Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jamda.2025.105721

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jpainsymman.2024.01.009

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Older people with noncancer conditions are less likely to be referred to palliative care services due to the inherent uncertain disease trajectory and a lack of standardised referral criteria. For older adults with noncancer conditions where prognostic estimation is unpredictable, needs-based criteria are likely more suitable. Eligibility criteria for participation in clinical trials on palliative care could inform a needs-based criteria. This review aimed to identify and synthesise eligibility criteria for trials in palliative care to construct a needs-based set of triggers for timely referral to palliative care for older adults severely affected by noncancer conditions.

Methods

A systematic narrative review of published trials of palliative care service level interventions for older adults with noncancer conditions. Electronic databases Medline, Embase, CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov. were searched from inception to June 2022. We included all types of randomised controlled trials. We selected trials that reported eligibility criteria for palliative care involvement for older adults with noncancer conditions, where > 50% of the population was aged ≥ 65 years. The methodological quality of the included studies was assessed using a revised Cochrane risk-of-bias tool for randomized trials. Descriptive analysis and narrative synthesis provided descriptions of the patterns and appraised the applicability of included trial eligibility criteria to identify patients likely to benefit from receiving palliative care.

Results

27 randomised controlled trials met eligibility out of 9,584 papers. We identified six major domains of trial eligibility criteria in three categories, needs-based, time-based and medical history-based criteria. Needs-based criteria were composed of symptoms, functional status, and quality of life criteria. The major trial eligibility criteria were diagnostic criteria (n = 26, 96%), followed by medical history-based criteria (n = 15, 56%), and physical and psychological symptom criteria (n = 14, 52%).

Conclusion

For older adults severely affected by noncancer conditions, decisions about providing palliative care should be based on the present needs related to symptoms, functional status, and quality of life. Further research is needed to examine how the needs-based triggers can be operationalized as referral criteria in clinical settings and develop international consensus on referral criteria for older adults with noncancer conditions.

DOI： 10.1186/s12904-023-01131-6

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Other Link： https://link.springer.com/article/10.1186/s12904-023-01131-6/fulltext.html

Authorship：Lead author  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Palliative Medicine  

<p>Bereavement of a close relative is recognized as a significant psychological stressor for family members. This study aimed to examine the impact of biological kinship on grief and depression among bereaved individuals who lost a parent. A nationwide questionnaire survey was conducted with family members of patients who died in 2017 and 2018. Grief and depression were assessed using the Prolonged Grief Disorder Scale and the Patient Health Questionnaire, respectively. After adjusting for gender, the prevalence of grief was 17.7% among biological children and 21.6% among daughters-in-law and sons-in-law; the prevalence of depression was 39.1% and 41.7%, respectively. Grief was significantly associated with kinship, whereas no such association was observed for depression. Even after adjusting for related factors such as caregiving frequency, being a biological child remained significantly associated with grief (adjusted odds ratio [aOR]=1.75, 95% confidence interval [CI]: 1.59–1.94). These findings suggest that both groups experienced a high level of psychological distress, regardless of biological ties. Therefore, healthcare providers should offer appropriate psychological support to all bereaved individuals, including daughters-in-law and sons-in-law—without making assumptions based on kinship.</p>

DOI： 10.2512/jspm.21.13

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DOI： 10.1016/j.jpainsymman.2025.08.018

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Publisher：Progress in Palliative Care  

Designating a surrogate decision-maker and discussing end-of-life preferences are essential steps to prepare for a potential future loss of decision-making capacity. Yet, little is known about the factors associated with better surrogate understanding of a person’s end-of-life preferences. We aimed to examine which sociodemographic factors, values related to end-of-life care, and decision-making-related factors were associated with perceived surrogate understanding of end-of-life preferences among adults who had designated a surrogate. This cross-sectional study entailed a secondary analysis of data from the Public Awareness of Hospice and Palliative Care Study 2018, a nationwide, web-based survey conducted in Japan. The survey included 1000 adults aged 20–79 who were registered with a market research company. Participants were asked to evaluate the extent to which their designated surrogate understood their end-of-life care preferences. The participants had a mean age of 50.3 years (SD = 15.7), and 51% were female. Among the 873 participants who had designated a surrogate, 57.4% had never discussed their end-of-life preferences with that person. Only 19.9% (n = 174) believed that their surrogate understood their preferences sufficiently. Perceived surrogate understanding was associated with several factors, including age, living status, preferences regarding diagnostic disclosure to family, preferences for end-of-life treatment goals, and the extent of prior end-of-life discussion. The results emphasize the value of end-of-life discussions and the influence of individual characteristics on perceived surrogate understanding.

