JournalTOCs

Palliative & Supportive Care
Journal Prestige (SJR): 0.611

Citation Impact (citeScore): 1
Number of Followers: 38

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1478-9515 - ISSN (Online) 1478-9523
Published by Cambridge University Press

[352 journals]

Legacy and communication in palliative and end-of-life care: Honoring Dr.
J. Randall Curtis
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  Authors: Rosa; William E., Hadler, Rachel A., Dzeng, Elizabeth, Sullivan, Donald R., Epstein, Andrew S., Nelson, Judith E.
  Pages: 376 - 377
  PubDate: 2023-04-18
  DOI: 10.1017/S1478951523000421
The Third Annual US Celebration of World Hospice and Palliative Care Day:
A virtual coming together to unify the global palliative care community
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  Authors: Rosa; William E., Pandey, Shila, Epstein, Andrew S., Connor, Stephen R., Andersen, Laurie J., Blackler, Liz, Desai, Anjali V., Koranteng, Lauren Akua, Breitbart, William S., Nelson, Judith E.
  Pages: 378 - 384
  Abstract: ObjectivesOn 3–4 October 2022, the Memorial Sloan Kettering Cancer Center Supportive Care Service and Department of Psychiatry and Behavioral Sciences hosted the Third Annual United States (US) Celebration of World Hospice and Palliative Care Day (WHPCD). The purpose of this article is to reflect on the event within the broader context of the international WHPCD theme: “healing hearts and communities.” We describe lessons learned in anticipation of the fourth annual conference to be held on 3–4 October 2023.MethodsDescription of the third annual event, conference planning team reflection, and attendee evaluation responses.ResultsThe Worldwide Hospice Palliative Care Alliance launched WHPCD in 2005 as an annual unified day of action to celebrate and support hospice and palliative care globally. Since 2020, the conference has attracted an increasing number of attendees from around the world. Two primary aims continue to guide the event: community building and wisdom sharing. Fifty-two interprofessional palliative care experts, advocates, patients, and caregivers provided 13 unique interactive sessions. Four hundred and fifty-eight multidisciplinary registrants from at least 17 countries joined the program. Free registration for colleagues in low- and middle-income countries, students and trainees, and individuals experiencing financial hardship remains a cornerstone of inclusion and equitable access to the event.Significance of resultsThe US WHPCD celebration provides a virtual platform that offers opportunities for scientific dissemination and collective reflection on hospice and palliative care delivery amid significant local and global changes in clinical practice, research, policy and advocacy, and population health. We remain committed to ensuring an internationally relevant, culturally diverse, and multidisciplinary agenda that will continue to draw increased participation worldwide during future annual events.
  PubDate: 2023-04-05
  DOI: 10.1017/S1478951523000391
Associations between Latino ethnicity and the use of emotional support and
completion of advance directives
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  Authors: Shen; Megan Johnson, Prigerson, Holly G., Maciejewski, Paul K.
  Pages: 385 - 391
  Abstract: ObjectivesLatino patients have been shown to engage in advance care planning (ACP) at much lower rates than non-Latino White patients. Coping strategies, such as the use of emotional support, may differentially relate to engagement in ACP among Latino and non-Latino patients. The present study sought to examine the moderating effect of ethnicity on the relationship between the use of emotional support as a coping strategy and completion of advance directives.MethodsThe present study employed a weighted sample (Nw = 185) of Latino and non-Latino White patient participants in Coping with Cancer III, an National Institutes of Health–sponsored, multisite, longitudinal, observational cohort study of patients with advanced cancer and their informal caregivers and oncology providers designed to evaluate Latino/non-Latino disparities in ACP and end-of-life cancer care. Main and interaction effects of Latino ethnicity and use of emotional support on patient use of advance directives were estimated as odds ratios.ResultsUse of emotional support was associated with dramatically lower do-not-resuscitate (DNR) order completion to a greater extent among Latino as compared to non-Latino patients (interaction AOR = 0.33, p = 0.005). Interaction effects were not statistically significant for living will or health-care proxy form completion.Significance of resultsUse of emotional support is associated with lower odds of completing DNRs among Latino than among non-Latino patients. Seeking and/or receiving emotional support may deter Latino patients from completing DNR orders. Research is needed to address both emotional needs and practicalities to ensure high quality end-of-life care among Latino patients with cancer.
