Palliative Care and Social Practice最新文献

{"title":"Institutional challenges in responding to Austria's Dying Decree Law: An evaluation from the perspectives of nursing and medical directors.","authors":"Tamina-Laetitia Vielgrader, Jana Marica Hluch, Klara Doppler, Elisabeth Lucia Zeilinger, Ricarda Mewes, Sabine Parrag, Thomas Wochele-Thoma, Maria Kletecka-Pulker, Stefan Dinges","doi":"10.1177/26323524261436925","DOIUrl":"https://doi.org/10.1177/26323524261436925","url":null,"abstract":"<p><strong>Background: </strong>On 1 January 2022, assisted suicide became legal in Austria with the enactment of the Dying Decree Law (Sterbeverfügungsgesetz, StVfG). This law has posed complex practical and ethical challenges for nursing facilities and hospitals. Medical and nursing directors are tasked with guiding their staff amidst legal uncertainties, emotional burdens, and limited institutional dialogue.</p><p><strong>Objectives: </strong>This study aimed to assess directors' self-reported knowledge of the law, their experiences managing assisted suicide requests, their perceived adequacy of support in navigating the legal framework, and the presence of institutional guidelines.</p><p><strong>Design: </strong>A cross-sectional mixed-methods study.</p><p><strong>Methods: </strong>An online questionnaire was used to collect data from 239 medical and nursing directors across all nine federal states of Austria (mean age = 49.5 years, SD = 8.5; 65.7% female, 32.2% male; 23.7% working in faith-based institutions, 61.9% in non-faith-based institutions, and 14.4% prefer not to disclose). Quantitative data were analysed using chi-square tests, <i>t</i> tests, and ANOVAs, while thematic analysis was applied to open-ended responses.</p><p><strong>Results: </strong>44.0% of directors knew the regulations of the Dying Decree Law but were insecure in regards to the application in practice, while 13.4% of directors reported no familiarity with Law at all. Legal familiarity correlated with gender (<i>p</i> = 0.020, <i>V</i> = 0.183) and institutional religious affiliation (<i>p</i> = 0.019, <i>V</i> = 0.197). Satisfaction with institutional guidelines was linked to gender (<i>p</i> = 0.004, <i>r</i> = 0.15), religious affiliation (<i>p</i> = 0.003, <i>r</i> = -0.15), and institution type (<i>p</i> = 0.011, η² = 0.126). While 36.2% reported no institutional guidelines on assisted suicide, 13.8% were unaware of their existence.</p><p><strong>Conclusion: </strong>The findings reveal knowledge gaps, institutional disparities, and limited guidance on the Dying Decree Law. Directors report insufficient preparedness, highlighting the need for clearer institutional guidelines and enhanced legal, ethical, and psychological support.</p><p><strong>Trial registration: </strong>This study was registered in the Open Science Framework (OSF) at https://osf.io/bgpsa.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261436925"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening death literacy in multicultural communities: Community-led interventions and cross-cultural validation of the Death Literacy Index.","authors":"Ali Lakhani, Georgia Rowley, Florine Dsouza, Kerrie Noonan, Jaklin Eliott","doi":"10.1177/26323524261418687","DOIUrl":"https://doi.org/10.1177/26323524261418687","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Death literacy - the knowledge, skills, and capacity to navigate end-of-life care, advance care planning, dying, and death care - is shaped by cultural, religious, and linguistic factors. The Death Literacy Index (DLI) captures practical, experiential, factual, and community domains. Currently, there is limited evidence about death literacy levels among culturally and linguistically diverse communities in multicultural settings, and little is known about how translated versions of the DLI perform psychometrically in these groups or how culturally tailored, community-delivered interventions can strengthen death literacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;(1) To evaluate the impact of culturally adapted, community-designed and delivered interventions on DLI subscale and total scores among Filipino, German, Italian, and Vietnamese communities in South Australia; and (2) to examine the preliminary psychometric properties (factor structure and reliability) of translated DLI instruments in these populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Pre-post intervention study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Community leaders in each group co-designed and delivered a community-specific intervention over 3-5 months using culturally familiar channels (workshops, radio/podcasts, social