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Clinical Management of Palliative Medicine
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Clinical Management of Palliative Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 May 2025) | Viewed by 5524

Special Issue Editor

Prof. Dr. Eva Katharina Masel

E-Mail Website
Guest Editor
Division of Palliative Medicine, Medical University of Vienna, 1090 Vienna, Austria
Interests: anxiety; cachexia; cancer care facilities; depression; dyspnea; humanities; nausea; pain; palliative care; psychiatry
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Palliative Care plays a critical role in improving the quality of life for patients with serious illness and their families. Recent advances in this field have been transformative, offering new insights and approaches to improve patient outcomes and experiences. This Special Issue aims to highlight the latest advances, research, and innovations in Palliative Medicine, providing a platform for experts to share their knowledge and contribute to the advancement of this vital area of healthcare. This Special Issue is intended for oncologists, clinical researchers, healthcare professionals and anyone involved in or interested in Palliative Medicine. It will provide valuable insights and information for clinicians seeking to improve their practice and researchers exploring new avenues of investigation shaping the future of healthcare. We invite submissions of original research articles, review articles, case studies, perspectives, and commentaries relevant to the theme of this Special Issue. Submissions should adhere to the journal's guidelines and will undergo rigorous peer review to ensure quality and relevance.

This Special Issue will cover a wide range of topics related to Palliative Medicine, including but not limited to the following:

  1. Advanced symptom management.
  2. Clinical, psychological, and spiritual aspects of care.
  3. Palliative Medicine in special populations (e.g., pediatrics, general medicine, internal medicine, geriatrics, oncology)
  4. Innovations in pain management.
  5. End-of-life decision making and advance care planning.
  6. Integrative Palliative Care approaches.
  7. Palliative Care in non-cancer conditions.
  8. Quality improvement and patient-centered care initiatives.

Prof. Dr. Eva Katharina Masel
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • advance care planning
  • death
  • ethics
  • hospice care
  • pain management
  • palliative care
  • psychosocial functioning

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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15 pages, 1981 KiB  
Article
Validation of the Palliative Care and Rapid Emergency Screening (P-CaRES) Tool in Germany
by Julia Schmitz, Mitra Tewes, Baicy Mathew, Marie Bubel, Clemens Kill, Joachim Risse, Eva-Maria Huessler, Bernd Kowall and Maria Rosa Salvador Comino
J. Clin. Med. 2025, 14(7), 2191; https://doi.org/10.3390/jcm14072191 - 23 Mar 2025
Viewed by 584
Abstract
Background/Objectives: The “Palliative Care and Rapid Emergency Screening Tool” (P-CaRES) is used to identify patients with palliative needs in the emergency department. This study aims to translate, adapt, and validate the P-CaRES tool for the German healthcare context. Methods: This is [...] Read more.
Background/Objectives: The “Palliative Care and Rapid Emergency Screening Tool” (P-CaRES) is used to identify patients with palliative needs in the emergency department. This study aims to translate, adapt, and validate the P-CaRES tool for the German healthcare context. Methods: This is a monocentric, non-interventional, retrospective study conducted in the emergency department of the University Hospital Essen, Germany. After a structured translation process, the tool’s face and content validity were evaluated using questionnaires completed by healthcare workers. Construct validity was established by comparing the results with the German-validated Supportive and Palliative Care Indicators Tool (SPICT). A palliative care physician blinded to the tool, independently assessed the screened patients, and made recommendations on the appropriateness of palliative care referrals. Results: Two hundred eighty-nine emergency department visits were examined. In addition, a total of 26 healthcare professionals were surveyed. 258 screenings were conducted, with P-CaRES identifying 50 positive cases (19.4%). Agreement between SPICT and P-CaRES was 88.4% (kappa: 0.67, 95% confidence interval (CI): [0.56, 0.78]), showing 64.7% sensitivity and 96.8% specificity. Expert comparison yielded 85.5% agreement (kappa: 0.54, 95% CI: [0.41, 0.68]), with 64.0% sensitivity and 90.8% specificity. Face and content validity showed strong agreement regarding the tool’s design, including its comprehensibility, applicability, ease of use, and precision, as well as its usefulness in referring patients to a specialized palliative care team. Conclusions: The study successfully validated a cultural and linguistic equivalent German version of the P-CaRES tool. Further research is necessary to assess the tool’s effectiveness in clinical practice. Full article
(This article belongs to the Special Issue Clinical Management of Palliative Medicine)
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11 pages, 252 KiB  
Article
Time from Final Oncologist Visit to Death and Palliative Systemic Treatment Use Near the End of Life in Heavily Pretreated Patients with Luminal Breast Cancer
by Mirosława Püsküllüoğlu, Marek Ziobro, Małgorzata Pieniążek, Renata Pacholczak-Madej, Sebastian Ochenduszko, Iwona Godek, Agata Adamkiewicz-Piejko and Aleksandra Grela-Wojewoda
J. Clin. Med. 2024, 13(22), 6739; https://doi.org/10.3390/jcm13226739 - 8 Nov 2024
Viewed by 905
Abstract
Background: Palliative care must be tailored for patients with extended disease trajectories, such as those with hormone receptor-positive, Human Epidermal Growth Factor Receptor 2 (HER2)-negative advanced breast cancer (ABC), including the appropriate timing of discontinuing treatment. This study aimed to assess the [...] Read more.
Background: Palliative care must be tailored for patients with extended disease trajectories, such as those with hormone receptor-positive, Human Epidermal Growth Factor Receptor 2 (HER2)-negative advanced breast cancer (ABC), including the appropriate timing of discontinuing treatment. This study aimed to assess the interval between the last oncologist visit and death and the application of systemic treatment near the end of life in this patient population. Methods: This retrospective study included patients with luminal ABC who received at least two lines of palliative systemic treatment at the National Research Institute of Oncology in Poland, and died between November 2020 and March 2024. Results: Seventy-six women, with a median age 62.8 years (range: 35.3–91.5), were included. The median number of prior palliative systemic treatment lines was three (range: 2–6). At their last recorded oncologist visit, 75% of the patients were receiving active treatment (53% with hormonal therapy and 22% with chemotherapy). Only 25% were under continuous palliative care at this visit. Treatment was administered within the last month of life to 53% of the patients. The median duration from the last oncologist visit to death was 23 days (range: 0–408). The duration of this time interval was only associated with the performance status at the last visit (p < 0.05). Conclusions: Oncologists frequently delay the recognition of the need to discontinue systemic therapy. Patients with luminal HER2-negative ABC may be offered numerous effective lines of systemic treatment, complicating this decision further. Implementing clearer guidelines for end-of-life care for this group and providing proper training for healthcare providers is essential. Full article
(This article belongs to the Special Issue Clinical Management of Palliative Medicine)
14 pages, 216 KiB  
Article
Examining Variability in Intra-Hospital Patient Referrals to Specialized Palliative Care: A Comprehensive Analysis of Disciplines and Mortality
by Claudia Fischer, Katharina Dirschmid and Eva Katharina Masel
J. Clin. Med. 2024, 13(9), 2653; https://doi.org/10.3390/jcm13092653 - 30 Apr 2024
Viewed by 1068
Abstract
Background: In Austria, specialized palliative care (SPC) access is limited, with unclear referral criteria, making it challenging to identify hospitalized patients requiring SPC and determine referral timing and mortality at the palliative care unit (PCU). Methods: This retrospective cohort study analyzed patients who [...] Read more.
Background: In Austria, specialized palliative care (SPC) access is limited, with unclear referral criteria, making it challenging to identify hospitalized patients requiring SPC and determine referral timing and mortality at the palliative care unit (PCU). Methods: This retrospective cohort study analyzed patients who underwent a palliative care (PC) needs assessment between March 2016 and November 2021 and were subsequently admitted to the PCU of Austria’s largest academic hospital. Demographic, clinical, and standardized referral form data were used for analysis, employing descriptive statistics and logistic regression. Results: Out of the 903 assessed patients, 19% were admitted to the PCU, primarily cancer patients (94.7%), with lung (19%) and breast cancer (13%) being most prevalent. Common referral reasons included pain (61%) and nutritional problems (46%). Despite no significant differences in referral times, most patients (78.4%) died in the PCU, with varying outcomes based on cancer type. Referral reasons like pain (OR = 2.3), nutritional problems (OR = 2.4), and end-of-life care (OR = 6.5) were significantly associated with the outcome PCU mortality. Conclusions: This study underscores Austria’s SPC access imbalance and emphasizes timely PC integration across disciplines for effective advance care planning and dignified end-of-life experiences in PCUs. Full article
(This article belongs to the Special Issue Clinical Management of Palliative Medicine)

