Palliative Medicine最新文献

{"title":"Identifying aspects of physiotherapy and occupational therapy provision in community palliative rehabilitation that could improve outcomes: A realist review.","authors":"Jane Manson, Paul Taylor, Susan Mawson, Joanne Bayly, Carol Keen, Jacqui Gath, Tracy Green, Frances Anderson, Rob Smith, Alicia O'Cathain","doi":"10.1177/02692163251331166","DOIUrl":"https://doi.org/10.1177/02692163251331166","url":null,"abstract":"<p><strong>Background: </strong>The provision of physiotherapy and occupational therapy in palliative care is often poorly understood. There is currently no guidance on how to deliver these services in the community, potentially leading to unwarranted variation in practice and unmet patient need.</p><p><strong>Aim: </strong>To identify aspects of physiotherapy and occupational therapy provision in community palliative rehabilitation that could improve outcomes.</p><p><strong>Design: </strong>A realist review of the literature following RAMESES standards, with stakeholder input throughout.</p><p><strong>Data sources: </strong>Iterative literature searches were conducted from September 2023 to April 2024. All relevant data sources relating to delivery of physiotherapy and occupational therapy in community palliative care were included.</p><p><strong>Results: </strong>Forty-two international publications were included, published between 2000 and 2023. Five key aspects were identified: (1) Early referral into community palliative rehabilitation. (2) Layered model, basing level of service on complexity of needs. Within this, clinicians without professional qualifications deliver simple interventions after assessment by a qualified physiotherapist or occupational therapist while specialist clinicians review more complex presentations. Services are cohesive by being integrated with primary care, other community services and specialist medical and palliative care and there is representation of physiotherapists and occupational therapists within leadership teams. (3) Holistic assessments form the backbone of the service with personalised interventions tailored to patients' needs and goals. (4) Accessible and flexible services are offered to meet patients' needs throughout their palliative journey. (5) Information and education for patients and carers are available throughout.</p><p><strong>Conclusions: </strong>Integrating these five key aspects of physiotherapy and occupational therapy provision into community palliative rehabilitation could help ensure palliative patients receive the therapy they need.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251331166"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024116","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":"An easier way to die?-A qualitative interview study on specialist palliative care team members' views on dying under sedation.","authors":"Jeremias Bazata, Sophie Meesters, Claudia Bozzaro, Violet Handtke, Jan Schildmann, Maria Heckel, Christoph Ostgathe, Claudia Bausewein, Eva Schildmann","doi":"10.1177/02692163251321320","DOIUrl":"10.1177/02692163251321320","url":null,"abstract":"<p><strong>Background: </strong>Professionals' personal perceptions of sedated patients in the context of palliative care may influence their opinion on sedation as treatment option. However, little is known of palliative care professionals' perception of patients dying under sedation.</p><p><strong>Aim: </strong>To explore German specialist palliative care team members' views on and perception of the dying process under sedation.</p><p><strong>Design: </strong>Qualitative phenomenological study using semi-structured interviews (<i>n</i> = 59). Interviews took place in-person after recruitment via a contact person and were transcribed verbatim. Framework Analysis was used for analysis.</p><p><strong>Setting/participants: </strong>Physicians, nurses, psychologists, physical therapists, chaplains, and social workers from 10 palliative care units and 7 specialist palliative homecare teams across 12 German cities.</p><p><strong>Results: </strong>Participants' views on patients dying under sedation can be grouped into: (i) those who perceived an influence of sedation on the dying process with and without positive and/or negative connotations and (ii) those who saw no difference between dying with or without sedation. Positive connotations referred to the perception of sedation providing an easier path. Concerns were mainly related to the deprivation of patients regarding a conscious dying. The metaphorical description of sedation as \"sleep\" was common among participants.</p><p><strong>Conclusions: </strong>The wide range of perceptions of patients dying under sedation may be rooted in different judgements regarding aspects of a good death. Clarifying ideals of a good death with professionals, patients, and relatives before sedation may support transparent decision-making and help avoid conflicts or moral distress.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"517-526"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468713","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":"Cognitive Authority Theory: Reframing health inequity, disadvantage and privilege in palliative and end-of-life care.","authors":"Katherine J Hunt, Carl R May","doi":"10.1177/02692163251321713","DOIUrl":"10.1177/02692163251321713","url":null,"abstract":"<p><strong>Background: </strong>There persist disparities in access to quality palliative and end-of-life care, often based on avoidable injustice. Research and theory to explain this health inequity focuses on structural or individual-based factors, overlooking important relational factors between health professionals, patients and families.</p><p><strong>Aim: </strong>To apply Cognitive Authority Theory in palliative and end-of-life care to explain neglected relational drivers of inequity in access and experience.