Palliative Medicine最新文献

{"title":"Evaluation of the \"Attentive Visitors\" training program to support community volunteers in their palliative care signposting role: a multimethods design.","authors":"Sabet Van Steenbergen, Sarah Dury, Luc Deliens, Kenneth Chambaere, Steven Vanderstichelen","doi":"10.1177/02692163261437605","DOIUrl":"https://doi.org/10.1177/02692163261437605","url":null,"abstract":"<p><strong>Background: </strong>The Attentive Visitors training was developed to increase community volunteers' knowledge, skills and confidence regarding their role, signposting, and communication to address palliative care needs with community residents and healthcare professionals.</p><p><strong>Aims: </strong>To pilot-test and evaluate the effectiveness and acceptability of the training at the volunteer level.</p><p><strong>Design: </strong>Multi-method design utilizing a quantitative pre-test/post-test survey before (T0), immediately after (T1) and 2 months after (T2) the training to assess effectiveness; focus groups and interviews to evaluate subjective effectiveness and acceptability; and the Most Significant Change Technique to capture the wider impact of the training.</p><p><strong>Settings/participants: </strong>Participants included community volunteers and stakeholders involved in palliative home care, primary care, and volunteer coordination in Flanders, Belgium. They were purposively sampled through Samana, a nonprofit organization supporting people with chronic illness and their informal caregivers.</p><p><strong>Results: </strong>The training was pilot-tested among 59 community volunteers across six locations in Flanders, Belgium. Thirty-seven (63%) volunteers completed both modules (i.e. the didactic and follow-up session). Nineteen volunteers participated in interviews and eight stakeholders took part in a group discussion. The training had a positive effect (at T2) on knowledge about palliative care (0.58 fewer incorrect answers at T2; <i>p</i> = 0.011) and self-efficacy in discussing identified needs with a community resident (+0.51 at T2; <i>p</i> < 0001) and healthcare professional (+0.42 at T2; <i>p</i> = 0022). Community volunteers reported increased awareness of their own importance, more self-efficacy in setting boundaries, and more self-confidence in communicating with community residents and healthcare professionals. Community volunteers indicated that the training met their expectations, was useful, and that benefits were proportionate to required efforts.</p><p><strong>Conclusions: </strong>The training was evaluated positively on effectiveness and acceptability, enabling volunteers to respond better to palliative care needs and to support them in their signposting role. Findings of this early evaluation, focusing on short-term outcomes, suggest that this training program can be scaled up and integrated into educational programs of stakeholder organizations.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163261437605"},"PeriodicalIF":3.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping patient journeys: Exploring patient and informal carer experiences of injectable anticipatory medication care in the community to identify opportunities for practice improvements.","authors":"Rosanna Fennessy, Artemis Paterson, James Ward, P John Clarkson, Ben Bowers","doi":"10.1177/02692163261437596","DOIUrl":"https://doi.org/10.1177/02692163261437596","url":null,"abstract":"<p><strong>Background: </strong>Injectable anticipatory medications are routinely prescribed ahead of need in many countries to help manage distressing end-of-life symptoms. However, little is known about the lived experience of patients and informal caregivers as they navigate their prescription, supply and use.</p><p><strong>Aim: </strong>To explore and map patient journeys in navigating anticipatory medication care, and to identify healthcare interactions with the greatest potential for enhancing patient and informal caregiver experiences of care.</p><p><strong>Design: </strong>Qualitative secondary analysis of longitudinal interview data using framework analysis and patient journey mapping techniques.</p><p><strong>Setting/participants: </strong>Adults (18+) prescribed anticipatory medications (<i>n</i> = 6), informal caregivers (<i>n</i> = 9) and health care professionals involved in their care (<i>n</i> = 5).</p><p><strong>Results: </strong>Visually mapping journeys highlighted that patients and informal caregivers' experiences of anticipatory medication processes varied greatly and were influenced by the context of care. All participants appreciated access to injectable medications for future symptom control. However, journeys repeatedly highlighted suboptimal information exchange between patients, informal caregivers and healthcare professionals, regarding their purpose and threshold for use. Navigating unfamiliar and complex end-of-life medication support systems was more challenging when patients lived alone or experienced communication difficulties.</p><p><strong>Conclusions: </strong>Patient and informal caregiver experiences of timely symptom control could be improved by healthcare professionals having open and ongoing conversations about the role of anticipatory medications. Simplified and well-signposted routes for accessing healthcare professional advice and medication input are needed. Using journey mapping offers a novel way to visually illustrate different patient and informal caregivers lived experience and can be adapted for researching experiences of various care pathways.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163261437596"},"PeriodicalIF":3.