media, and printed/online resources). Thus, four parallel but distinct interventions were implemented, one in each cultural/language community. The DLI was professionally translated (German, Italian, Tagalog, Vietnamese) with community review. Surveys were administered in preferred languages at baseline (T1) and ~6 weeks post-intervention (T2). Psychometrics (T1, &lt;i&gt;n&lt;/i&gt; = 242): confirmatory factor analysis (CFA) and reliability. Impact (matched pairs, &lt;i&gt;n&lt;/i&gt; = 100): Wilcoxon signed-rank tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Psychometrics (T1, &lt;i&gt;n&lt;/i&gt; = 228): Subscale CFAs supported the translated DLI across groups, while the total-scale fit was poor - reinforcing a multidimensional construct; internal consistency was good-excellent overall, with weaker reliability for Talking Support subscale (Vietnamese) and some variability in Experiential Knowledge. Intervention impact (matched pairs, &lt;i&gt;n&lt;/i&gt; = 100): Filipino participants showed significant increases in median scores across all four DLI subscales and the total DLI score (medium-large effects); Vietnamese participants showed significant decreases in Practical Knowledge and total DLI scores, with little change on other subscales; German and Italian groups demonstrated small, mostly non-significant increases on selected DLI subscales (particularly Factual and Community Knowledge), with minimal change in total DLI scores. Across groups, DLI subscales capturing knowledge of resources and supports generally improved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Culturally tailored, community-delivered interventions can strengthen death literacy, but effects vary by cultural/linguistic context. DLI subscales","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261418687"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping death literacy in the East of England: A cross-sectional survey with qualitative insights to inform public health strategy.","authors":"Guy Peryer, Krishnan Puri Sudhir, Adam P Wagner, Jessica Blake","doi":"10.1177/26323524261443547","DOIUrl":"https://doi.org/10.1177/26323524261443547","url":null,"abstract":"<p><strong>Background: </strong>Death literacy can act as a public health asset that enables individuals and communities to navigate end-of-life care with confidence and competence. It encompasses knowledge, skills, experiential learning, and social action. In the United Kingdom, low levels of death literacy may hinder equitable care and contribute to avoidable harms.</p><p><strong>Aims: </strong>The study had three aims: (i) to assess death literacy in the East of England using the Death Literacy Index (DLI) to inform applied policy research; (ii) to explore sociodemographic and experiential factors associated with DLI scores; and (iii) to examine how various knowledge domains function as community assets or indicate areas in need of targeted intervention.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey with adults aged 18 years and over across six areas in the East of England. The survey included sociodemographic questions, the 29-item DLI, and free-text responses. Quantitative analysis used ordinary least squares regression to identify associations between DLI scores and covariates. Qualitative data were analysed using a framework approach, integrating the Quintuple Aim for health care improvement and DLI domains, including an added Relational Knowledge domain to the death literacy framework dimension for the purposes of the analysis.</p><p><strong>Results: </strong>Of 1725 respondents, 1224 completed the survey. The mean DLI score was 5.8/10. Experiential Knowledge was the highest scoring DLI domain (mean = 7.3/10); Factual Knowledge scored lowest (mean = 4.7/10). End-of-life training and recent bereavement were strong predictors of higher DLI scores. Qualitative themes highlighted under-resourced support systems, need for improved coordination of statutory services, and importance of Relational and Community Knowledge.</p><p><strong>Conclusion: </strong>The DLI can act as a pragmatic tool for guiding civic action and informing public health strategy. Mobilising death literacy requires relational approaches, community engagement, and equity-focused commissioning. Recognising death literacy as both a public health asset and a civic capability can contribute to population health and support sustainable end-of-life care systems. Social capital and collective action are essential to mobilising death literacy at scale.