Other

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12 pages, 602 KiB  
Systematic Review
The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors
by Neel H. Mehta, Megh Prajapati, Rishi Aeleti, Kush Kinariwala, Karina Ohri, Sean McCabe, Zachary Buller, Sandra Leskinen, Noah L. Nawabi, Vatsal Bhatt, Keval Yerigeri and Vivek Babaria
J. Clin. Med. 2024, 13(16), 4871; https://doi.org/10.3390/jcm13164871 - 18 Aug 2024
Viewed by 2231
Abstract
Background: Diagnosis with a brain tumor is a critical event in the lives of patients and their families due to poor medical prognoses and complex clinical care. Spiritual care interventions have been known to have meaningful effects in morbid diagnoses and palliative [...] Read more.
Background: Diagnosis with a brain tumor is a critical event in the lives of patients and their families due to poor medical prognoses and complex clinical care. Spiritual care interventions have been known to have meaningful effects in morbid diagnoses and palliative medicine, but their role in the neuro-oncologic patient’s experience is poorly understood. This systematic review explores the role of spirituality and its relevance to patient care in the diverse setting of brain tumors. Methods: A comprehensive systematic review was conducted following PRISMA-SR guidelines. PUBMED was queried for studies on spirituality and neuro-oncology. Identified studies included RCTs, interviews, surveys, and case reports that examined spirituality in neuro-oncological clinical care, quality of life, and patient experience. Of 214 articles identified, 21 studies met the inclusion criteria, and the results were narratively synthesized. Results: Spirituality may play a significant role in mental well-being by reconciling existential questions faced by both patients and caregivers, and can serve as a valuable resource to improve mental well-being and reduce rates of palliative caregiver burnout. However, the paucity of studies examining the education and integration of spiritual awareness within the clinical literature warrants further study. Conclusions: While spiritual care interventions may improve the quality of life and mental wellness of patients and their caregivers, it is unclear how spiritual awareness and education should best be implemented. Further research is needed to better understand how key components of spiritual awareness can be integrated into medical education to deepen the patient–physician relationship and improve clinical experiences. Full article
(This article belongs to the Special Issue Clinical Management of Palliative Medicine)
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