  PubDate: 2023-04-11
  DOI: 10.1017/S1478951523000366
Race-conscious serious illness communication: An interpersonal tool to
dismantle racism in practice and research
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  Authors: Rosa; William E., Brown, Crystal E., Curtis, J. Randall
  Pages: 492 - 497
  Abstract: BackgroundRacism significantly contributes to inequitable care quality and outcomes for people of color with serious illness, their families, and their communities. Clinicians use serious illness communication (SIC) to foster trust, elicit patients’ needs and values, and deliver goal-concordant services. Current SIC tools do not actively guide users to incorporate patients’ experiences with racism into care.Objectives1) To explicitly address racism during SIC in the context of the patient’s lived experience and 2) to provide race-conscious SIC recommendations for clinicians and researchers.MethodsApplying the conceptual elements of Public Health Critical Race Praxis to SIC practice and research through reflection on inclusive SIC approaches and a composite case.ResultsPatients’ historical and ongoing narratives of racism must be intentionally welcomed in physically and psychologically safe environments by leveraging empathic communication opportunities, forging antiracist palliative care practices, removing interpersonal barriers to promote transparent patient–clinician relationships, and strengthening organizational commitments to strategically dismantle racism. Race-conscious SIC communication strategies, skills, and examples of talking points are provided.DiscussionRace-conscious SIC practices may assist to acknowledge racial dynamics within the patient–clinician encounter. Furthermore, race-conscious SIC may help to mitigate implicit and explicit bias in clinical practices and the exclusionary research cultures that guide them.
  PubDate: 2023-04-05
  DOI: 10.1017/S147895152300038X
Curating and/or suffering: On palliative care and museums
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  Authors: Kahambing; Jan Gresil
  Pages: 565 - 566
  PubDate: 2023-03-23
  DOI: 10.1017/S1478951523000263
Communication skills training for medical residents: Enhancing a
psychosocial approach of patient care
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  Authors: Gil; F.L., Hernández-Ribas, R., Sánchez, N., Gil, J., Casellas-Grau, A.
  Pages: 392 - 398
  Abstract: ObjectivesOne of the issues that has increasingly become relevant to medical practice is the ability to communicate well with patients. Better communication results in better care for the patient, as well as greater satisfaction for the physician. For this reason, the aim of this study was to assess the efficacy of a communication skills training program for medical residents (MR).MethodEighty-six MR underwent a 6-month training program in three phases: a 12-h theory and practice workshop, a period of real practice, and a 4-h workshop in which the most challenging scenarios were role played with an actress. In each phase (T0, T1, and T2), participants’ beliefs about their competence in caring for patients’ psychosocial aspects and their self-confidence in communication skills were assessed.ResultsNo differences were found between T0 and T1 in participants’ beliefs of self-competence in psychosocial care. However, this competence significantly improved after completion of the entire program. Only 7 of the 12 areas explored in communication skills significantly improved between T0 and T1. However, after T2 completion, significant improvements were observed in all 12 areas.Significance of resultsThe research results highlight the usefulness and importance of training young doctors to foster their psychosocial approach to patient care and improve their confidence in their own communication skills. The results also show the appropriateness of the structure of the training: the key features of the programme were the follow-up of the participants in three phases over 6 months, and a focus on the needs of the residents and the resolution of difficult clinical cases, with the support of an actress. Therefore, the training presented in this study may become a guide for other trainings in other contexts with similar objectives.
  PubDate: 2022-03-08
  DOI: 10.1017/S147895152200030X
Development and preliminary validation of a scale to assess physicians’
emotional distress intolerance in end-of-life care communication
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  Authors: Brondolo; Elizabeth, Keating, Luke, Crete, Abigail, Kaur, Amandeep, Randrianarivony, Rina, Statman, David, Schwartz, Joseph E., Basello, Gina, Roth, Alan R.