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261443547"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating dementia knowledge and action in Ghana: Evidence from a participatory stakeholder workshop.","authors":"Precious Adade Duodu, Joshua Okyere, Dorothy Wilson, Abigail Kabukie Dosoo, Peter Boakye, Bibha Simkhada, Caroline Barker, Warren Gillibrand, Padam Simkhada","doi":"10.1177/26323524261442208","DOIUrl":"https://doi.org/10.1177/26323524261442208","url":null,"abstract":"<p><strong>Background: </strong>Knowledge confined within academic or clinical silos has limited utility to influence policy. To bridge the gap between evidence and action, a participatory, co-creation workshop was convened of persons living with dementia, family carers, healthcare professionals, policy actors, spiritual or faith-based leaders, and community advocates in a collective process of dialogue, reflection, and solution design.</p><p><strong>Objectives: </strong>The research aimed to determine whether stakeholders' knowledge and attitudes towards dementia improved following the workshop.</p><p><strong>Methods: </strong>Data were drawn from a multi-method assessment from a participatory research dissemination and co-creation workshop held in Kumasi, Ghana. A non-parametric Wilcoxon signed-rank test was selected as the primary analytical tool for the pre-post-test. A reflexive thematic analysis was implemented for the qualitative data.</p><p><strong>Results: </strong>Following the workshop, participants reported feeling significantly more informed about dementia prevalence in Ghana (<i>Z</i> = 2.510, <i>p</i> = 0.012), the challenges faced by family caregivers (<i>Z</i> = 3.030, <i>p</i> = 0.002), and common caregiver coping strategies (<i>Z</i> = 3.247, <i>p</i> = 0.001). Understanding of socioeconomic (<i>Z</i> = 2.525, <i>p</i> = 0.012) and gender-related (<i>Z</i> = 2.569, <i>p</i> = 0.010) influences on dementia risk, and caregiving also improved. Attitudinally, participants expressed stronger agreement that family caregivers deserve more support (<i>Z</i> = 2.828, <i>p</i> = 0.005), that dementia care should be a higher health system priority (<i>Z</i> = 2.445, <i>p</i> = 0.014), and that faith-based organisations have an important role (<i>Z</i> = 2.001, <i>p</i> = 0.045). Proposed solutions included policy advocacy and systems thinking, community- and home-based care, collaborative networks, caregiver support programmes, stigma reduction and cultural reorientation, and involvement of religious leaders.</p><p><strong>Conclusion: </strong>There is a need to formalise and resource a community of practice, thus ensuring sustained collaboration, structured knowledge exchange, collective action across sectors, whilst piloting a caregiver support programme and home-care model with rigorous monitoring and evaluation. It is time for policymakers to enact a comprehensive dementia care policy to guide and regulate all stakeholders in the continuum of dementia care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261442208"},"PeriodicalIF":2.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The centrality of \"family first\" among Chinese migrants in determining experiences of palliative care: An integrative literature review.","authors":"Xuan Wang, Deborah Raphael, Merryn Gott, Jackie Robinson","doi":"10.1177/26323524261437364","DOIUrl":"https://doi.org/10.1177/26323524261437364","url":null,"abstract":"<p><p>To reduce the health inequalities, it is important to understand the experiences of Chinese migrants receiving palliative care. This study focuses on how health systems can enhance the cultural safety of palliative care for Chinese migrants. How do cultural values and migration experiences shape Chinese families' experience of palliative care? To review the evidence relating to the experiences of Chinese migrants and their families receiving palliative care. This integrative review included quantitative and qualitative studies reported in English. Study quality was assessed using the Critical Appraisal Skills Programme. Results were analyzed using thematic analysis. An electronic database search of Medline, PubMed, CINAHL, Scopus, Embase, and PsycINFO was performed. Eleven papers were included. Thematic analysis identified four themes: self-isolation, far from help, sociocultural shifts experienced by migrants, and trust problems arising from migrant experience. These themes were underpinned by a common belief of \"family first.\" With this core belief, patients and families make decisions that they believe will benefit the family. This review identifies the centrality of \"family first\" among Chinese migrants in determining experiences of palliative care. More research is needed to develop culturally appropriate palliative care services to support the growing global population of Chinese migrants.