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of and implementation requirements for telehealth in palliative care patients with advanced cancer: A systematic review and meta-analysis.","authors":"Arisa Kawashima, Taiji Noguchi, Taiki Furukawa, Akiko Unesoko, Shintaro Togashi, Kazuki Sato","doi":"10.1177/02692163251403395","DOIUrl":"10.1177/02692163251403395","url":null,"abstract":"<p><strong>Background: </strong>Telehealth is being integrated with palliative care for patients with advanced cancer to improve access to specialized palliative care. However, its effectiveness and implementation requirements in palliative care remain unclear.</p><p><strong>Aim: </strong>This study evaluates the effectiveness of and implementation requirements for telehealth in palliative care patients with advanced cancer.</p><p><strong>Design: </strong>This was designed as a systematic review and meta-analysis with narrative synthesis (registered; CRD42024581786). The effects on patients' quality of life, symptom burden, and depression were analyzed using a random-effects meta-analysis of randomized controlled trials. A narrative synthesis was conducted for all included studies.</p><p><strong>Data sources: </strong>MEDLINE, Embase, and Cochrane Library databases were searched in September 2025. Eligible studies comprised controlled trials, observational studies, and qualitative studies involving adults with advanced cancer who received telehealth in palliative care.</p><p><strong>Results: </strong>Of the 4232 records screened, 42 met the inclusion criteria, and six were eligible for meta-analysis. Telehealth interventions primarily involved videoconferencing, telephone, or text-based communication. Telehealth in palliative care demonstrated significant improvement in quality of life (standardized mean difference: 0.81; 95% CI: 0.09-1.53) and reduction in symptom burden (standardized mean difference: -1.44; 95% CI: -2.24 to -0.65) but had no significant effects on depression. Implementation requirements included trained multiprofessional teams, accessible digital infrastructure, sustainable reimbursement mechanisms, and standardized outcome measurements.</p><p><strong>Conclusions: </strong>Telehealth in palliative care may help improve quality of life and alleviate symptom burden among patients with advanced cancer. Future research should identify optimal delivery models and examine equity-related barriers to support wider implementation and policy development.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"588-607"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>'It showed me that he sensed I was there. . .'</i>, The 'relational' use of an electrophysiological tool for evaluating the level of discomfort of people at the end of life: A reflexive thematic analysis.","authors":"Chloé Prod'homme, Flore Homey-Dusautois, Manon Denié, Licia Touzet, Claire Pasqualini, Magali Pierrat, François Puisieux, Philippe Sabot","doi":"10.1177/02692163251393576","DOIUrl":"10.1177/02692163251393576","url":null,"abstract":"<p><strong>Background: </strong>The Analgesia Nociception Index device may serve as a guide to a person's parasympathetic activity via the heart rate variability. It is used to assess the level of discomfort of non-communicative patients at the end of life. Although the index's acceptability in palliative care have been demonstrated, the healthcare professionals and the patient's relatives did not have direct, continuous access to the monitor screen.</p><p><strong>Aim: </strong>To evaluate how healthcare professionals and patients' relatives in a palliative care unit perceived the use of the Analgesia Nociception Index.</p><p><strong>Design: </strong>A qualitative, comprehensive, two-centre study was based on individual, semidirective interviews. The interview data were evaluated in a reflexive, thematic analysis.</p><p><strong>Setting/participants: </strong>We interviewed (i) healthcare professionals who used the Analgesia Nociception Index in their routine practice and (ii) the relatives of patients who had been monitored with the tool during their stay in the unit.</p><p><strong>Results: </strong>A total of 28 interviews were conducted. The device was perceived mainly to be an additional medical technique for increasing a person's level of comfort. Some professionals highlighted a risk of re-medicalizing the end of life, with a display screen that distracted attention from the person. A few relatives stated that the changes on the screen were a way of staying in touch with their loved one's perception. The tool helped to increase the value of the relatives' support.</p><p><strong>Conclusion: </strong>The present results might help clinicians to tailor the monitoring to each patient's situation and to communicate more effectively with both care teams and relatives.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"678-687"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health: Early steps in a digital transformation in palliative care.","authors":"Christoph Ostgathe, Amara Callistus Nwosu","doi":"10.1177/02692163261439240","DOIUrl":"10.1177/02692163261439240","url":null,"abstract":"","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"586-587"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study with patients, care-partners, clinicians, and bioethicists to identify ethical considerations of artificial intelligence tools in palliative care.","authors":"John Y Rhee, Paul Miller, Zachary Tentor, Amanda Reich, Alexi A Wright, Charlotta Lindvall","doi":"10.1177/02692163251409290","DOIUrl":"10.1177/02692163251409290","url":null,"abstract":"<p><strong>Background: </strong>The use of artificial intelligence (AI) in medicine has surged. Given the sensitive nature of palliative care, it is crucial to apply AI tools in a patient-centered and ethical manner.