Evidence map›Paper›PMID 40200976›Full record

ArticleHome health care management & practice2025

The Paradox of Choice in Palliative Care Decision-Making in Managed Long-Term Care: A Qualitative Study.

Jiyoun Song, Lynette Ramlogan, Sasha Vergez, Anahita Davoudi, Sridevi Sridharan, Hannah Cho, June Stanley, Margaret V McDonald, Kathryn H Bowles, Jingjing Shang and 2 more

Abstract read
In one paragraph

Article in Home health care management & practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jiyoun SongUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.ORCID 0000-0003-0362-0670
Lynette RamloganVNS Health, New York, NY, USA.
Sasha VergezVNS Health, New York, NY, USA.
Anahita DavoudiVNS Health, New York, NY, USA.
Sridevi SridharanVNS Health, New York, NY, USA.
Hannah ChoUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
June StanleyVNS Health, New York, NY, USA.
Margaret V McDonaldVNS Health, New York, NY, USA.
Kathryn H BowlesUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Jingjing ShangColumbia University School of Nursing, New York City, NY, USA.
Patricia W StoneColumbia University School of Nursing, New York City, NY, USA.
Maxim TopazVNS Health, New York, NY, USA.

Funding

Project-003P20NR018072 · NINR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHANG, JINGJING, STONE, PATRICIA W. · 2018 to 2022
$1.9M
NINR NIH HHS P20 NR018072
6 · The paper itself

Abstract

Palliative care offers undeniable advantages to elderly patients with multiple chronic illnesses in managed long-term care. However, only approximately 14% of those who require palliative care actually receive it. To investigate factors influencing decision-making regarding palliative care acceptance, and healthcare providers' communication strategies, which patients or family caregivers perceive during managed long-term care. Qualitative thematic content analysis study. Two data sources from home and community-based health care organization in a metropolitical city in the Northeastern United States were used: (a) retrospectively collected 79 phone call audio recordings between patients and/or family caregivers with healthcare providers when initiate palliative care option, and (b) prospectively collected 10 exploratory qualitative interviews with patients and/or family caregivers for this study purpose. From a total of 89 conversations, 7 themes emerged during palliative care decision-making: (a) capability for self-management; (b) symptom severity; (c) perceptions of chronic disease; (d) satisfaction with current health services; (e) code status; (f) caregiver burden and (g) other reasons, including financial considerations and service affiliations. In addition, from 10 qualitative interviews, 4 key themes in healthcare providers' communication that optimize palliative care conversations were indicated: (i) trust and relationship dynamics; (ii) positive reinforcement and personal connection; (iii) conversation setting and initiator; and (iv) collaborative approach to care coordination. Enhancing decision-making around palliative care and improving acceptance of palliative care services may be improved through the integration of personalized care plans, empathetic communication, use of symptom-inclusive assessments for timely care, and proactively addressing caregiver burden.

Indexed as

community health servicesnursing informaticspalliative carepatient preferencequalitative research

Identifiers

PMID40200976
PMCPMC11978416

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.