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261437364"},"PeriodicalIF":2.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative care beyond traditional boundaries: A nationwide survey of bereavement support in the form of conversations and Palliative Care Registry utilization at Swedish stroke units.","authors":"Sophie Mårtensson, Åsa Rejnö","doi":"10.1177/26323524261439943","DOIUrl":"https://doi.org/10.1177/26323524261439943","url":null,"abstract":"<p><strong>Background: </strong>Globally, stroke is the second leading cause of death. About 20% of patients with acute stroke die within 30 days of onset, yet fewer than 10% receive palliative care, and only a small fraction of these receive it in specialized palliative units. Rather, they are treated in stroke units, where both knowledge of palliative care and support for bereaved family members may be inconsistent and limited.</p><p><strong>Objectives: </strong>To describe the occurrence and design of bereavement support in the form of conversations offered to family members of patients who die from acute stroke in a stroke unit, as well as the registration in the Swedish Register of Palliative Care.</p><p><strong>Design: </strong>This study employed a quantitative descriptive design with a cross-sectional approach.</p><p><strong>Methods: </strong>A study-specific survey consisting of three main questions and several follow-up questions was used. All 72 stroke units in Sweden were contacted in person, by phone, or by email; 71 units ultimately participated.</p><p><strong>Results: </strong>Bereavement support in the form of conversations was provided to the family members of patients who had died from an acute stroke in 34 (48%) of the 71 stroke units. Among these, 21 units offered bereavement support to family members in all deaths, while 13 provided it when the need for support was identified. In total, 60 of the 71 stroke units (84%) register in the Swedish Register of Palliative Care, and of these, 25 units systematically use the registered data.</p><p><strong>Conclusion: </strong>Neither bereavement support in the form of conversations nor the systematic use of the palliative care registry are fully established part of care at stroke units. To ensure good and equitable end-of-life care, support for bereaved family members needs to be strengthened. Palliative registry data from stroke units represent an underutilized resource with the potential to improve both palliative care and bereavement support.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261439943"},"PeriodicalIF":2.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voices that matter: Bereaved carers' perspectives of support and person-centred care in residential aged care homes.","authors":"Julie M Brose, Yong Hao Ng, Kirsten Auret, Bruce Rumbold, Samar Aoun","doi":"10.1177/26323524261426397","DOIUrl":"https://doi.org/10.1177/26323524261426397","url":null,"abstract":"<p><strong>Background: </strong>Bereaved carers' perspectives on the quality of end-of-life care in residential aged care homes (RACHs) provide critical insights into person-centred care delivery and support provision. Understanding bereaved carers' experiences of formal and informal support, and their perceptions of staff responsiveness to residents' values and preferences, is essential for improving end-of-life care standards.</p><p><strong>Objectives: </strong>To capture bereaved carers' perspectives on formal and informal support received and the delivery of person-centred care within RACHs.</p><p><strong>Methods: </strong>A descriptive qualitative study used free-text responses from an online survey for bereaved carers whose loved ones died in a RACH between 2021 and 2024 in Western Australia. Questions were structured according to the six priorities of the Western Australian End-of-Life and Palliative Care Strategy 2018-2028. Open-ended items allowed participants to expand on their experiences of social support before and after death and to comment on the extent to which residents' and families' values were taken into consideration. Thematic analysis examined carers' perceptions of informal and formal support received and care provided.</p><p><strong>Findings: </strong>Among 317 respondents representing 46 RACHs, five themes reflected carers' perspectives: (1) Stretched thin: carer concerns about unmet needs; (2) Navigating gaps: carer experiences with end-of-life care; (3) Seeking involvement: carers' role in care decisions; (4) Navigating decline: challenges in dementia care; and (5) Caring for the carer: the impact of RACHs and community support.