Palliative Medicine[JOURNAL]
Sun
200 papers
Designing an Artificial Intelligence Transcription Tool to Support Multimodal Serious Illness Communication: Institutional Experience and Best Practices.
Murdaugh K, Kwok IB
J Palliat Med · 2026 May · PMID 42198934 · Publisher ↗
BACKGROUND: Communication during serious illness is often complex, emotionally charged, and cognitively demanding, particularly for patients and families with limited health literacy, sensory impairments, or language bar...
BACKGROUND: Communication during serious illness is often complex, emotionally charged, and cognitively demanding, particularly for patients and families with limited health literacy, sensory impairments, or language barriers. Existing communication supports inadequately address diverse information-processing needs, underscoring the need for thoughtfully designed, technology-enabled interventions. LOCAL PROBLEM: Within inpatient palliative care settings, family meetings frequently convey high-stakes information without a durable, accessible record of the conversation for patients and caregivers. This limitation may exacerbate disparities in understanding, recall, and decision making, especially for individuals who benefit from visual or multimodal communication supports. METHODS: We employed a multiphase, iterative development and rapid refinement process to design an artificial intelligence (AI)-enabled communication support tool that generates written transcripts of palliative care family meetings. Development was guided by ethical principles, user-centered design, and early engagement with institutional data security, privacy, and regulatory leadership. The interdisciplinary development team included palliative care physicians, gerontologists, and a physician with training in public health who led the computational development. INTERVENTIONS: The intervention involved the development of a multimodal communication tool that produces AI-generated written transcripts of clinician-led family meetings, designed to supplement-not replace-verbal communication. Development occurred in collaboration with institutional IT, privacy, and security leadership to enable future integration into existing clinical workflows and governance structures, while supporting transparency, clinician oversight, and institutional compliance. RESULTS: The development process demonstrated that generation of high-quality, AI-generated written transcripts of family meetings is feasible within inpatient palliative care settings and institutional data security architectures. Early co-development with clinical leadership and regulatory stakeholders streamlined implementation while maintaining ethical and institutional safeguards. CONCLUSIONS: In the context of the rapid evolution of AI technologies, clinically led, ethically grounded development of AI-generated written transcripts for serious illness communication, involving institutional IT, privacy and security leadership, clinicians, patients, and caregivers, is feasible and may enhance accessible, patient-centered communication.
A Cross-Sectional Street Survey Examining a Preference for Truth-Telling in Serious Illness and End-of-Life in Maputo City Province.
Heller LD, McPherson ML, Wright P … +4 more , Namisango E, McCord J, Alexander C, Cagle J
J Palliat Med · 2026 May · PMID 42198925 · Publisher ↗
BACKGROUND: Little is known about how Mozambicans feel about end-of-life preferences, especially their preferences for truth-telling in serious illness. AIM: To understand the end-of-life preferences and priorities of Mo...
BACKGROUND: Little is known about how Mozambicans feel about end-of-life preferences, especially their preferences for truth-telling in serious illness. AIM: To understand the end-of-life preferences and priorities of Mozambicans in Maputo City Province and their preferences for truth-telling in serious illness. DESIGN: A face-to-face community-based street survey was performed with Mozambican nationals, aged ≥18, and fluent in Portuguese. METHODS: Using convenience sampling, structured interviews investigated preferences in a hypothetical scenario of serious illness such as cancer. Descriptive analysis examined variations. General data were collected about illness understanding/steps in treatment, experiences/preferences with death, preferences in decision making, and end-of-life priorities. SETTING/PARTICIPANTS: The sample ( = 397) was stratified by province, age, and gender. Participants were from five districts of Maputo City Province. RESULTS: The primary analysis was truth-telling. Binary logistic regression analyses were performed to explore the influence of age, gender, education, religion, and ethnicity on preferences for truth-telling. There was a statistically significant association with higher education and all variables examined: assessing the association between education/religion and the preference for truth-telling over all other responses (OR = 3.6, = 0.002), as well as, education/religion and the preference of truth-telling to the individual, versus family (OR = 3.627, = 0.020), and the association between education/ethnicity and the preference of telling-telling to the individual, not family (OR = 3.832, = 0.015). Catholics were more likely to desire truth-telling to the individual versus family (OR = 2.975, = 0.042). CONCLUSIONS: Those with higher education and Christian religion were more likely to desire doctors to tell the truth about diagnosis.
Evaluation of the Forced Inspiratory Suction and Swallow Tool for Chemotherapy-Induced Hiccups.
