Evidence map›Paper›PMID 41974615›Full record

ArticleJournal of palliative medicine2026

"It Felt Like Throwing in the Towel": Family Caregiver Perspectives on End-of-Life Decision Making in Chronic Obstructive Pulmonary Disease.

Natalia Smirnova, Tivona Batieste, Sarah H Cross, Samir Jamdar, Catherine S Peterson, Camille P Vaughan, Dio Kavalieratos

Abstract read
In one paragraph

Article in Journal of palliative medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Natalia SmirnovaDivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-2964-2512
Tivona BatiesteDepartment of Medicine, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-5524-5094
Sarah H CrossDivision of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA.
Samir JamdarDepartment of Medicine, Emory University, Atlanta, Georgia, USA.
Catherine S PetersonDivision of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA.
Camille P VaughanDivision of Geriatrics and Gerontology, Department of Medicine, Emory University, Atlanta, Georgia, USA.
Dio KavalieratosDivision of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Institutional Career Development CoreKL2TR002381 · NCATS · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Anandi Nayan Sheth · 2017 to 2026
$14.1M
Advancing Symptom Science and Management in Cystic Fibrosis: Biological, Social, and Clinical MechanismsR01HL171735 · NHLBI · EMORY UNIVERSITY · PI Dionysios Kavalieratos · 2024 to 2026
$1.9M
Dying While Poor: Investigating Multi-level Determinants of Inequities in End-of-life Care for Adults with Heart FailureK01HL175212 · NHLBI · EMORY UNIVERSITY · PI Sarah Harrington Cross · 2025 to 2026
$286k
NCATS NIH HHS KL2 TR002381NCATS NIH HHS UL1 TR002378NHLBI NIH HHS K01 HL175212NHLBI NIH HHS L30 HL170378NHLBI NIH HHS R01 HL171735
6 · The paper itself

Abstract

backgroundChronic obstructive pulmonary disease (COPD) has an unpredictable trajectory and high symptom burden, complicating end-of-life (EOL) decisions around place of death and hospice use. Little is known about how families navigate these decisions.

methodsWe conducted semi-structured interviews with bereaved caregivers of people with COPD who received pulmonary care at a U.S. academic center and died within 12 months. Two investigators performed template analysis to identify themes.

resultsWe interviewed 18 caregivers (median age 58; 50% Black; 89% female). Fifty-six percent of decedents received hospice; 33% died at home. Caregivers described five themes: missed prognostic cues and poor communication; hospice as both loss and relief; home as ideal but hospital as default; financial influences on decisions; and mismatch between hospice and COPD needs.

conclusionsCaregivers identified a readiness gap driven by prognostic uncertainty, communication challenges, and financial constraints. Clearer communication and hospice models better aligned with COPD are needed.

Indexed as

CaregiversDecision MakingPulmonary Disease, Chronic ObstructiveTerminal CareAdultAgedAged, 80 and overFemaleHospice CareHumansInterviews as TopicMaleMiddle AgedQualitative ResearchUnited Stateschronic obstructive pulmonary diseasedecision makingfamily caregiverqualitative research

Identifiers

PMID41974615
PMCPMC13245674

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.