  Pages: 399 - 410
  Abstract: ContextEnd-of-life care (EOLC) communication is beneficial but underutilized, particularly in conditions with a variable course such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). Physicians’ emotional distress intolerance has been identified as a barrier to EOLC communication. However, studies of emotional distress intolerance in EOLC have largely relied on anecdotal reports, qualitative data, or observational studies of physician–patient communication. A free-standing measure of multiple dimensions of distress tolerance is warranted to enable the identification of individuals experiencing distress intolerance and to facilitate the effective targeting of interventions to improve distress tolerance.ObjectivesThis study provides preliminary data on the reliability and validity of the Physician Distress Intolerance (PDI) scale. We examine potential subdimensions of emotional distress intolerance.MethodFamily medicine and internal medicine physicians completed the PDI, read vignettes describing patients with COPD or CHF, and indicated whether they initiated or delayed EOLC communication with their patients with similar conditions.ResultsExploratory and confirmatory factor analyses were performed on separate samples. Confirmatory factor analysis confirmed that a three-factor solution was superior to a two- or one-factor solution. Three subscales were created: Anticipating Negative Emotions, Intolerance of Uncertainty, and Iatrogenic Harm. The full scale and subscales had adequate internal consistency and demonstrated evidence of validity. Higher scores on the PDI, indicating greater distress intolerance, were negatively associated with initiation and positively associated with delay of EOLC communication. Subscales provided unique information.Significance of resultsThe PDI can contribute to research investigating and addressing emotional barriers to EOLC communication.
  PubDate: 2022-04-04
  DOI: 10.1017/S1478951522000219
An exploration of financial toxicity among low-income patients with cancer
in Central Texas: A mixed methods analysis
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  Authors: Petruzzi; Liana J., Prezio, Elizabeth, Phillips, Farya, Smith, Blake, Currin-McCulloch, Jennifer, Blevins, Cheasequah, Gaddis, Damon, Eckhardt, S. Gail, Kvale, Elizabeth, Jones, Barbara
  Pages: 411 - 421
  Abstract: ObjectiveFinancial toxicity is of increasing concern in the United States. The Comprehensive Score for Financial Toxicity (COST) is a validated measure; however, it has not been widely utilized among low-income patients and may not fully capture financial toxicity in this population. Furthermore, the relationships between financial toxicity, quality of life (QOL), and patient well-being are poorly understood. We describe the experience of financial toxicity among low-income adults receiving cancer care. We hypothesized that higher financial toxicity would be associated with less income and lower quality of life. Qualitative interviews focused on the financial impact of cancer treatment.MethodThis study was conducted at a cancer clinic in Central Texas. Quantitative and qualitative data were collected in Fall and Spring 2018, respectively. The quantitative sample (N = 115) was dichotomized by annual income ($15,000). Outcomes included financial toxicity (COST), quality of life (FACT-G), and patient well-being (PROMIS measures: Anxiety, Depression, Fatigue, Pain Interference, and Physical Function). Associations between quality of life, patient well-being, and financial toxicity were evaluated using linear regression. Sequential qualitative interviews were conducted with a subsample of 12 participants.ResultsPatients with $15k across multiple measures. A multivariate linear regression found QOL (Β = 0.17, 95% CI = 0.05, 0.29, p = 0.008) and insurance status (Β = −3.79, 95% CI = −7.42, −0.16, p = 0.04), but not income, were significantly associated with financial toxicity. Three qualitative themes regarding patient's access to cancer care were identified: obtaining healthcare coverage, maintaining financial stability, and receiving social support.Significance of resultsLow-income patients with cancer face unique access barriers and are at risk for forgoing treatment or increased symptom burdens. Comprehensive assessment and financial navigation may improve access to care, symptom management, and reduce strain on social support systems.