Kishi Y, Fujimoto H, Kobayashi T … +7 more , Tomaru A, Oka S, Ishinaga H, Ueda K, Hirata T, Sakaguchi M, Kako J
J Palliat Med · 2026 May · PMID 42198921 · Publisher ↗
BACKGROUND: Chemotherapy-induced hiccups (CIH) impair quality of life in patients with cancer, yet effective nonpharmacological management is limited. The Forced Inspiratory Suction and Swallow Tool (FISST) has shown eff...
BACKGROUND: Chemotherapy-induced hiccups (CIH) impair quality of life in patients with cancer, yet effective nonpharmacological management is limited. The Forced Inspiratory Suction and Swallow Tool (FISST) has shown efficacy in healthy individuals. OBJECTIVES: This study aimed to evaluate the usefulness of the FISST for chemotherapy-induced hiccups (CIH). DESIGN: This was a prospective observational study. SETTING/SUBJECTS: This study enrolled 44 hospitalized patients receiving chemotherapy at a single center in Japan; patients who developed hiccups during hospitalization were included in the analysis. MEASUREMENTS: Hiccup frequency, distress (Numerical Rating Scale [NRS] 0-10), and adverse events were evaluated. RESULTS: Three patients were excluded owing to aspiration during the practice session, and 19/41 who developed hiccups were analyzed. Median hiccup frequency decreased from 6.0 to 0.3 episodes/min. Median NRS scores decreased from 4.0 to 0. One patient experienced transient aspiration during FISST use. No serious adverse events occurred. CONCLUSION: The FISST may be a simple, self-administered option for CIH, warranting cautious use and further controlled evaluation.
Cannabidiol and Cancer Survivors: Utilization and Experiences.
Salz T, Mishra Meza A, Chino F … +7 more , Furberg H, Raghunathan NJ, Jinna S, Brens J, Lapen K, Mao JJ, Korenstein D
J Palliat Med · 2026 May · PMID 42198914 · Publisher ↗
BACKGROUND: The benefits and harms of cannabidiol (CBD), a cannabis constituent with minimal psychoactive effects, are unknown in cancer populations. OBJECTIVE: We sought to describe CBD experiences among people currentl...
BACKGROUND: The benefits and harms of cannabidiol (CBD), a cannabis constituent with minimal psychoactive effects, are unknown in cancer populations. OBJECTIVE: We sought to describe CBD experiences among people currently or recently treated for cancer (survivors). DESIGN: We conducted a survey eliciting experiences with, and attitudes toward, CBD. SETTINGS/PARTICIPANTS: Survivors of 9 different cancers treated at a cancer center completed the survey. MEASUREMENTS: Proportions for each survey item were reported. Bivariate logistic regression models compared survivor characteristics between CBD users and nonusers. RESULTS: Among 1258 respondents, 18% percent ( = 226) used CBD after cancer diagnosis. Most survivors who used CBD did so to relieve symptoms (90%, 204/226), most commonly pain (55%, 125/226); difficulty sleeping (47%, 107/226); stress, anxiety, or depression (35%, 80/226); and neuropathy (18%, 40/226). Most survivors who used CBD for symptom relief reported improvement, ranging from 60% reporting improvement in neuropathy (24/40) to 85% reporting improvement in energy or fatigue (17/20). Almost half of those who used CBD (104/223, 47%) stopped early, most commonly because it did not help (31/104, 30%). In unadjusted analyses, CBD users were more likely to be young or have brain or gastrointestinal cancer, compared to non-users ( < 0.05 for both). CONCLUSIONS: In a large sample of survivors, about a fifth used CBD, primarily for symptom relief of distress (stress, anxiety, or depression), sleep, pain, and neuropathy, and more than half of survivors reported at least some benefit for each concern. Clinical trials are needed to evaluate the safety and efficacy of CBD with regard to these common symptoms.
Racially and Ethnically Marginalized Patients' Perspectives on Nurse-Led Serious Illness Conversations.
Tabata-Kelly M, Sheu C, Bulger AL … +6 more , Ruan M, Bullock K, Gray TF, Healy BJ, Wichmann L, Bernacki RE
J Palliat Med · 2026 May · PMID 42198911 · Publisher ↗
BACKGROUND: Although racial and ethnic disparities in serious illness conversations have been documented, the experiences of racially and ethnically marginalized patients in nurse-led conversations remain underexplored....
