{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T19:35:45Z","timestamp":1782761745696,"version":"3.54.5"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"NIH\/NCI","award":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}]},{"name":"NIH\/NCI","award":["1R25CA240111-01A1"],"award-info":[{"award-number":["1R25CA240111-01A1"]}]},{"name":"NIH","award":["T32 CA00946"],"award-info":[{"award-number":["T32 CA00946"]}]},{"DOI":"10.13039\/100012787","name":"Office of the Vice Chancellor for Research and Graduate Education, University of Wisconsin-Madison","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012787","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001395","name":"Wisconsin Alumni Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001395","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Existential concerns are inherent in serious illness and at the end of life, yet communication to address such concerns can be challenging. This study explored multidisciplinary oncology clinicians\u2019 experiences navigating existential communication with patients and families, as well as what makes existential communication meaningful and challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study analyzed responses to open-ended survey questions collected from N = 83 participants (multidisciplinary oncology clinicians, including nurses, social workers, and chaplains) who participated in a communication training course. Data were analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Themes across clinicians\u2019 experiences of existential communication with patients and families included existential questions; guilt\/regret; fears about the future; grief; preparing for death; values and goals of care; spiritual concerns; and letting go. Meaningful experiences included bearing witness; providing emotional support and information; easing suffering; learning and growing; and the honor of accompanying patients and families through the end of life. Challenges included discomfort when talking about death; facing denial; being unable to \u201cfix it\u201d; resistance to palliative care among oncology team members, patients, and families; fear of saying the wrong thing; navigating conflicting values; responding to spiritual concerns; barriers to inclusive, high-quality care; and struggling with emotions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Existential communication is a vital yet challenging part of oncology care. Clinicians find deep meaning in this work but face emotional and systemic barriers. Findings highlight the need for training, reflection, and institutional support to help clinicians engage in existential communication with patients and families near the end of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091251405390","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:20:35Z","timestamp":1764807635000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Existential Communication With Patients and Families: A Qualitative Exploration of Multidisciplinary Oncology Clinicians\u2019 Experiences"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-1687","authenticated-orcid":false,"given":"Megan","family":"Miller","sequence":"first","affiliation":[{"name":"University of Wisconsin-Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0680-8911","authenticated-orcid":false,"given":"William E.","family":"Rosa","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley","family":"Buller","sequence":"additional","affiliation":[{"name":"City of Hope Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-1812","authenticated-orcid":false,"given":"Meghan","family":"McDarby","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Youngblood","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty R.","family":"Ferrell","sequence":"additional","affiliation":[{"name":"City of Hope Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/go.22.00038"},{"key":"e_1_3_8_3_2","volume-title":"Staring at the Sun: Overcoming the Terror of Death","author":"Yalom ID","year":"2008","unstructured":"Yalom ID. Staring at the Sun: Overcoming the Terror of Death. Jossey-Bass Inc; 2008."},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1188\/08.Onf.241-247"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70033"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2024.0209"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2019.03.006"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2024.0070"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0431"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091241265108"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241234800"},{"key":"e_1_3_8_14_2","unstructured":"Dedoose Version 10.0.25. 2025. https:\/\/www.dedoose.com\/"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3456"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/07347332.2025.2541643"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002379"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2023-004448"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2019.0689"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0696"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2012.712608"},{"key":"e_1_3_8_22_2","volume-title":"Grief That Does Not End. Continuing Bonds: New Understandings of Grief","author":"Rosenblatt P","year":"1996","unstructured":"Rosenblatt P. Grief That Does Not End. Continuing Bonds: New Understandings of Grief. Taylor & Francis; 1996."},{"key":"e_1_3_8_23_2","first-page":"1072","volume-title":"Integration of Spiritual Care into Palliative Care Service Delivery Models. Oxford Textbook of Palliative Medicine","author":"Beaussant Y","year":"2021","unstructured":"Beaussant Y, Nichipor A, Balboni T. Integration of Spiritual Care into Palliative Care Service Delivery Models. Oxford Textbook of Palliative Medicine. 6th ed. Oxford University Press; 2021:1072-1080.","edition":"6"},{"key":"e_1_3_8_24_2","unstructured":"Agency for Healthcare Research and Quality. Warm handoff: intervention. https:\/\/www.ahrq.gov\/patient-safety\/reports\/engage\/interventions\/warmhandoff.html"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/02813432.2018.1459235"},{"key":"e_1_3_8_26_2","volume-title":"The Reflective Practitioner: How Professionals Think in Action","author":"Sch\u00f6n DA","year":"1992","unstructured":"Sch\u00f6n DA. The Reflective Practitioner: How Professionals Think in Action. Routledge; 1992."},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.1515\/dx-2019-0106"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01221-5"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.04.040"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000979092.39243.d4"},{"key":"e_1_3_8_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2022.06.007"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.08.002"},{"key":"e_1_3_8_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4829"},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.811612"}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091251405390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10499091251405390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091251405390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:31:37Z","timestamp":1777368697000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10499091251405390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":33,"alternative-id":["10.1177\/10499091251405390"],"URL":"https:\/\/doi.org\/10.1177\/10499091251405390","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"article-number":"10499091251405390"}}