</p><p><strong>Aim: </strong>We sought to understand the ethical implications of implementing AI-based tools in palliative care from various stakeholders.</p><p><strong>Design: </strong>Using a framework of ethics of care, we conducted thematic analysis to identify emerging themes.</p><p><strong>Setting/participants: </strong>We recruited and interviewed 22 participants: six patients, four care-partners, five clinicians, three bioethicists, and four clinician-bioethicists, recruited through a single hospital clinic for patients and care-partners and purposeful snowball sampling for clinicians and bioethicists based on their knowledge and interest in AI-based tools. The mean age of participants was 48 years old; 64% were male. Clinician participants had practiced for a mean of 11 years, and ethicists for 15 years. We aimed to recruit clinicians and bioethicists from multiple states and specialties.</p><p><strong>Results: </strong>From the interviews we extracted five main themes: (1) Primacy of the doctor-patient relationship over AI performance; (2) Humans have intuition and nuance that AI lacks; (3) Agreement about the importance of oversight of AI tools; (4) New AI technologies should include a process for patient education; and (5) AI increases efficiency, scalability, and a more unified approach to serious illness.</p><p><strong>Conclusions: </strong>When building and implementing AI-based tools, we recommend: establishing oversight committees; reflecting on the unique contributions of humans to care; proactively educating patients and contextualizing the tools; and ensuring data use is restricted to clinical care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"667-677"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting to online and telephone bereavement support provision during the COVID-19 pandemic: A mixed methods study of bereavement service provider perspectives and lessons learnt for current practice.","authors":"Lucy E Selman, Jenny Birchall, Eileen J Sutton, Tracey Stone, Renata Medeiros Mirra, Emma Gilbert, Mirella Longo, Kathy Seddon, Anne M Finucane, Alison Penny, Anthony Byrne, Emily Harrop","doi":"10.1177/02692163251383324","DOIUrl":"10.1177/02692163251383324","url":null,"abstract":"<p><strong>Background: </strong>Provision of remote (online/telephone) bereavement support accelerated during the COVID-19 pandemic. However, the extent and impact of this change and lessons learnt are unknown.</p><p><strong>Aim: </strong>To determine the extent to which UK voluntary and community sector bereavement services moved to remote support provision during the pandemic, explore providers' perspectives on this shift, and consider implications.</p><p><strong>Design: </strong>Mixed methods explanatory sequential study, conducted spring 2021: (1) Online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers.</p><p><strong>Setting/participants: </strong>147 services participated in the survey; 44.5% hospice/palliative care services; 15.1% national charities/organisations; 11.6% local charities/ organisations. 24 interviews were conducted across 14 services.</p><p><strong>Results: </strong>Pre-pandemic, remote support was offered by <10% of bereavement organisations. By spring 2021, there had been increases in online: peer group meetings (3.4% pre-pandemic to 33% during, OR 13.8), facilitated group meetings (4.1%-56%, OR 30.48), 1:1 support (8.8%-83%, OR 50.3), and specialist intervention (3.4%-36%, OR 16.01). Telephone bereavement support was also more widely available. The appropriateness and acceptability of these changes differed by client group. Adaptations presented organisational/logistical challenges, and difficulties for support providers working from home. Smaller organisations with fewer resources found these harder to accommodate. Hybrid working and new technologies were reported to increase service efficiency and cost-effectiveness.</p><p><strong>Conclusions: </strong>Remote delivery of bereavement support increased support capacity and can potentially reduce inequities in access. However, it needs to be carefully tailored, and is not appropriate for everyone. Staff and volunteers providing remote services require training and support.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"617-631"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital patient-reported outcome measures in palliative home care: A feasibility study.","authors":"Katerina Hriskova, Isabel Sophie Burner-Fritsch, Farina Hodiamont, Anna Bolzani, Stefanie Kolmhuber, Christina Ramsenthaler, Claudia Bausewein","doi":"10.1177/02692163251409294","DOIUrl":"10.1177/02692163251409294","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome measurement supports high quality patient-centred palliative care. Little is known about whether their digital application is feasible in palliative home care.</p><p><strong>Aim: </strong>To test the feasibility of digital patient-reported outcome measure (ePROM) in specialist palliative home care (SPHC)Design:A feasibility study employing a mixed-methods design (Palli-MONITOR Phase II). The tested ePROM intervention was based on the electronic version of the Integrated Palliative Care Outcome Scale (eIPOS). Data collection included the recruitment and drop-out rates, ePROM user characteristics and information on technical feasibility, and focus groups with SPHC professionals. Descriptive statistics were used to analyse the quantitative data, while focus groups were analysed using the framework approach. Integrated analysis was conducted through joint display.</p><p><strong>Setting/participants: </strong>Four German SPHC teams; patients used personal devices to complete eIPOS, with data sent to the SPHC electronic medical record; professionals joined focus groups.</p><p><strong>Results: </strong>The overall recruitment rate was 4.7% (82/1744), and 22.7% (82/361) among eligible patients. 