BACKGROUND: Although racial and ethnic disparities in serious illness conversations have been documented, the experiences of racially and ethnically marginalized patients in nurse-led conversations remain underexplored. AIM: To explore racially and ethnically marginalized patients' experiences of nurse-led serious illness conversations and their engagement in discussions about goals and future care. DESIGN: A mixed-methods convergent study using surveys and semi-structured interviews. SETTING/PARTICIPANTS: Racially and ethnically marginalized patients ≥18 years old from a single U.S. health care system. MEASUREMENTS: The Advance Care Planning Engagement Survey, Serious Illness Conversation Patient Experience Survey, and semi-structured interviews. RESULTS: Fifteen patients participated in the study. Participants felt confident engaging in advance care planning (mean: 4.35/5.00) but were less ready to act (mean: 3.40/5.00). Nearly half reported that nurse-led serious illness conversations increased hopefulness about their quality of life, closeness with the nurse, sense of control over medical decisions, and understanding of their future health. The mean "heard and understood" score was 3.00, indicating that nurse-led conversations moderately helped participants feel heard and understood. Integrated analysis showed that nurse-led serious illness conversations supported participants feel comfortable and confident engaging in discussions about their goals and future care. Nurse-led conversations also helped foster a better understanding of participants' future health. However, confidence did not translate into readiness in the context of multifaceted distress. DISCUSSION: Nurse-led serious illness conversations facilitated greater confidence among racially and ethnically marginalized patients to discuss their goals and future care and fostered understanding of their future health; however, additional support is needed to address multifaceted distress affecting readiness.
"Golden" moments and more in grief talk: Healthcare professionals' approaches to discussing loss and grief with parents of children with severe neurological impairment.
Brennan E, Guerin S
Palliat Med · 2026 May · PMID 42183593 · Publisher ↗
BACKGROUND: Experiential studies on healthcare professionals' approaches to loss and grief discussions with parents of children with severe neurological impairment are needed to understand grief experiences of this emerg...
BACKGROUND: Experiential studies on healthcare professionals' approaches to loss and grief discussions with parents of children with severe neurological impairment are needed to understand grief experiences of this emerging populationAim:This study aimed to explore healthcare professionals' experiences regarding their approach to these discussions, as well as to gather recommendations for best practices in initiating these conversations. DESIGN: A qualitative exploratory study was conducted. Transcripts were analysed using reflexive thematic analysis, adhering to the reflexive thematic analysis reporting guidelines (RTARG). SETTING/PARTICIPANTS: The study purposively sampled healthcare professionals ( = 20) from medical, health, allied health, and social care disciplines. Participants were recruited within hospital, hospice, community, and disability settings in Ireland. RESULTS: Four key themes were identified during the analysis: (1) , (2) , (3) , and (4) They represent how professionals purposefully engaged in loss and grief discussions, attuning to moments when parents were receptive to such discussions. Professionals emphasised the need to respect parents' autonomy in seeking and accepting grief support. Compassionate communication was central to these discussions. CONCLUSIONS: This study represents a foundational step in understanding how professionals approach discussions of loss and grief. The themes underscore the need for increased awareness among professionals to ensure grief support is available at the level of contact, as advocated by the public health model of bereavement support. This study emphasises the importance of supporting bereavement care throughout the condition trajectory.
Enablers to successful patient and public involvement in Palliative Care Research: Qualitative perspectives of public members and Program Coordinators.
Wilson M, Philip J, Hofmeyer C … +4 more , Paluch A, Panozzo S, Hudson P, Collins A
Palliat Med · 2026 May · PMID 42183588 · Publisher ↗
BACKGROUND: Despite policy and health service imperatives for public involvement to be embedded within palliative care research, this practice is not commonplace. Few empirical studies have sought to explore and evaluate...
BACKGROUND: Despite policy and health service imperatives for public involvement to be embedded within palliative care research, this practice is not commonplace. Few empirical studies have sought to explore and evaluate models of public involvement for palliative care. AIM: To explore experiences of public involvement within palliative care, and to identify enablers for successful models of involvement. DESIGN: An exploratory qualitative design was utilized. Semi-structured interviews were conducted via zoom or telephone, and interview transcripts were subjected to inductive thematic analysis. SETTING/PARTICIPANTS: Purposive sampling of 23 participants with experience of public involvement in palliative care or related areas, across different health institutions in Australia and the United Kingdom, including public members and public involvement program coordinators. RESULTS: Twelve public members and 11 program coordinators described their experience with public involvement in a palliative or related healthcare setting. Three themes emerged relating to successful involvement (1) : opportunities to enhance team familiarity, early involvement, consistent point of contact, and inclusion of more than one public member. (2) : flexible roles and processes, ongoing communication, formal recognition of public input. (3) : mentoring opportunities, upskilling for public members and researchers. These enablers promoted a collegial atmosphere that enhanced personal and collective experiences of public involvement. CONCLUSIONS: This study reveals enablers that potentially shape the extent and effectiveness of public involvement in palliative care. Integrating these enablers has implications for future models of public involvement in palliative care and potential for enhanced research outcomes.