</p><p><strong>Methods: </strong>Cognitive Authority Theory, a middle-range theory of power relations between individuals and authority over knowledge, was developed from empirical and review data. This paper demonstrates its utility in explaining an overlooked component of inequity in palliative care: interactions between health professionals and patients/caregivers.</p><p><strong>Results: </strong>Using examples from the palliative care literature, we characterise how people who are socially disadvantaged have fewer resources to exploit during consultations with health professionals which makes it difficult for them to have their voices heard, their choices prioritised by others, and to express their expertise. We examine the implications of health professionals' judgements of expertise for care access, experience, involvement and appropriateness. We offer a fresh perspective on the mechanisms by which stereotypes, bias and power imbalances between health professionals and patients reinforce existing health inequities, drawing on the role of social privilege in shaping inequity in palliative care.</p><p><strong>Conclusion: </strong>This paper provides a new language to articulate relational drivers of inequity in palliative care. It explains how to use Cognitive Authority Theory to design and interpret research to determine how healthcare interactions reinforce both social privilege and social disadvantage at end-of-life.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"448-459"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516304","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 couldn't live without hope': A qualitative study using reflexive thematic analysis on approaches to hope and prognostic awareness among people with advanced disease.","authors":"Miroslava Janoušková, Adam Houska, Sára Víchová, Martin Loučka","doi":"10.1177/02692163251323558","DOIUrl":"10.1177/02692163251323558","url":null,"abstract":"<p><strong>Background: </strong>Hope plays a pivotal role in enhancing the quality of life and coping strategies of individuals living with advanced diseases. The nature of the relationship between hope and prognostic awareness is unclear.</p><p><strong>Aim: </strong>To explore the experiences and meanings of hope and their association with prognostic awareness among people with advanced incurable diseases.</p><p><strong>Design: </strong>Qualitative phenomenological study using reflexive thematic analysis of semi-structured interviews.</p><p><strong>Setting/participants: </strong>Interviews with 24 participants aged 30-99 years with advanced incurable disease were conducted in hospices and hospitals in the Czech Republic.</p><p><strong>Results: </strong>We generated four distinct approaches to hope and prognostic awareness: Technical, Spiritual, Minimalist and Pragmatic. Each approach exhibited unique cognitive, emotional and behavioural dimensions of hope and prognostic awareness. The Technical and Minimalist approaches showed fluctuating hope influenced by medical updates, while the Spiritual and Pragmatic approaches demonstrated stable hope resilient to prognostic information.</p><p><strong>Conclusions: </strong>Recognizing these diverse hope approaches can guide tailored interventions in palliative care. Healthcare providers should adapt their communication strategies based on people's predominant hope orientations to support effective coping and enhance end-of-life care outcomes. This study sheds light on how different individuals navigate hope amidst terminal illnesses, providing insights into the nuanced psychological and emotional dynamics that influence their coping mechanisms.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"473-482"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606141","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":"An electronic pre-visit agenda-setting questionnaire in ambulatory palliative care is feasible and acceptable to patients, care partners, and clinicians: A mixed methods evaluation.","authors":"Matthew M Wilson, Kathleen Broglio, Maxwell T Vergo, Amber E Barnato, Amelia M Cullinan, Julie R Doherty, Joel R King, Anna Marie Devito, Anne B Holmes, Jennifer J Hinson, Kimberley R Holt, Megan M Holthoff, Emily G Kobin, Alaina R Legere, Eugene C Nelson, Elizabeth A O'Donnell, Catherine H Saunders, Stephanie C Tomlin, Kathryn B Kirkland, Aricca D Van Citters","doi":"10.1177/02692163251321327","DOIUrl":"10.1177/02692163251321327","url":null,"abstract":"<p><strong>Background: </strong>To provide patient-centered healthcare for people with serious illness, healthcare teams must elicit needs, goals, preferences, and values from patients and care partners.</p><p><strong>Aim: </strong>Describe feasibility and acceptability of an electronic pre-visit agenda-setting questionnaire for patients and care partners to identify these topics before ambulatory palliative care visits.</p><p><strong>Design: </strong>Concurrent mixed-methods formative evaluation of questionnaire feasibility and acceptability. We extracted questionnaire responses and patient characteristics from electronic health records and sent anonymous post-visit patient experience surveys. Researchers conducted thematic analysis on semi-structured interviews with participants.</p><p><strong>Setting/participants: </strong>Patient participants had an active patient portal account and ambulatory visit at a free-standing palliative care clinic in a tertiary academic medical center in rural Northeastern United States between June 2021 and March 2023. Clinic staff included physicians, nurse practitioner, social worker, nurses, and scheduling secretary. Most visits were conducted via video or telephone.