60/82 patients completed the study. A total of 470 eIPOS forms were submitted to the SPHC teams. The rate of non-responses for closed-ended IPOS-items was low (max. 5.3%). Professionals noted that recruitment was challenged by patients' unstable conditions, short care duration, time constraints, team attitudes and technical barriers like limited internet access or device unfamiliarity.</p><p><strong>Conclusion: </strong>Not all patients in SPHC can use ePROMs due to limited life expectancy and technical barriers. However, consistent and complete use of eIPOS forms indicates that it is feasible for digitally literate patients and can effectively support care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"632-643"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth in palliative care settings: A systematic review of argument-based ethics literature.","authors":"Leen Krieckemans, Alice Cavolo, Michael Casaer, Chris Gastmans","doi":"10.1177/02692163251360115","DOIUrl":"10.1177/02692163251360115","url":null,"abstract":"<p><strong>Background: </strong>The need for palliative care is rising rapidly, but meeting global demand is falling behind. Telepalliative care offers a potential solution, though its implementation requires careful ethical evaluation.</p><p><strong>Aim: </strong>To provide an overview of the ethical concepts and arguments related to telepalliative care as presented in the argument-based literature.</p><p><strong>Design: </strong>We conducted a systematic review of argument-based literature following PRISMA-guidelines (PROSPERO: CRD42024533732). Data extraction and synthesis followed the Qualitative Analysis Guide of Leuven.</p><p><strong>Data sources: </strong>We searched 12 databases covering medical, ethical, and technological disciplines using broad, unfiltered terms. Publications in English, French, German, or Dutch on telehealth, palliative care, and ethics were considered. Two researchers independently screened publications, using peer review as a quality proxy due to the lack of standards for argument-based literature.</p><p><strong>Results: </strong>Twenty-six publications were included. Two main ethical approaches emerged: one related to the four principles of biomedical ethics and the other to care. Regarding respect for autonomy, telepalliative care may both promote and limit autonomy, with concerns raised about informed consent, privacy, and confidentiality. Regarding beneficence, potential improvements in symptom management and quality of life were identified. Regarding non-maleficence, risks such as replacing in-person care and medicalizing the home environment were highlighted. Regarding justice, issues of access, equity, distributive justice, and environmental issues were addressed. Concerns about the patient-provider relationship and holistic care were central to care-related arguments.</p><p><strong>Conclusions: </strong>Telehealth's benefits challenge its incompatibility with palliative care, however, significant risks threaten core palliative care values. Thus, careful implementation must prioritize ethical considerations.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"655-666"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telepalliation creates a sense of security: A qualitative study of patients with cancer receiving palliative care.","authors":"Jarl Voss Andersen Sigaard, Elisabet Dortea Ragnvaldsdóttir Joensen, Una Rósa Birgisdóttir, Helle Spindler, Birthe Dinesen","doi":"10.1177/02692163251364145","DOIUrl":"10.1177/02692163251364145","url":null,"abstract":"<p><strong>Background: </strong>With the aging population and increasing prevalence of chronic illnesses, the demand for palliative care is rising. However, only a small percentage of patients in need receive palliative care. Many prefer home-based care, valuing continuous support and communication from healthcare professionals. Telepalliative care, utilizing telehealth technology, may enhance home-based palliative care by improving access to professionals, facilitating communication, and offering a cost-effective approach.</p><p><strong>Aim: </strong>The aim of this study was to explore patients' experiences with the functionality of the Telepalliation program while receiving specialized palliative care.</p><p><strong>Design: </strong>Qualitative sub-study within the multimethod randomized control trial (RCT) on the Telepal platform (ClinicalTrials.gov: NCT04995848) using semi-structured individual interviews inspired by Brinkmann & Kvale. Data was thematically coded using NVIVO 12.0 software.</p><p><strong>Setting/participants: </strong>The study was conducted at the University Hospital of Southern Denmark. Eighteen were randomly selected for interviews. Eligible patients were over 18, receiving specialized palliative care, and diagnosed with cancer, terminal heart failure, chronic obstructive pulmonary disease, or motor neuron disease.</p><p><strong>Results: </strong>Four key themes emerged: \"Sense of coherence,\" \"Telepal platform,\" \"Roles of spouse/partner and relatives,\" and \"Cross-sector collaboration.\" The program improved patients' sense of security and coherence by enhancing communication with healthcare professionals. Some challenges arose due to fatigue and questionnaire volume. The platform also successfully integrated relatives into the care process.</p><p><strong>Conclusions: </strong>The Telepal program enhanced communication, continuity, and personalized care, improving the sense of security for patients and families, though some patients faced challenges with fatigue and questionnaire burden.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"608-616"},"PeriodicalIF":3.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}