Hawaii's CMS-Approved Community-Based Palliative Care Benefit: A Model for State Medicaid Innovation.
Chapman IJ, Saetz RS
J Palliat Med · 2026 May · PMID 42178775 · Publisher ↗
BACKGROUND: Hawaii implemented a statewide Community Palliative Care benefit in 2025 under its Section 1115 Medicaid Demonstration waiver to expand access to interdisciplinary palliative care for Medicaid beneficiaries w...
BACKGROUND: Hawaii implemented a statewide Community Palliative Care benefit in 2025 under its Section 1115 Medicaid Demonstration waiver to expand access to interdisciplinary palliative care for Medicaid beneficiaries with serious illnesses. METHODS: This policy analysis synthesizes federal and state policy documents, implementation guidance, and relevant literature to describe the development, operational design, and implementation strategy of the benefit. RESULTS: The benefit establishes standardized eligibility criteria, interdisciplinary staffing expectations, unified documentation standards, and a blended reimbursement model. Development incorporated extensive stakeholder engagement, including clinicians, managed care organizations, hospice programs, and community organizations. CONCLUSIONS: Hawaii's model provides a structured statewide framework for Medicaid-covered community-based palliative care and offers lessons for other states seeking to expand access to serious illness care.
When Care Persists Beyond Intervention.
Augusto-Rodrigues M, Geber-Júnior JC
J Palliat Med · 2026 May · PMID 42178760 · Publisher ↗
Abstract loading — click title to view on PubMed.
Fast Facts and Concepts #534: Body Image Considerations in Patients with Serious Illness.
Myerson J, Brewerton YL, Hutchinson SZ
J Palliat Med · 2026 May · PMID 42178757 · Publisher ↗
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Dealing with Death: Health Care Professional Perspectives after Pediatric Patient Death.
Huang MZ, Henne M, Roth R … +1 more , Doshi A
J Palliat Med · 2026 May · PMID 42175727 · Publisher ↗
BACKGROUND: Many pediatric health care professionals (HCPs) experience patient death and continue to carry out their clinical roles, including caring for the child's family immediately after being impacted by a child's d...
BACKGROUND: Many pediatric health care professionals (HCPs) experience patient death and continue to carry out their clinical roles, including caring for the child's family immediately after being impacted by a child's death. Yet, HCPs are often overlooked as those who experience grief and require support in the coping process themselves. OBJECTIVES: To identify the variety of ways HCPs cope and the resources they utilize when dealing with a patient death. DESIGN: Qualitative study with one-on-one semistructured interviews. SETTING/SUBJECTS: HCPs at a U.S. tertiary children's hospital across different professional disciplines (medical decision makers, treatment implementers, and psychosocial support providers), different clinical environments (critical care units, medical units, emergency room, and outpatient), and a range of health care experience (from <1 year to >20 years). MEASUREMENTS: Data were analyzed using grounded theory and in an inductive manner. Factors and themes were identified in an iterative process. RESULTS: Briefly, 22 HCPs completed an interview. A multitude of factors influence HCPs' experience after pediatric patient death. Three major themes were identified: (1) HCPs rely on their professional community for processing and coping after patient death, (2) HCPs have a deep sense of duty toward each other and toward patients/families, which may drive their desire for knowledge and practice improvement, and (3) HCPs seek to make meaning following patient death. CONCLUSIONS: Health care institutions and their leaders have many opportunities to support HCPs after patient death.
Stuck in Despair: Cognitive Behavioral Therapy Informed Communication for Serious Illness Care.
Gamble A, Chammas D, Brenner KO … +1 more , Temple S
J Palliat Med · 2026 May · PMID 42175646 · Publisher ↗
Patients with serious medical illnesses may respond to the challenges of their illness in unique ways, shaped by personal, relational, and contextual factors. For many patients, depression and anxiety are common and may...