</p><p><strong>Conclusion: </strong>Bereaved carers perceived significant variability in person-centred support for themselves and the residents within RACHs, with quality often dependent on individual staff skills, confidence and communication style, and timely access to doctors or palliative care services. However, carers spoke positively about the support from the wider community. The expressed feeling to be cared \"about\" rather than just cared \"for\" could be explored by a collaborative compassionate communities approach to care integrated in RACHs. This may strengthen the capacity of the wider community to support carers before and after bereavement.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261426397"},"PeriodicalIF":2.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive study of cancer care experiences and burden of rural South Dakotans.","authors":"Sarah Mollman, Teddi Dowling, Patricia Woolridge, Jamie Hillmer, James Odom, Marie Bakitas, Hossein Moradi Rekabdarkolaee, Brandon M Varilek","doi":"10.1177/26323524261438152","DOIUrl":"https://doi.org/10.1177/26323524261438152","url":null,"abstract":"<p><strong>Background: </strong>American Indian (AI) persons with advanced cancer (PwAC) in South Dakota have seen increased rates of cancer incidence and mortality compared to national rates. These inequities are driven by social determinants of health. Providing early palliative care is highly important for rural PwAC but is sparsely available in rural South Dakota.</p><p><strong>Objective: </strong>To explore cancer care experiences and patient symptoms and caregiver burden among AI and rural PwAC, and their family caregivers (FCGs), to understand the barriers and opportunities for adapting an early palliative care intervention.</p><p><strong>Design: </strong>Descriptive study design reporting on the qualitative and quantitative data collected.</p><p><strong>Methods: </strong>PwAC and FCG participants were recruited from a rural healthcare facility delivering cancer care and serving AI tribal and rural/frontier populations. Quantitative data were collected using online surveys to discover symptoms and caregiving burden among PwAC (<i>n</i> = 18) and FCGs (<i>n</i> = 12), respectively. These participants were invited to semi-structured interviews to elicit perspectives of rural cancer care delivery (<i>n</i> = 11 PwAC and 8 FCGs).</p><p><strong>Results: </strong>PwAC experience moderate symptom burden with 83.3% lacking energy, 77.8% feeling drowsy, and 72.2% feeling pain. FCGs experience high caregiver burden across all three subscales of the caregiving scale. Qualitative analysis found an overarching category of \"Healthcare Fragmentation Amplified by Living in a Rural/Frontier Location\" with three underlying codes: \"Being Seen and Heard: Value-Based Connection to Distant Resources,\" \"Facilitating Decision Making from Afar,\" and \"Problem Solving Skills and Solutions.\"</p><p><strong>Conclusion: </strong>This study demonstrates that rural cancer care is challenged by multiple factors, including fragmented healthcare, lack of healthcare infrastructure, and vast travel distances. This greatly impacts PwAC and FCG's ability to feel seen and heard, make decisions, and problem-solve. Supportive programs designed for the local rural context are imperative to improve the quality of life for rural PwAC and their FCGs.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261438152"},"PeriodicalIF":2.2,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A whole-process management intervention to transform pessimistic attitudes toward cancer care among internal medicine residents.","authors":"Yi-Chen Huang, Yan-Fang Xing, Jian-Liang Xu, Li Zou, Ya-Qin Sun, Kou-Xing Zhang, Xiang-Yuan Wu, Xing Li","doi":"10.1177/26323524261436927","DOIUrl":"https://doi.org/10.1177/26323524261436927","url":null,"abstract":"<p><strong>Background: </strong>In China, improved cancer survival contrasts with persistent pessimistic attitudes among clinicians, which impacts care quality. We developed a \"Whole-Process Management\" (WPM) training program to bridge this gap by reshaping internal medicine residents' understanding of the cancer care continuum.</p><p><strong>Objective: </strong>To investigate whether a WPM clinical training strategy can transform pessimistic attitudes toward cancer care and foster a more integrated understanding of palliative therapy among internal medicine residents.