DOI： 10.1080/09699260.2025.2538914

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Language：English   Publisher：Journal of Palliative Medicine  

Background: Parents who have lost their children to death often experience high levels of grief and depression. However, studies on the grief and depression experienced by parents who have lost an adult child to cancer are scarce. Objectives: To clarify the risk and characteristics of grief and depression in parents who have lost an adult child to cancer. Design: A nationwide mortality follow-back survey was conducted in Japan with participants identified using death certificate data for cancer. Between February 2019 and February 2020, a questionnaire was distributed to 110,990 bereaved family members; 60,797(63.1%) responses were received, and 50,639 were analyzed. Setting/Subjects: The participants included Japanese bereaved families who lost a family member between 2017 and 2018, that is, 13-25 months before initiating this study. At the time of their child’s death, the parents were the primary caregivers. Measurements: Data on key factors such as patient and bereaved family background, family caregiving burden, and bereaved family grief and depression were collected. Results: Bereaved parents who had lost their adult children had a higher likelihood of experiencing grief and depression than those who had lost other family members (adjusted odds ratio: 2.0, 95% confidence interval: 1.71, 2.34). Furthermore, factors such as motherhood and death at home increased the likelihood of grief and depression among bereaved parents. Conclusions: The results suggest that early support is needed for mothers experiencing strong grief and depression, as well as for parents whose adult children die at home.

DOI： 10.1177/10966218251368494

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jpainsymman.2025.08.018

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s41999-025-01299-5

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DOI： 10.1177/10966218251368494

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ejon.2025.102875

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Language：English   Publisher：Journal of Pain and Symptom Management  

The authors regret that the affiliation of M.H., S.Y., M.H., and A.K. was listed as the Department of Clinical Oncology and Chemotherapy at Nagoya University Hospital in Nagoya, Japan. This should have been listed as the Department of Nursing at Nagoya University Hospital in Nagoya, Japan. The authors would like to apologize for any inconvenience caused.

DOI： 10.1016/j.jpainsymman.2024.05.019

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Language：Japanese   Publisher：(NPO)日本緩和医療学会  

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Language：English   Publisher：Annals of Palliative Medicine  

Background: Establishing appropriate quality assessment indicators for palliative care in intensive care units (ICUs) is vital. This systematic review summarizes the existing quality indicators (QIs) for palliative care in ICUs. It assesses the methodological quality of QI development to pave the way for more valid QIs. Methods: A literature search was conducted using MEDLINE, PsycINFO, CINAHL, Cochrane databases, and the Ichushi-web database for Japanese literature for all studies published until November 2021. The included QIs were drawn from the National Consensus Project for Quality Palliative Care (NCP) and the Donabedian model of quality. Methodological quality was assessed based on the appraisal of indicators through the research and evaluation tool. Results: Five studies were included, from which 109 indicators were extracted: 78% were process indicators, 5% were outcome indicators, and 17% were structure indicators. The most common indicators addressed the palliative care domain of “ethical and legal aspects of care” (n=38, 30%). Another distinctive feature of some indicators was a focus on supporting ICU staff. Regarding methodological quality, the “scientific evidence” varied (11–89%). Most of the data on QI measures and data sources were obtained from a review of electronic medical records (EMRs). Administrative data also provided a few measurable indicators. Conclusions: Out of all the QIs covered in this review, most were process indicators, and only a few were outcome indicators. Ethical and legal aspects of care and support for the ICU staff emerged as unique to palliative care. Although the existing QIs can be used for palliative care in ICUs, more specific indicators are urgently needed. Continuous quality assessment and improvement, as well as the addition of more palliative care practices in ICUs, would provide further evidence and help develop valid QIs.

DOI： 10.21037/apm-22-1005

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