were included in existing curricula by more than 60% of respondents. PDs identified ten topics to be of great need for fellows, all but one of which were included in at least 40% of programs' curricula. Negotiation was the exception being included in only 20% of programs' curricula.
Medicare Advantage plan spending and payments under the hospice carve-out
09/13/25 at 03:35 AMMedicare Advantage plan spending and payments under the hospice carve-outJAMA Network Open; by Meghan Bellerose, Andrew M Ryan, Claire K Ankuda, David J Meyers; 8/25In 2021, the Centers for Medicare & Medicaid Services implemented a Value-Based Insurance Design (VBID) model to test the impact of including hospice services in the Medicare Advantage (MA) benefits package. In December 2024, the VBID was ended following widespread dissatisfaction ... Under the carve-out model, after an MA enrollee elects hospice, health care related to their terminal illness is paid for by fee-for-service (FFS) Medicare. MA plans stop receiving the inpatient and outpatient portions of that enrollee's capitated payment but continue to receive premium and rebate payments. In this cross-sectional study, MA plans received high premium and rebate payments for beneficiaries enrolled in hospice despite low health care spending after enrollees elected hospice. To reduce excess payments, the Centers for Medicare & Medicaid Services could require MA plans to submit information on enrollees' use of supplemental benefits and adjust payments made after election of hospice to align with spending.
Patient-and caregiver-identified goals for advance care planning in patients with dementia or cognitive impairment
09/13/25 at 03:30 AMPatient-and caregiver-identified goals for advance care planning in patients with dementia or cognitive impairmentDementia; by Kristin L Rising, Angela M Gerolamo, Nazanin Sarpoulaki, Venise J Salcedo, Grace Amadio, Robin Casten, Anna Marie Chang, Alexzandra T Gentsch, C Virginia O'Hayer, Barry Rovner, Brooke Worster; 8/25Despite an aging population and acknowledged importance of advance care planning (ACP) for persons living with cognitive impairment, few engage in ACP. Most existing tools to facilitate ACP discussions focus on medical outcomes, despite research documenting that persons with cognitive impairment often have quality of life outcomes as primary goals. This qualitative study engaged persons with mild cognitive impairment (MCI) or dementia and their carers to identify outcomes that are most important to inform development of a tool to guide ACP interventions with this population. Participants identified 23 outcome categories for ACP interventions within the following six domains: social life, family involvement, current lifestyle, physical independence, financial independence and healthcare goals. Of the 23 outcome categories, the majority (86%) were quality of life goals and only a small fraction (14%) were healthcare specific.
Improving community-based palliative care explanations: Insights from persons declining services
09/13/25 at 03:25 AMImproving community-based palliative care explanations: Insights from persons declining servicesAmerican Journal of Hospice & Palliative Care; by Kira G Sheldon, Kathryn H Bowles, Elizabeth A Luth; 8/25Beneficiaries and caregivers had mixed understandings of palliative care, including: no knowledge, belief that it was the same as or pre-hospice, and accurate, but often one-dimensional understandings of it. Participants recommended providing individualized, tailored explanations focused on the person's health concerns in simple language with follow-up materials to improve engagement with palliative care. Small adjustments to how palliative care is explained may increase understanding among older adults and caregivers, particularly among those with limited or inaccurate knowledge. Among those familiar with palliative care, providing accessible and clear explanations customized to the person's specific care needs can further broaden understanding and increase perceived relevance.
The role of PMHNPs in palliative psychiatry: An ethical framework for care when remission is unattainable
09/13/25 at 03:20 AMThe role of PMHNPs in palliative psychiatry: An ethical framework for care when remission is unattainableJournal of Hospice and Palliative Nursing; by Trae Stewart; 8/23Patients with serious and persistent mental illness may experience intractable suffering despite exhaustive treatment, challenging the dominant curative paradigm in psychiatry. Palliative psychiatry offers an emerging alternative-prioritizing comfort, dignity, and quality of life when remission is no longer attainable. This article presents a comprehensive ethical and clinical framework for integrating palliative psychiatry into psychiatric-mental health nurse practitioner (PMHNP) practice. Drawing parallels with somatic palliative care, the author explores the theoretical foundations, diagnostic complexities, and ethical imperatives guiding palliative psychiatry. Legal challenges, such as hospice eligibility criteria and involuntary treatment statutes, are also examined, with recommendations for practice and policy reform. Assistant Editor's note: As I search for pertinent articles to add to this newsletter, I am delighted to find so many that address a variety of aspects of palliative care. I see articles on palliative care in the ED, palliative care for special populations, palliative care for transplant patients, and as highlighted in this article, palliative care in psychiatry. It makes me think that maybe, just maybe(!), the many benefits of palliative care are finally being recognized and embraced by mainstream health care.
Implementing education for community adult hospice nurses to expand pediatric hospice and palliative care
09/13/25 at 03:15 AMImplementing education for community adult hospice nurses to expand pediatric hospice and palliative careJournal of Hospice and Palliative Nursing; by Shelly C Wenzel; 8/25Pediatric hospice and palliative patients require specially-trained clinicians to provide holistic support in areas such as disease progression, illness trajectory, and goals of care. An asynchronous online educational module, including a pre- and postmodule survey, was developed to provide education on timely pediatric quality-of-life conversations and skills for nurses who work with the adult population. Following the education module, participants reported an increase in comfort from 25% to 93.3% and willingness from 59% to 93.3%. Additionally, postmodule confidence level increased to 94%. These findings suggest an asynchronous educational module approach benefits the needs of community-based adult hospice and palliative nurses and gains learned from this module may enhance nurse skill and improve access to care.
Clinicians who practice primarily in nursing homes and the quality of care for residents with Alzheimer Disease and related dementias
09/13/25 at 03:10 AMClinicians who practice primarily in nursing homes and the quality of care for residents with Alzheimer Disease and related dementiasJAMA Health Forum; by Hyunkyung Yun, Mark Aaron Unruh, Yuting Qian, Yongkang Zhang, Hye-Young Jung; 8/25In this cohort study, receipt of care from a SNFist [skilled nursing facility specialist] vs a non-SNFist was associated with a 7% decrease in the odds of a hospitalization and a 7% decrease in the odds of an emergency department visit for an ambulatory care–sensitive condition among residents with dementia. Findings of this cohort study suggest that the use of SNFists by NHs [nursing homes] may enhance the quality of care for residents with ADRD [Alzheimer disease and related dementias].