Patients with serious medical illnesses may respond to the challenges of their illness in unique ways, shaped by personal, relational, and contextual factors. For many patients, depression and anxiety are common and may feature avoidance or withdrawal, negative expectations for outcomes, repetitive negative thinking (rumination and/or worry), sad mood, and/or irritability. These symptoms often arise from a complex and bidirectional interplay between a patient's emotions, thoughts, and behaviors. This dynamic system provides clinicians with multiple, clinically actionable entry points to foster patient engagement in treatment and coping with serious illness. This article illustrates how core principles from cognitive behavioral therapy (CBT) can inform serious illness communication, adapted for use by general palliative care clinicians in appropriate clinical contexts. Using a composite clinical case, we demonstrate the use of CBT principles as a way of organizing our clinical understanding of a patient who is feeling "stuck," from which CBT-informed techniques, such as guided discovery, cognitive restructuring, and behavioral experiments, can be implemented to reduce distress and promote adaptive coping.
End-of-Life Care for Hospitalized Patients with Severe Obesity.
Dewar S, Denny R, Kumar N … +2 more , Kabeto M, Montagnini M
J Palliat Med · 2026 Apr · PMID 42169669 · Publisher ↗
BACKGROUND: Severe obesity (body mass index [BMI] ≥ 40 kg/m) is linked to multimorbidity, high hospitalization rates, ICU care, and increased mortality. The end-of-life care trajectory and the role of palliation for thes...
BACKGROUND: Severe obesity (body mass index [BMI] ≥ 40 kg/m) is linked to multimorbidity, high hospitalization rates, ICU care, and increased mortality. The end-of-life care trajectory and the role of palliation for these patients remain poorly understood. OBJECTIVE: This study aims to describe the provision of palliative and end-of-life care to decedents with severe obesity at a large tertiary care medical center. DESIGN: Utilizing a cross-sectional design, this study conducted a chart review to compare decedents across three BMI categories. Demographic, clinical, and palliative care data were analyzed using descriptive statistics and logistic, negative binomial, and Poisson regression models. SETTINGS/SUBJECTS: The study comprised 202 adult inpatients who passed away in 2019 at a large tertiary care academic medical center in the United States. Decedents were categorized into BMI groups: nonobese/overweight (BMI 18-29.9 kg/m), Class I/II obesity (BMI 30-39.9 kg/m), and Class III (severe) obesity (BMI ≥ 40 kg/m). Data regarding clinical and palliative care were extracted through retrospective chart review. RESULTS: Median age at death was 68.8 years; 54.5% were female, and 84.2% were white. Higher BMI correlated with younger age ( < 0.0001). Decedents with severe obesity (BMI ≥ 40 kg/m) had 4.15 times higher odds of ICU utilization (95% CI: 1.55, 11.11), = 0.010. Across palliative care domains, no significant differences were observed in the documentation of goals of care discussions, prognosis, or symptom burden by BMI category. However, after adjustment for age, race, and gender, decedents with severe obesity (BMI ≥ 40 kg/m) had over three times higher odds of spiritual care documentation compared with those with BMI 18-29.9 kg/m (adjusted OR: 3.02, 95% CI: 1.19, 7.69, = 0.026). Documentation rates for psychosocial and cultural aspects of care, as well as structured process measures, showed no significant variation by BMI group. CONCLUSION: Decedents with severe obesity tended to be younger, more frequently received ICU care, and had increased documentation of spiritual support before death. In contrast, the provision of other core palliative care domains did not significantly differ across BMI categories. Further research is needed to explore care trajectories and palliative needs of severely obese patients.
Promoting Adjustment Among Families Impacted by Non-Curable, Advanced Stage Parental Cancer: A Randomized Controlled Trial of the Enhancing Connections Palliative Care Program.
Lewis FM, Griffith KA, Ganschow P … +8 more , Gadi VK, Tercyak KP, Oxford M, Fukui J, Derry-Vick H, Manst D, Zahlis EH, Shands ME
J Palliat Med · 2026 Apr · PMID 42169668 · Publisher ↗
BACKGROUND: Annually hundreds of thousands of children are impacted by a parent with cancer, and an estimated 25% have advanced stage disease. Programs to assist these families lag far behind the need. OBJECTIVES: To tes...