  PubDate: 2022-03-18
  DOI: 10.1017/S1478951522000256
AD-LAST! An interdisciplinary clinical workshop to improve cultural and
spiritual awareness in advance care planning skills
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  Authors: Pan; Cynthia X., Spinelli, Alexandra, Litrivis, Evgenia, Popoviciu, Ariana, Thomson, Kelly Persaud, Brondolo, Elizabeth
  Pages: 422 - 428
  Abstract: ObjectivesClinicians report training deficits in advance care planning (ACP), including limits to their understanding of cultural/spiritual influences on patient decision-making and skills in interdisciplinary teamwork. This study describes Advance Directives-Live Action Simulation Training (AD-LAST), an interdisciplinary experiential and didactic training program for discussing ACP and end-of-life (EOL) care. AD-LAST highlights cultural/spiritual variations in medical decision-making.MethodsProspective educational cohort study with pre-post intervention survey. AD-LAST incorporated standard curricular tools for didactic and experiential training in ACP/EOL communication. Study conducted in an urban community teaching hospital in Queens, NY, one of the most diverse counties in the USA. Participants included physicians, house staff, nurses, therapists, and other disciplines. AD-LAST format was a one-day workshop. The morning focused on didactic teaching using widely available curricular tools. The afternoon involved experiential practice with standardized patient-actors. Pre-post intervention questionnaires assessed ACP operational knowledge and self-efficacy (i.e., self-confidence in skills) in ACP and EOL communication. Repeated measure ANOVAs evaluated changes from pretest to posttest in knowledge and self-efficacy.ResultsA total of 163 clinical staff participated in 21 AD-LAST training sessions between August 2015 and January 2019. Participants displayed a significant increase from pretest to posttest in total knowledge (p < 0.001), ACP procedural knowledge (p < 0.001), ACP communication/relationships knowledge (p < 0.001), and self-efficacy (p < 0.001). Knowledge and self-efficacy were not correlated and represented independent outcomes. Postprogram evaluations showed greater than 96% of participants were highly satisfied with AD-LAST, especially the opportunity to practice skills in real-time and receive feedback from members of other professional groups.Significance of resultsAD-LAST, a multifaceted training program deployed in an interdisciplinary setting, is effective for increasing ACP knowledge and self-efficacy, including the capacity to address cultural/spiritual concerns. The use of standard tools facilitates dissemination. The use of case simulations reinforces learning.
  PubDate: 2022-03-15
  DOI: 10.1017/S1478951522000232
Prolonged mechanical ventilation and caregiver strain: Home vs. long-term
care facility
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  Authors: Marcus; Esther-Lee, Jacobs, Jeremy M., Stessman, Jochanan
  Pages: 429 - 437
  Abstract: ObjectiveThe number of patients treated with prolonged mechanical ventilation (PMV) is steadily rising. Traditionally treated within specialized long-term care facilities (LTCFs), healthcare providers are increasingly promoting homecare as a technologically safe, humane, and cheaper alternative. Little is known concerning their informal caregivers (ICGs), despite their crucial role in facilitating care. This study examines caregiver strain among the primary ICG of PMV patients treated at home vs. LTCF.MethodThis study was an observational cross-sectional study. The study enrolled 120/123 PMV patients ≥18 years within the study region (46 treated with homecare/74 treated at the LTCF) and 106 ICGs (34 ICGs/46 homecare patients and 72 ICGs/74 LTCF patients). Caregiver assessment included the 13-item Modified Caregiver Strain Index (Mod CSI) (0–26 maximum); patient assessment included symptom burden (the revised Edmonton Symptom Assessment System).ResultsThe mean age of ICGs was 58.9 years old; 60.4% were females; 82.1% were married; 29.2% were patient's spouses; and 40.6% were patient's children. The total Mod CSI was 13.58 (SD 6.52) and similar between home vs. LTCF (14.30 SD 7.50 vs. 13.26 SD 6.03, p = 0.50), or communicative vs. non-communicative patients (13.50 SD 7.12 vs. 13.64 SD 6.04, p = 0.93). Hierarchical analysis identified three clusters of caregiver strain, with ICGs at home vs. LTCF reporting significantly lower mood strain, higher burden, and similar levels of lifestyle disturbance. In adjusted models, homecare was significantly associated with reduced mood strain and increased burden, while increased patient symptomatology was significantly associated with total strain, mood, and burden strain clusters.Significance of resultsRecognizing the different patterns of caregiver strain at home or LTCF is a prerequisite for addressing their palliative care needs and improving the wellbeing and resilience of informal caregivers, who often play a critical role in deciding whether to treat the PMV patient at home or LTCF.