</p><p><strong>Results: </strong>Completion rate was 50% for pre-visit questionnaires (2107 of 4204 visits). Patients completing post-visit surveys (following 859 visits) reported the pre-visit questionnaire was easy to complete (75%) and helped their conversations with clinicians (79%). Patients who believed their clinician reviewed their responses rated shared decision-making higher (82%) than those who did not (59%). Semi-structured interviews with five patients, two care partners, and seven clinicians identified four themes: the questionnaire engages patients in pre-visit planning, incorporates care partners into the care team, facilitates care for the care partner, and improves perceived efficiency and care quality.</p><p><strong>Conclusions: </strong>An electronic pre-visit questionnaire was feasible and acceptable in ambulatory palliative care visits.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"507-516"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493054","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":"More than 3 years of teleconsultations: A retrospective cohort study in specialized outpatient palliative care.","authors":"Sarah Veldeman, Tobias Martin, Johannes Wüeller, Michael Czaplik, Andreas Follmann","doi":"10.1177/02692163251321717","DOIUrl":"10.1177/02692163251321717","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine in palliative care is advancing to conquer challenges like staff shortages and limited access. Though feasibility and acceptance are proven, the clinical effects of teleconsultations (a nurse on-site consulting with a remote physician) have yet to be studied. The impact on physicians' workload or which patients it suits best, remain unclear.</p><p><strong>Aim: </strong>This study analyses the effect of teleconsultations on physician quota (number of physician-attended home visits divided by total number of home visits) and hospitalizations in specialized outpatient palliative care (SOPC) after 3 years of use in Aachen, Germany.</p><p><strong>Design: </strong>In a single-center, retrospective cohort study (September 2019-March 2023), clinical data was retrieved from a palliative care provider.</p><p><strong>Setting/participants: </strong>1756 patients with diseases from all medical disciplines received care during the observation period. By clinicians' choice 384 received teleconsultations, while 1372 did not.</p><p><strong>Results: </strong>833 teleconsultations were conducted. Telemedicine patients were younger (72.8 ± 12.5 years vs. non-telemedicine 74.4 ± 12.8 years, <i>p</i> = 0.011), presented more diagnoses (<i>p</i> < 0.001), while scope of symptoms and diagnoses was equivalent. Telemedicine patients had a longer duration of stay within the SOPC and more home visits. Physician quota in the telemedicine group was lower (<i>p</i> < 0.001). A matched pairs analysis (<i>n</i> = 726) showed no significant difference in hospitalizations.</p><p><strong>Conclusions: </strong>Telemedicine can reduce physician quota, alleviating personnel shortages while providing time for care-intensive patients and creating capacity for more patients. Telemedicine seems suited for multimorbid, long-term patients. A matched pairs analysis showed no difference in hospitalizations in telemedicine patients.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"499-506"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524065","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":"Systematic adaptation of public health palliative care interventions across settings using ADAPT guidance: Methodological learnings from the EU NAVIGATE project.","authors":"Fien Van Campe, Kenneth Chambaere, Lara Pivodic, Joni Gilissen, Barb Pesut, Wendy Duggleby, Tinne Smets, Katarzyna Szczerbińska, Maja Furlan de Brito, Andrew Davies, Davide Ferraris, Annicka van der Plas, Bianca Scacciati, Lieve Van den Block","doi":"10.1177/02692163251320507","DOIUrl":"10.1177/02692163251320507","url":null,"abstract":"<p><strong>Background: </strong>Systematic adaptation of evidence-informed interventions is critical for effective transfer across settings. Public health palliative care interventions pose unique challenges because of their complexity and embedding in dynamic, real-life settings. The ADAPT guidance provides a comprehensive framework for systematically adapting evidence-informed health interventions, yet its application in public health palliative care remains unexplored.</p><p><strong>Aim: </strong>Within the EU NAVIGATE project, this study describes the international adaptation process of a Canadian navigation program supporting older people with cancer experiencing declining health, for implementation in six European countries. It also reflects on the methodological insights gained from applying the ADAPT guidance in public health palliative care.</p><p><strong>Design: </strong>Using an iterative five-stage multi-method approach, we followed the ADAPT guidance and its recommended frameworks. Stage 1 assessed context-intervention fit and identified core and adaptable components of the original intervention. Stage 2 adapted implementation materials, while stage 3 involved a contextual analysis. Stage 4 focused on adapting the training for implementers, and stage 5 reviewed feasibility.</p><p><strong>Results: </strong>The ADAPT guidance proved flexible and useful, though systematic adaptation posed challenges due to the unique complexities of public health palliative care interventions. These included balancing intervention integrity with cultural sensitivities and local juridical regulations regarding end of life. Our process addressed these challenges through contextual assessments, identifying core components, engaging with original developers, and collaboration between local and international adaptation teams.</p><p><strong>Conclusions: </strong>A systematic adaptation process, guided by the ADAPT guidance is feasible, but transferring public health palliative care interventions requires careful methodological, contextual, and conceptual considerations.