Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2025
Impact of Diagnosis Nondisclosure on Quality of Dying in Cancer Patients: A Bereavement Study.
Patients should be optimally informed about their illness for patients' autonomy and shared decision-making. However, diagnosis nondisclosure to patients is traditionally widespread in Japanese culture with family-oriented autonomy. There is insufficient research on quality of death (QOD) and quality of care (QOC) among patients who are not told their diagnosis. ⋯ We demonstrated that overall QOD and QOC in decedents with cancer were significantly higher in decedents with explicit cancer diagnoses. Furthermore, bereaved family members' outcomes were better among the family members of decedents with an explicit cancer diagnosis.
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J Pain Symptom Manage · Feb 2025
Implementation and Evaluation of a Pediatric Palliative Care Curriculum for Adult-Track HPM Fellows.
Hospice and Palliative Medicine (HPM) fellowship training provides education on caring for patients from early childhood through adulthood. Yet, there are few guidelines about how to teach these key components, and more specifically the components of Pediatric Palliative Care (PPC), to fellows who have a variety of backgrounds prior to entering HPM fellowship. ⋯ The study revealed some limitations in the current curriculum design, such as its lack of consistency. However, it also highlighted several strengths, including the importance of flexibility and personal responsibility for learning. The results provide valuable insights into the experiences among fellows and educators at a single institution with a PPC Curriculum for adult-track HPM fellows.
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J Pain Symptom Manage · Feb 2025
Distributed Opioids in Morphine Equivalent: A Global Measure of Availability for Palliative Care.
Estimates of serious health-related suffering (SHS) demonstrate immense unmet need for palliative care, predominately in low- and middle-income countries (LMICs). Because opioids are essential medicines in palliative care (PC), measuring their availability can be used to evaluate the capacity of health systems to meet need. ⋯ DOME and DOME%SHSNEED can be used to monitor health system progress to redress disparities and promote access to medically indicated opioid therapy in palliative care.
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J Pain Symptom Manage · Feb 2025
Electronic Health Record Serious Illness Conversation Dashboards: An Implementation Case Series.
Dashboards are used to track and visualize quality indicators within health systems to improve clinical performance. Structured serious illness conversation (SIC) documentation templates within electronic health records (EHR) have enabled the development of SIC dashboards for quality improvement. Little is known about the successes and challenges of SIC dashboards. ⋯ Dashboards can be powerful tools for identifying gaps in SIC and driving interventions for clinician practice change. However, challenges related to clinician adoption of structured templates for SIC documentation and mixed clinician receptivity to data feedback may limit their reliability and use.
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J Pain Symptom Manage · Feb 2025
Pediatric Palliative Care Simulation Improves Resident Learning Outcomes: an 11-Year Review.
Many general pediatrics residents lack sufficient opportunities to conduct difficult conversations with families, particularly about end-of-life care. Simulation learning is an effective means of practicing professional skills. A pediatric palliative care (PPC) physician is uniquely suited to mentor residents and fellows learning to lead difficult conversations through simulation. Co-facilitation of the simulated difficult conversation by a bereaved parent or family member enhances the learning experience. ⋯ Simulations with bereaved parent actors improved general pediatrics residents' performance and comfort during difficult conversations and are transportable to diverse settings.