  PubDate: 2022-03-10
  DOI: 10.1017/S147895152200027X
Which has more influence on a family's assessment of the quality of dying
of their long-term care resident with dementia: Frequency of symptoms or
quality of communication with healthcare team'
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  Authors: Charest-Drapeau; Olivia, Provencher, Véronique, Trottier, Lise, Léonard, Guillaume, Wilchesky, Machelle, Bravo, Gina
  Pages: 438 - 444
  Abstract: ObjectiveSymptoms present at the end of life and the quality of communication with the healthcare team have both been shown to impact family assessments of the quality of dying of their loved one with dementia. However, the relative contributions of these two factors to family assessments have not yet been investigated. To address this knowledge gap, we explored which of these two factors has more influence on family assessments of the quality of dying of long-term care (LTC) residents with dementia.MethodThis is a secondary analysis of a mortality follow-back study. Ninety-four family members of LTC residents who had died with dementia assessed the quality of dying (very good or not very good), the frequency of symptoms, and the quality of communication with the healthcare team using a self-administered questionnaire mailed 1 month after the resident's death. Logistic regression analyses were performed to determine the relative contributions of the two independent variables of primary interest (frequency of symptoms and quality of communication) to the families’ assessments of the quality of dying.ResultsMultivariate analyses revealed that the quality of communication with the healthcare team was closely linked to the quality of dying (p = 0.009, OR = 1.34, 95% CI = 1.09–1.65), whereas the frequency of symptoms was not (p = 0.142, OR = 1.05, 95% CI = 0.98–1.11) after controlling for potential confounders.Significance of resultsOur findings show that healthcare providers’ ability to engage in the end-of-life conversations with families outweighs the frequency of symptoms in family assessments of the quality of dying of their relative with dementia. Enhancing healthcare providers’ ability to communicate with families about the end-of-life care could improve families’ perceptions of the quality of dying of their relative with dementia and, consequently, ease their grieving process.
  PubDate: 2022-03-29
  DOI: 10.1017/S1478951522000323
Voice your values, a tailored advance care planning intervention in
persons living with mild dementia: A pilot study
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  Authors: Vellani; Shirin, Puts, Martine, Iaboni, Andrea, McGilton, Katherine S.
  Pages: 445 - 453
  Abstract: BackgroundIn the early stage of dementia, persons living with dementia (PLwD) can identify their values and wishes for future care with a high degree of accuracy and reliability. However, there is a paucity of research to guide best practices on how best to incorporate advance care planning (ACP) in older adults diagnosed with mild dementia and therefore only a minority of these individuals participate in any ACP discussions. We developed an intervention called Voice Your Values (VYV) that healthcare professionals can implement to identify and document the values of PLwD and their trusted individuals such as friends or family.PurposeThis single-group pre-test and post-test design aimed to determine the feasibility, acceptability, and preliminary efficacy of the VYV intervention.MethodsA convenience sample of 21 dyads of PLwD and their trusted individuals were recruited from five outpatient geriatric clinics. The tailored VYV intervention was delivered to the dyads over two sessions using videoconferencing.ResultsIn terms of feasibility, the recruitment rate was lower (52%) than the expected 60%; the retention rate was high at 94%, and the intervention fidelity was high based on the audit of 20% of the sessions. In terms of preliminary efficacy, PLwD demonstrated improvement in ACP engagement (p =
  PubDate: 2022-04-28
  DOI: 10.1017/S1478951522000475
“A Wanderer's Tale”: The development of a virtual reality application
for pain and quality of life in Australian burns and oncology patients
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  Authors: Desselle; Mathilde R., Holland, Lucy R., McKittrick, Andrea, Kennedy, Glen, Yates, Patsy, Brown, Jason
  Pages: 454 - 460
  Abstract: ObjectivesThe primary objective of this study was to co-design and conduct a pilot evaluation of a novel, immersive virtual reality (VR) experience for procedural pain and anxiety in an Australian healthcare setting. The secondary objective was to identify key parameters that can facilitate the development and implementation of VR experiences in clinical practice.MethodA qualitative, Design Box method was selected for co-design. It was used with adult burns survivors and adolescents and young adults (AYAs) with cancer, and healthcare professionals from these fields to identify the practical and design parameters required for the application of VR technology within the clinical setting. Results informed the development of the VR experience that was evaluated by consumers and healthcare professionals, who completed qualitative surveys. Thematic analysis was conducted on co-design notes and survey data.ResultsProcedural pain and management was a challenge for both cohorts, but particularly the burns cohort. Anxiety was significant challenge for both cohorts. Boredom and quality of life was a significant challenge, particularly for the AYA oncology cohort. These results informed the development of “A Wanderers Tale,” an Australiana-themed, gaze-controlled VR application for Oculus Quest platforms. Thematic analysis results suggest that cultural preferences, procedural contexts of use, and agency through customization and interaction are three parameters to consider when creating or selecting VR experiences for application in health.Significance of resultsThis work describes a novel method for the use VR as an adjuvant pain management tool in patients with burns and cancer. The VR experience may provide a culturally, practice and procedure-appropriate tool in comparable settings of care. The study also describes interdisciplinary co-design and evaluation approaches that can help maximize the use of VR to improve healthcare approaches that address clinical challenges in pain, anxiety, and quality of life for patients while in hospital.