BACKGROUND: Annually hundreds of thousands of children are impacted by a parent with cancer, and an estimated 25% have advanced stage disease. Programs to assist these families lag far behind the need. OBJECTIVES: To test the short-term efficacy of a telephone-delivered cancer parenting program for child-rearing parents with non-curable, advanced-stage cancer, the Enhancing Connections Palliative Care (EC-PC) Program. DESIGN: Two-group randomized controlled trial with assessment at three months. Experimental group parents received five educational counseling sessions by telephone at two-week intervals; participants in the alternative treatment control group were mailed a booklet about ways to communicate and support children's coping with parental cancer. SETTING: The program was delivered centrally from the study center. SUBJECTS: Fifty-six child-rearing parents with non-curable advanced cancer were enrolled from medical providers, service agencies, and cancer centers in the United States. MEASUREMENTS: Outcomes were parents' and children's depressed mood and anxiety, parenting skills, parenting self-efficacy, and children's behavioral-emotional adjustment. RESULTS: Between-group analysis using Mixed Models showed a significant effect that benefitted the experimental group: parenting skills significantly improved compared with controls. Results were clinically significant in both the intent to treat ( = 0.54, = 0.34) and per-protocol analysis ( = 0.64, = 0.018). Effect sizes were larger in the experimental group compared with controls. Within-group analysis reflected additional improvements in parents' self-efficacy, depressed mood, and children's behavioral-emotional adjustment. CONCLUSIONS: EC-PC is a telephone-delivered intervention that significantly improved parenting skills and offers a scalable approach to support families coping with advanced cancer. Larger trials are warranted.
Good palliative care for people with severe mental illnesses: A Group Concept Mapping study.
Briek J, Shabani A, Marijnissen RM … +3 more , de Kam H, Oude Voshaar RC, Rhebergen D
Palliat Med · 2026 May · PMID 42169477 · Publisher ↗
BACKGROUND: High-quality palliative care is an international human right. Despite reduced life expectancy, people with severe mental illness face major disparities in access and quality. AIM: This study explored requirem...
BACKGROUND: High-quality palliative care is an international human right. Despite reduced life expectancy, people with severe mental illness face major disparities in access and quality. AIM: This study explored requirements for good palliative care for people with severe mental illness as perceived by stakeholders. DESIGN: This Group Concept Mapping study used a mixed-methods participatory design with two phases: (1) an online brainstorming period (25 days), in which participants could respond several times to the focus prompt about good palliative care for patients with severe mental illness, and (2) individual sorting and rating of statements, followed by data analysis using multidimensional scaling and hierarchical cluster analysis. SETTING/PARTICIPANTS: This study included 163 broadly defined stakeholders involved in severe mental illness care in the Netherlands, predominantly healthcare professionals, including client representatives and relatives. RESULTS: Based on 98 unique statements derived from 515 responses, a concept map of seven clusters emerged: "Selfcare for healthcare professionals," "Expertise," "Communication in advance care planning (highest rated cluster)," "Care chain," "Organization and policy making," "Advance care planning" and "Patient centred care." Statement 66, "Centralize the patient," was considered most important. CONCLUSIONS: Good palliative care for people with severe mental illness is challenged by complexity, stigma and varied stakeholder demands. As basic requirements are often unmet in mental health care, individuals with severe mental illness are at increased risk of being deprived of their rights to receive quality palliative care. This study underscores the need to extend care recommendations and improve professional training, focusing on self-care and interdisciplinary education.
Impact of Patient-Oncologist Language Concordance on the Quality of End-of-Life Care.
Yoh K, Yellin LR, Agarwal J … +9 more , Finnegan P, Vattakalam RM, Buckley De Meritens A, Dioun S, Randall TC, Pua T, Clair CMS, Wright JD, Hou JY
J Palliat Med · 2026 May · PMID 42159044 · Publisher ↗
OBJECTIVE: To compare end-of-life (EOL) care quality indicators for patients with gynecologic malignancies whose primary oncologist spoke their preferred language (language-concordant care) versus those who did not (lang...