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"460-472"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658127","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":"Peer review and <i>Palliative Medicine</i>: Guiding reviewers' contributions to ensuring high quality publications.","authors":"Catherine Walshe, Kim Beernaert, Poh Heng Chong, Sonya Lowe, Sandra Martins Pereira, Sarah Yardley","doi":"10.1177/02692163251321082","DOIUrl":"10.1177/02692163251321082","url":null,"abstract":"","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"444-447"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468716","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":"Healthcare professionals' perspectives of providing end-of-life care for infants, children and young people in acute settings: A multi-site qualitative study.","authors":"Emma Victoria McLorie, Julia Hackett, Laura Barrett, George Peat, Helen Weatherly, Sebastian Hinde, Gabriella Walker, Jane Noyes, Sam Oddie, Chakrapani Vasudevan, Richard G Feltbower, Bob Phillips, Catherine Hewitt, Richard Hain, Gayathri Subramanian, Andrew Haynes, Andrew Papworth, Lorna Katharine Fraser, Fliss E M Murtagh","doi":"10.1177/02692163251320204","DOIUrl":"10.1177/02692163251320204","url":null,"abstract":"<p><strong>Background: </strong>Paediatric end-of-life care is an important part of palliative care, and provides care and support for children in the last days, weeks, months or year of life. However, there is currently a picture of inconsistent and disjointed provision. Despite differences in delivery models across countries and cultures, healthcare professionals need to be able to support families through this difficult time. However, there is limited evidence to base high quality end-of-life care.</p><p><strong>Aim: </strong>To explore healthcare professionals' experiences of delivering end-of-life care to infants, children and young people, their needs and the factors affecting access and implementation.</p><p><strong>Design: </strong>Qualitative study employing online focus groups, analysed using framework analysis.</p><p><strong>Setting/participants: </strong>Healthcare professionals who provided end-of-life care to infants, children and young people, across cancer centres and neonatal and paediatric intensive care units.</p><p><strong>Results: </strong>A total of 168 professionals from 13 tertiary hospitals participated in 23 focus groups. Three themes highlighted many barriers to delivering optimal care: (1) <i>Professional perceptions of end-of-life care</i>; (2) <i>What we want to provide versus what we can</i> and (3) <i>Workforce and sustainability: Healthcare professional support</i>. These illustrate professionals' awareness and desire to deliver high-quality care, yet are constrained by a number of factors, suggesting the current system is not suitable.</p><p><strong>Conclusions: </strong>This study provides an in-depth exploration of paediatric end-of-life care, from those professionals working across the settings accounting for the majority of end-of-life care delivery. Many of these issues could be resolved by investment in: funding, time, education and support to enable delivery of increasingly complex end-of-life care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"483-498"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493057","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":"Asian family members' participation in advance care planning: An integrative review.","authors":"Jing-Da Pan, Ka Yan Ho, Gui-Fen Guan, Min-Min Chang, Cui-Rong Tan, Xin-Yan Qiu, Hong-Li Liu, Ke-Lan Lin, Wen-Ting Xu, Shan Pan, Qi Liu, Ting Mao, Katherine Ka Wai Lam, Dong-Lan Ling","doi":"10.1177/02692163251317856","DOIUrl":"10.1177/02692163251317856","url":null,"abstract":"<p><strong>Background: </strong>Family members play a pivotal role in advance care planning for patients with life-limiting illnesses, particularly in Asia, where cultural values stress family-centeredness and paternalism.</p><p><strong>Aim: </strong>To synthesize the evidence pertaining to the extent of Asian family members' involvement in advance care planning.</p><p><strong>Design: </strong>An integrative review was conducted.</p><p><strong>Data sources: </strong>Data sources included MEDLINE, EMBASE, CINAHL, Web of Science, PubMed, Wan Fang, China National Knowledge Infrastructure databases, Google Scholar, and Open Gray.</p><p><strong>Results: </strong>21 studies were included. The willingness of Asian family members to participate in advance care planning is high, while their actual engagement remains low. Based on the barriers, facilitators, and Asian family members' roles influencing participation identified in our study, a six-dimensional conceptual model was developed: Asian family members' roles, problem-solving skills, communication, affective responsiveness, affective participation, and controlling behavior in advance care planning. Barriers to effective participation were identified: inadequate advance care planning legislation, insufficient public education, and influences from Confucianism or traditional beliefs. Additionally, filial piety was shown to have a paradoxical effect on Asian family members' participation in advance care planning in Asian countries.</p><p><strong>Conclusions: </strong>This study proposes a culturally sensitive model to illustrate family members' participation in advance care planning in Asia. This lays a foundation to develop culturally specific interventions to enhance family participation in advance care planning in the future. We recommend that Asian governments should enact legislations, enhance public education, and incorporate cultural characteristics into relevant policy frameworks to foster greater family involvement in advance care planning.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"373-390"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493056","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}