{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:01:57Z","timestamp":1777384917221,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003975","name":"Israeli Cancer Association","doi-asserted-by":"crossref","award":["2021-1185"],"award-info":[{"award-number":["2021-1185"]}],"id":[{"id":"10.13039\/501100003975","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:p>Multiple myeloma (MM) is a hematologic malignancy characterized by a significant symptom burden and a complicated disease trajectory, highlighting the necessity for early integration of palliative care (PC). This study assessed the effects of a nurse-led, integrative early palliative care intervention in comparison to standard care for patients with multiple myeloma. The intervention included weekly symptom tracking, structured follow-ups, and proactive symptom management. Patient-reported outcomes were assessed at baseline, 3\u00a0months, and 6\u00a0months using validated instruments. The number of emergency department (ED) visits and hospitalizations were assessed to measure the burden to the health care system.<\/jats:p>\n                  <jats:p>\n                    The integrated model improved anxiety as measured by HADS (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .01), quality of life (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001) and reduced pain (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .01), fatigue (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .01), drowsiness (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .007), and depression (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .04). Nausea, shortness of breath, and loss of appetite remained unchanged. These findings highlight the benefits of a nurse-led, integrative PC approach in reducing symptom burden and enhancing psychological well-being among patients with MM. Early integration of this model within hematology services has the potential to improve patient outcomes, although institutional adaptations may be needed to optimize its effect on health care utilization.\n                  <\/jats:p>","DOI":"10.1177\/10499091251408467","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T14:02:44Z","timestamp":1767448964000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Nurse-Led Integrated Palliative Care Intervention for Patients With Multiple Myeloma"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-3967","authenticated-orcid":false,"given":"Shulamit","family":"Ohana","sequence":"first","affiliation":[{"name":"Henrietta Szold Hadassah Hebrew University School of Nursing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freda","family":"DeKeyser Ganz","sequence":"additional","affiliation":[{"name":"Henrietta Szold Hadassah Hebrew University School of Nursing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9620-781X","authenticated-orcid":false,"given":"Adir","family":"Shaulov","sequence":"additional","affiliation":[{"name":"Hebrew University of Jerusalem"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1188\/17.CJON.E25-E30"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1243997"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-06979-7"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55975"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25764"},{"key":"e_1_3_8_7_2","volume-title":"Palliative Care","author":"World Health Organization (WHO)","year":"2020","unstructured":"World Health Organization (WHO). Palliative Care. Geneva: World Health Organization; 2020. [Internet]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care. [cited 2025 Nov 12]. Available from:."},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2023-004524"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-024-08665-2"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2022-004124"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0361"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12895"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2017.05.009"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2017.05.006"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951514000649"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24294"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18286"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0234"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.05.009"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjop.12637"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.3.974"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211022957"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-017-0250-8"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-020-0702-x"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.10398"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.07.014"}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091251408467","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10499091251408467","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091251408467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:31:38Z","timestamp":1777368698000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10499091251408467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,3]]},"references-count":25,"alternative-id":["10.1177\/10499091251408467"],"URL":"https:\/\/doi.org\/10.1177\/10499091251408467","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,3]]},"article-number":"10499091251408467"}}