OBJECTIVE: To compare end-of-life (EOL) care quality indicators for patients with gynecologic malignancies whose primary oncologist spoke their preferred language (language-concordant care) versus those who did not (language-discordant care). METHODS: We conducted a retrospective chart review of patients with gynecologic malignancies who died between March 1, 2020, and May 30, 2024. The primary outcome was performance on National Quality Forum (NQF) quality indicators, a composite of six measures of aggressive EOL care. We used multivariable logistic regression to examine associations between language-discordant care and aggressive EOL care, adjusting for age, insurance status, and cancer stage at diagnosis. RESULTS: Briefly, 83 patients met inclusion criteria; 60 (72.3%) received care from a language-concordant oncologist and 23 (27.7%) from a language-discordant oncologist. Discordant patients were more likely to identify as Hispanic or Asian and to have Medicaid insurance. Aggressive EOL care, defined as an NQF score ≥1, occurred in 87.0% of discordant patients compared with 60.0% of concordant patients ( = 0.0174). After adjusting for age, insurance, and cancer stage, language-discordant care was associated with more than six-fold higher odds of aggressive EOL care (adjusted odds ratios: 6.05, 95% confidence intervals: 1.38-26.53). CONCLUSION: Language discordance between patients and oncologists was associated with greater likelihood of aggressive EOL care in gynecologic oncology. Addressing language barriers is essential to improving equity and aligning care with patients' goals at the end of life.
Implementing psilocybin-assisted therapy in palliative care settings: A survey of stakeholders.
Plourde L, Chang SL, Nguyen O … +6 more , Garel N, Farzin H, Stephan JF, Fallu JS, Dorval M, P3A Research Group
Palliat Med · 2026 Jul · PMID 42154482 · Full text
BACKGROUND: While the adoption of psilocybin-assisted therapy for existential distress offers promising support for patients with life-threatening illnesses, implementing this intervention into palliative care settings p...
BACKGROUND: While the adoption of psilocybin-assisted therapy for existential distress offers promising support for patients with life-threatening illnesses, implementing this intervention into palliative care settings presents significant real-world challenges. AIM: To examine palliative care stakeholders' knowledge and attitudes regarding psilocybin-assisted therapy, and identify barriers and facilitators to its implementation. DESIGN: We conducted a cross-sectional online survey between April 15 and December 18, 2024. The survey assessed perceived knowledge, attitudes, and perceived barriers and facilitators to the effective integration of psilocybin-assisted therapy into palliative care settings. SETTING/PARTICIPANTS: One hundred and twenty-one adults involved in palliative care (physicians, other healthcare professionals, caregivers, and managers) were recruited from Canada's four most populous provinces: Québec, Ontario, Alberta, and British Columbia. RESULTS: Forty-three percent of stakeholders reported having good knowledge of psilocybin's potential benefits and risks. Attitudes towards psilocybin-assisted therapy were predominantly non-favourable (61%), yet varied across occupational groups ( < 0.0001), with 95% of physicians reporting favourable attitudes. The lack of trained healthcare providers was viewed as the primary barrier to implementation. Key facilitators included further research and developing standardised intervention protocols. Sixty-eight percent of stakeholders endorsed the introduction of psilocybin-assisted therapy during the early stages of the illness trajectory. CONCLUSIONS: Translating the potential of psilocybin-assisted therapy for existential distress from clinical trials into palliative care settings requires careful consideration and collaboration with stakeholders. Given the significant divergence in perspectives between clinical and non-clinical groups, tailored interprofessional education could help build shared understanding and support effective implementation. Being conducted in Canada, transferability to different regulatory frameworks may be limited.
Models of palliative care for culturally and linguistically diverse people in high-income nations: A scoping review.
Dadich A, Rowley G, Ooi C … +2 more , Eliott J, Laurence C
Palliat Med · 2026 May · PMID 42141843 · Publisher ↗
BACKGROUND: Access to palliative care remains uneven for people described, often variably and controversially, as culturally and linguistically diverse. Terminology and definitions differ across jurisdictions, shaping ho...
BACKGROUND: Access to palliative care remains uneven for people described, often variably and controversially, as culturally and linguistically diverse. Terminology and definitions differ across jurisdictions, shaping how models are designed, implemented, and reported. Evidence on model design and impact for people of culturally and linguistically diverse backgrounds is limited and heterogeneous. AIM: To map what is known about palliative care models for adults of culturally and linguistically diverse backgrounds in high-income nations, describing model components, reported outcomes, implementation influences, and gaps. DESIGN: A scoping review was conducted, guided by the JBI manual and the PRISMA-ScR checklist. DATA SOURCES: In May 2024, MEDLINE, CINAHL, and Scopus were searched. Eligible publications described a palliative care model for adults of culturally and linguistically diverse backgrounds in high-income nations and reported evidence of utility. Letters, commentaries, editorials, protocols, reviews, and anonymously-authored publications were excluded. No limits on date, design, numbers, outcomes, or language were applied. RESULTS: Five publications met the inclusion criteria. Four shared components were identified - culturally sensitive care, family and community engagement, interdisciplinary and community-based approaches, as well as education and empowerment - with reported benefits for patients and family members. However, the evidence-base was geographically narrow, with no explicit engagement with an intersectional analytic lens. CONCLUSIONS: This review indicates areas of apparent consensus about core components, while underscoring conceptual and evidentiary limitations. Future research should employ theoretically-informed, structurally-oriented, and co-produced approaches that clarify definitions and examine how models address intersecting disadvantages and organisational constraints to achieve equitable, scalable palliative care.