  PubDate: 2022-06-09
  DOI: 10.1017/S1478951522000530
Family functioning and psychosocial symptoms among Latinx patients coping
with advanced cancer
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  Authors: Torres-Blasco; Normarie, Castro-Figueroa, Eida M., Zamore, Carolina, Claros, Maria, Peña-Vargas, Cristina, Rosario, Lianel, Sanabria, Gabriella, Breitbart, William, Costas-Muñiz, Rosario
  Pages: 461 - 464
  Abstract: ObjectivesThis brief report aims to describe and determine the association of family functioning (e.g., cohesion and expressiveness) with psychosocial needs among Spanish Latinx patients coping with advanced cancers.MethodsDescriptive and correlation analyses were performed on data from 103 patients coping with advanced cancer (Stages III and IV). The measures used were the Family Relationships Index, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy: General.ResultsResults indicated that most of the participants had low family function (65%). Participants with higher family functioning (35%) had high levels of quality of life [r(103) .318, p
  PubDate: 2022-09-13
  DOI: 10.1017/S1478951522001201
Valued Outcomes in the Cancer Experience (VOICE)™: Development and
validation of a multidimensional measure of perceived control
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  Authors: Zaleta; Alexandra K., Fortune, Erica E., Miller, Melissa F., Yuen, Eva Y.N., McManus, Shauna, Hurley, Karen, Golant, Mitch, Goldberger, Sara, Shockney, Lillie D., Buzaglo, Joanne S.
  Pages: 465 - 476
  Abstract: ObjectiveEnhancing cancer patients’ sense of control can positively impact psychological well-being. We developed and assessed the psychometric properties of Valued Outcomes in the Cancer Experience (VOICE)TM, a measure of patients’ perceived control over key personal priorities within their cancer experience.MethodsVOICE construction and testing were completed in three phases with separate participant samples: (1) item generation and initial item pool testing (N = 459), (2) scale refinement (N = 623), and (3) confirmatory validation (N = 515).ResultsA 21-item measure was developed that captures cancer patients’ sense of control in seven key domains: (1) Purpose and Meaning, (2) Functional Capacity, (3) Longevity, (4) Quality Care, (5) Illness Knowledge, (6) Social Support, and (7) Financial Capability. VOICE demonstrated adequate internal consistency (full-scale α = 0.93; factor α = 0.67–0.89) and adequate to strong convergent and discriminatory validity.Significance of resultsVOICE measures cancer patients’ perceived control across a diverse range of personal priorities, creating a platform for elevating patient perspectives and identifying pathways to enhance patient well-being. VOICE is positioned to guide understanding of the patient experience and aid the development and evaluation of supportive care interventions to enhance well-being.
  PubDate: 2022-10-26
  DOI: 10.1017/S1478951522000724
Clinicians’ practices and attitudes regarding advance care planning in
mainland China: A multicenter cross-sectional survey
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  Authors: Cai; Siyu, Wang, Xianjing, Wang, Ruixin, Zhou, Yuchen, Zhou, Xuan, Peng, Xiaoxia
  Pages: 477 - 482
  Abstract: ObjectivesThis study aims to explore clinicians’ practices and attitudes regarding advance care planning (ACP) in mainland China.MethodsThis study was a multicenter cross-sectional survey. Clinicians from tertiary hospitals in Beijing, Guangxi, and Inner Mongolia were invited to participate in the study. A questionnaire was formulated based on related literature to obtain information including demographic characteristics, and practices and attitudes toward ACP.ResultsThe total number of participants included 285 clinicians. The data response rate was 84.57%. Most of the clinicians had an inadequate understanding of ACP. Only a few clinicians had experience in participating or witnessing an ACP or related end-of-life discussions. Among 285 clinicians, 69.82% of clinicians were willing to introduce ACP to patients. Two hundred and thirty-eight (83.51%) clinicians wanted more education on ACP. Almost all clinicians believed that patients had the right to know about their diagnosis, prognosis, and available care options. Most clinicians (82.11%) regarded that ACP was partially feasible in mainland China. If clinicians had a serious illness, almost everyone was willing to find out their true health status and decide for themselves, and 81.40% wanted to institute an ACP for themselves. The biggest barriers to the use of ACP in mainland China were cultural factors. Statistical analysis revealed that some or good understanding level (P = 0.0052) and practical experience (P = 0.0127) of ACP were associated with the positive willingness.Significance of resultsACP is still in its infancy in mainland China. Clinicians had inadequate understanding and minimal exposure to ACP. Most clinicians recognized the value and significance of ACP and had a positive attitude toward ACP. Clinicians need to be provided with education and training to promote their ACP practices. Culturally appropriate ACP processes and documents need to be developed based on Chinese culture and Chinese needs.