</p><p><strong>Design: </strong>A pre-post study utilizing semi-structured interviews. Responses were coded using a predefined categorical framework (positive/negative/NA) and compared before versus after the intervention to characterize internal medicine residents' attitudinal shifts regarding cancer curability, treatment toxicity, and the role of palliative care within the cancer care continuum.</p><p><strong>Methods: </strong>Fifty-seven junior internal medicine residents undergoing oncology rotation at a university-affiliated hospital (January 2022-January 2023) received the WPM intervention. This novel training employed longitudinal patient case tracking and structured reflective seminars to help internal medicine residents view cancer as a chronic condition that can be actively managed.</p><p><strong>Results: </strong>The WPM program significantly reduced pessimistic attitudes. Internal medicine residents recognizing patients in good physical condition increased from 26% to 81% (<i>p</i> < 0.001). Perceptions of treatment toxicity (53% vs 4%), ineffectiveness (75% vs 4%), and expense (84% vs 7%) substantially decreased (all <i>p</i> < 0.001). Awareness of tumor curability improved from 5% to 79% (<i>p</i> < 0.001). The program also improved attitudes toward palliative care: understanding of hospice care principles increased from 0% to 75% (<i>p</i> < 0.001), willingness to consider hospice care for terminal patients rose from 21% to 84% (<i>p</i> < 0.001), and willingness to prescribe opioid analgesics increased from 9% to 93% (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The WPM clinical training strategy effectively addresses pessimistic attitudes by transforming internal medicine residents' clinical perspective from isolated tasks to the patient's entire journey, thereby enhancing their ability to provide integrated palliative and anti-cancer care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261436927"},"PeriodicalIF":2.2,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative and end-of-life care from an education lens. An international systematic review of undergraduate medical and nursing students' knowledge, perceptions, and orientation towards palliative and end-of-life care.","authors":"Germanus Natuhwera, Peter Ellis, Eve Namisango","doi":"10.1177/26323524261433191","DOIUrl":"https://doi.org/10.1177/26323524261433191","url":null,"abstract":"<p><strong>Introduction: </strong>Nursing and medical schools and universities are increasingly integrating palliative and end-of-life care education in their curricula. However, research on the impacts of training and education on future nurses and physicians remains sparse.</p><p><strong>Aim of the review: </strong>The aim of this review was to systematically appraise existing research evidence on undergraduate nursing and medical students' knowledge, perception, and orientation towards palliative and end-of-life care.</p><p><strong>Methods: </strong>This international systematic review was conducted between April and May 2021 and was updated in May 2024. A systematic search was conducted in four databases: Hinari 'Research4Life', Cumulated Index to Nursing and Allied Health Literature (CINAHL), Google scholar and PubMed. Methodological quality of the included studies was assessed using the Mixed-Methods Appraisal Tool. A data extraction sheet was developed for this review. A convergent integrated approach to mixed-method data synthesis and integration was used to analyse and report the evidence. Braun and Clarke's inductive and deductive thematic analysis approach was used to identify main themes.</p><p><strong>Results: </strong>A total of 64 peer-reviewed research articles met eligibility criteria and were included in the review. Of the 64 eligible research articles, 34 employed a descriptive quantitative cross-sectional design, 11 studies were qualitative, 14 used a quantitative non-randomised design and 5 were mixed methods. The review identified three major thematic categories: (1) students' knowledge of palliative and end-of-life care, (2) attitude, perception and orientation towards palliative and end-of-life care and (3) predictors of knowledge, orientation, attitude and perception towards palliative and end-of-life care.</p><p><strong>Conclusion: </strong>Findings suggest inadequacy and variability in knowledge levels, self-efficacy, willingness, perception and orientation towards palliative care and end-of-life care. Surprisingly, this is common across studies, including those from high-resource countries. Inadequate, limited and/or inconsistent curricula and training content about palliative and end-of-life care is a common theme in the literature.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"20 ","pages":"26323524261433191"},"PeriodicalIF":2.2,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}