Home Hospice Service Use Trends in Israel 2014-2023.
Mayan I, Hovav B, Yakov G … +5 more , Katz G, Duchin O, Geva-Robinson S, Hunt LJ, Sabar R
J Palliat Med · 2026 May · PMID 42136049 · Publisher ↗
BACKGROUND: In Israel, several policies have supported the growth of home-based hospice through a unique public-private care delivery and financing system. Yet, little is known about trends in home hospice use in Israel....
BACKGROUND: In Israel, several policies have supported the growth of home-based hospice through a unique public-private care delivery and financing system. Yet, little is known about trends in home hospice use in Israel. OBJECTIVE: To describe 10-year trends in diagnosis, length of stay (LOS), and discharge patterns among home hospice patients in Israel. DESIGN: We conducted a retrospective cohort study of all patients admitted to Sabar Health's home hospice program between 2014 and 2023. Demographic and clinical data were analyzed by primary diagnosis: Cancer, dementia, end-organ failure, frailty, and neurodegenerative disease. Trends in enrollment, LOS, and live discharge rates were assessed over time. RESULTS: Among 25,673 patients, the proportion with cancer annually declined from 88.6% in 2014 to 57.8% in 2023, while admissions for dementia rose from 0% in 2014 to 19.6% in 2023. Median LOS increased from 20 to 35 days, with the longest durations observed among patients with dementia and neurodegenerative disease. Live discharge rates also rose, particularly in the dementia group from 12.2% to 20% over the observed period, with a growing share occurring after ≥180 days. CONCLUSIONS: Home hospice care in Israel has evolved significantly over the past decade, with increasing enrollment of patients with prolonged and uncertain illness trajectories. These trends emphasize the need for more adaptable eligibility frameworks, improved prognostic tools, and expanded caregiver support to meet the needs of a diversifying hospice population.
Connecting Residents and Children with Severe Neurological Impairment Using a Novel Personal History Tool.
Weisner PA, Xia A, Onur D … +3 more , Dahlgren I, Wilhelm K, Bogetz JF
J Palliat Med · 2026 May · PMID 42121327 · Publisher ↗
BACKGROUND: Residents lack confidence caring for children with severe neurological impairment (SNI). The novel personal history tool, SHINE (Self, Happy, Ill, Names, and Extra), was codeveloped by families and residents...
BACKGROUND: Residents lack confidence caring for children with severe neurological impairment (SNI). The novel personal history tool, SHINE (Self, Happy, Ill, Names, and Extra), was codeveloped by families and residents to strengthen residents' confidence in connecting with children with SNI and their families. OBJECTIVES: To describe SHINE's use among residents and its impact on residents' burnout, meaningful work, and confidence in caring for children with SNI. METHODS: Residents at an academic children's hospital in the United States received small-group teaching on the use of SHINE. Participants completed baseline, one-, and three-month post-intervention surveys, which included resident demographics; self-reported tool use; and resident burnout, meaningful work, and confidence in caring for children with SNI. Data were analyzed descriptively and using Pearson's chi-square tests. RESULTS: Briefly, 88% ( = 37/42) of eligible residents participated (25 interns [67%], 12 senior residents [32%]). After one month, respondents reported they found the tool helpful/very helpful ( = 11, 92%), were likely/very likely to continue using it ( = 11, 92%), and recommended it to future residents ( = 16, 100%). At baseline, residents reported low confidence caring for children with SNI (mean = 2.08, standard deviation (SD) : 0.84 on a 1 = low to 4 = high Likert scale). After one month, respondents reported improvements in (1) understanding the nonmedical needs of patients (mean increase: 0.71, SD: 0.85, value = 0.006) and (2) understanding life outside the hospital (mean increase: 0.94, SD: 0.87, value = 0.003). Respondents reporting higher use of the tool experienced larger gains. No significant differences were seen in burnout or meaningful work. CONCLUSION: SHINE may improve resident self-reported confidence in caring for children with SNI.
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