  PubDate: 2022-03-14
  DOI: 10.1017/S1478951522000177
Is spiritual well-being related to survival time of inpatients with
advanced cancer' An East Asian cohort study
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  Authors: Hiratsuka; Yusuke, Suh, Sang-Yeon, Won, Seon Hye, Choi, Sung Eun, Kim, Sun-Hyun, Cheng, Shao-Yi, Chen, Ping-Jen, Yoon, Seok-Joon, Koh, Su-Jin, Park, Shin Ae, Seo, Ji-Yeon, Hui, David, Yamaguchi, Takashi, Morita, Tatsuya, Tsuneto, Satoru, Mori, Masanori, Inoue, Akira
  Pages: 483 - 491
  Abstract: ObjectivesIt has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.MethodsThis international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.ResultsA total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).Significance of resultsSWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
  PubDate: 2022-06-27
  DOI: 10.1017/S1478951522000682
Palliative care nurses’ experiences of stress, anxiety, and burnout:
A thematic synthesis
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  Authors: Clayton; Malcolm, Marczak, Magda
  Pages: 498 - 514
  Abstract: ObjectivesThis systematic literature review aimed to critically appraise empirical evidence investigating palliative care (PC) nurses’ experiences of stress, anxiety, and burnout.MethodsSix databases (PsycINFO, MEDLINE, Scopus, CINAHL, PubMed, and Web of Science) covering literature within psychology, medicine and healthcare, and social sciences were searched from inception until December 2020. Studies were eligible if they included qualitative literature reporting on experiences of nurses working in a PC setting of stress, anxiety, or burnout, and were published in English. Eighteen studies satisfied the review's inclusion criteria and were considered relevant to the review aims. Critical appraisal was undertaken using the Critical Appraisal Skills Programme Qualitative Checklist.ResultsThematic synthesis identified three main themes: When work becomes personal, The burden on mind and body, and Finding meaning and connection. The findings suggested that stress, anxiety, and burnout are deeply personal feelings experienced by nurses both on an emotional and physical level. Additionally, PC nurses’ experiences can differ in meaning and strength depending on their relationships with patients, patients’ families, and colleagues.Significance of the resultsThe synthesis highlighted that PC nurses' experiences are complex, encompassing clinical and organizational challenges, and the personal impact their work has on them. Having a greater understanding of the factors that contribute to PC nurses’ experiences may help in PC nurses’ core training and continuing professional education, as well as the provision of effective supervision and staff support.
  PubDate: 2022-06-16
  DOI: 10.1017/S147895152200058X
Communicating is analogous to caring: A systematic review and thematic
synthesis of the patient–clinician communication experiences of
individuals with ovarian cancer
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  Authors: Pozzar; Rachel A., Berry, Donna L.
  Pages: 515 - 533
  Abstract: ObjectiveTo systematically review and synthesize the patient–clinician communication experiences of individuals with ovarian cancer.MethodsThe CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient–clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion.ResultsOf 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants’ experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness.Significance of resultsPatient–clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient–clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.
  PubDate: 2022-05-18
  DOI: 10.1017/S1478951522000621
The effectiveness of compassion-based interventions among cancer patients:
A systematic review and meta-analysis
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  Authors: Fan; Ya-Chi, Hsiao, Fei-Hsiu, Hsieh, Chia-Chen
  Pages: 534 - 546
  Abstract: ObjectivesThis study examined the effects of compassion-based intervention on mental health in cancer patients by using systematic review and meta-analysis of randomized controlled trials (RCTs).MethodsEleven bibliographic databases were searched from their earliest data available date up to March 1, 2022. The databases were PubMed, CINAHL, MEDLINE, PsycINFO, WOS, Cochrane, Embase, Scopus, ProQuest Dissertations, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan.ResultsTen studies from 2015 to 2021 were included with a total of 771 cancer patients. Most were targeted at women with breast cancer. Brief compassion-based interventions of approximately 30 minutes were conducted by audio file, paper, and web-based self-guided writing prompts. Most were conducted after the completion of active treatment. Anxiety was the most measured outcome. Constructive compassion-based interventions with 4- to 12-week sessions were conducted by a trained facilitator. Most were conducted for patients who had undergone treatment, and depression was the most measured outcome. The meta-analysis indicated that compassion-based interventions had a significant effect of reducing depression and increasing self-compassion. Moderation analysis indicated that constructive intervention showed more benefits of increased self-compassion than brief intervention. Both face-to-face and non-face-to-face web-delivered formats had benefits for increasing self-compassion compared with the control condition.Significance of resultsCompassion-based interventions might provide an effective strategy for improving self-compassion and depression among patients with breast cancer. Suggestions for further research and health-care providers follow.
  PubDate: 2022-11-18
  DOI: 10.1017/S1478951522001316
Letter from a medical oncology scribe
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  Authors: Smith; Brian R.
  Pages: 549 - 549
  PubDate: 2022-03-08
  DOI: 10.1017/S1478951522000281
The efficacy of “rapid tele-psychotherapy” with single-session music
therapy: A personal reflection as a founder
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  Authors: Situmorang; Dominikus David Biondi
  Pages: 550 - 551
  PubDate: 2022-03-23
  DOI: 10.1017/S1478951522000293
Hidden floodgate
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  Authors: Cassano; Hope L.
  Pages: 552 - 553
  PubDate: 2022-05-16
  DOI: 10.1017/S1478951522000578
A clinical catharsis: Moral distress and the uses of tragedy in palliative
care
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  Authors: Petriceks; Aldis H.
  Pages: 554 - 555
  PubDate: 2022-03-23
  DOI: 10.1017/S1478951522000359
The last time I saw mother
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  Authors: Kellehear; Allan
  Pages: 556 - 556
  PubDate: 2022-06-24
  DOI: 10.1017/S1478951522000815
Against our post-modern palliation
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  Authors: Gurgenci; Taylan
  Pages: 557 - 558
  PubDate: 2022-07-14
  DOI: 10.1017/S1478951522000827
Witness
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  Authors: Li; Sophia Lynn
  Pages: 559 - 560
  PubDate: 2022-08-01
  DOI: 10.1017/S147895152200102X
Nonmedical opioid use at the end of life: A tale of addiction and a last
wish
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  Authors: Tang; Michael, Arthur, Joseph, Cooper, Alexandra, Clark, Matthew, Bruera, Eduardo
  Pages: 561 - 563
  Abstract: BackgroundNonmedical opioid use (NMOU) has been associated with opioid overdose deaths. This pattern of misuse can be seen in those using opioids for cancer-associated pain. We present a case that highlights the complexities associated with NMOU and a patient’s care at the end of life.Cases DescriptionA patient with a metastatic solid tumor malignancy along with co-occurring history of polysubstance abuse was admitted to an acute palliative and supportive care unit (APSCU). The patient demonstrated behaviors concerning for NMOU during her hospital stay but had increased symptom expression concerning for worsening dyspnea while in the APSCU. Unfortunately, she used home opioids, which was unknown to the team at the time along with requesting for higher doses of opioids that were being prescribed. This caused a worsening respiratory status and affected her care. Using an interdisciplinary approach, the providers managed her symptoms and discharged her safely to see her child.ConclusionThis highlights the complexities of the alleviation of suffering in those with NMOU. It is important to continue to manage NMOU at the end of life due to its effects on quality of life. A multimodal approach is recommended to identify and care for these patients.
  PubDate: 2022-12-22
  DOI: 10.1017/S1478951522001717
Alone
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  Authors: Bayley; Zana
  Pages: 564 - 564
  PubDate: 2022-11-15
  DOI: 10.1017/S1478951522001584