Palliative Care and Social Practice最新文献

{"title":"Till death do us Part: experiences of migrant live-in care workers facing the death of their care recipients - a study from Israel.","authors":"Daniella Arieli, Gila Amitay, Dalit Yassour-Borochowitz","doi":"10.1177/26323524251326105","DOIUrl":"10.1177/26323524251326105","url":null,"abstract":"<p><strong>Background: </strong>As ageing in place becomes more widespread, the burdens on relatives of older people at advanced stages of illness, particularly those reaching life's end, become greater, requiring a level of support and responsibility that often exceeds the families' abilities. A common solution is employing live-in care workers, frequently migrant workers.</p><p><strong>Objectives: </strong>This study explores how live-in migrant care workers experience and cope with their care recipients' end-of-life and death phases.</p><p><strong>Methods: </strong>This study is based on an ethnographic study that included 37 interviews with live-in migrant care workers employed in the homes of older adults in Israel.</p><p><strong>Results: </strong>We identified four themes: (1) Loneliness and fear due to the need to make decisions; (2) Devotion; (3) Trauma, loss and disenfranchised grief; and (4) The impact of the national immigration policy. The first two themes related to the care workers' pre-death experiences, the third their post-death experiences and the last extraneous factors affecting end-of-life care.</p><p><strong>Discussion: </strong>Live-in care workers, often the last to accompany their care recipients in their final moments, develop a sense of devotion and responsibility, often leading to feelings of fear and loneliness. Their lower occupational status and sociocultural foreignness affect them in the pre-death and post-death phases. The local immigration policy also influences their motivation to work with palliative patients.</p><p><strong>Conclusion: </strong>Applying a feminist critical social care perspective, we recommend policy and social attitude changes regarding live-in migrant care workers' role in end-of-life care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326105"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765315","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":"Neuropalliative care for Parkinson's disease in India: a qualitative exploration of healthcare professionals' perspectives.","authors":"Prerna Sharma, Upasana Baruah, Suman Kushwaha, Akanksha Yadav, Rajinder K Dhamija","doi":"10.1177/26323524251326952","DOIUrl":"10.1177/26323524251326952","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of Parkinson's disease (PD) in India is roughly 10% of the global burden, which is a considerable public health concern. The burden on healthcare services in India is substantial due to the variations in PD prevalence and the country's large population. The unique cultural, ethnic, and social differences in India give rise to distinct needs among PD patients and their caregivers. Neuropalliative care (NPC) is an emerging subspecialty with a holistic approach that requires a unique skill set and the involvement of allied healthcare professionals who play a crucial role in providing integrated services.</p><p><strong>Aim: </strong>The objective of this study is to explore the experiences and perspectives of the primary and allied healthcare professionals working with persons with PD in India.</p><p><strong>Methods: </strong>The current study employed a qualitative, exploratory, inductive research design, using in-depth interviews with 15 primary and allied healthcare professionals who had more than 5 years of experience working with persons with PD. Participants worked in varied settings such as academic hospitals, rehabilitation services, and tertiary care hospitals.</p><p><strong>Results: </strong>The mean years of work experience for the participants were 7.5 ± 3.26 years with a mean number of 30.8 ± 14.8 patients with PD per month. Thematic analysis of the data revealed 5 main themes and 20 subthemes. The major themes revealed were understanding of NPC, the needs of patients and caregivers of PD, barriers and challenges, interventions for patients and caregivers, facilitators, and components of NPC for PD.</p><p><strong>Conclusion: </strong>To provide a structured stepped-care approach to managing PD, there is a need to understand the psychosocial and palliative care aspects of PD in patients and caregivers in the Indian context. Adequate training and resource allocation are needed for NPC to be adopted in clinical care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326952"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765312","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 role of the municipal welfare domain in palliative care: exploring the views of coordinators of Dutch regional palliative care networks.","authors":"Trudy Schutter, Ian Koper, Kris Vissers, Jeroen Hasselaar","doi":"10.1177/26323524251326188","DOIUrl":"10.1177/26323524251326188","url":null,"abstract":"<p><strong>Background: </strong>Collaboration between the healthcare domain and welfare domain could benefit people confronted with an incurable disease residing at home and their informal caregivers, but little is known about this collaboration regarding palliative care. There are regional palliative care networks in the Netherlands, supporting interdisciplinary integrated palliative care; each network has a network coordinator who is a primary liaison for the network and who has an overview of palliative care services and activities in the region. However, the view of the networks on the role of the welfare domain and collaboration with the welfare domain in the field of palliative care is unknown.</p><p><strong>Objective: </strong>The aim of this study is to explore the awareness of professionals for the social dimension of palliative care and to explore how collaboration between the healthcare domain and the Dutch municipal welfare domain, in the field of palliative care, can be improved.</p><p><strong>Design: </strong>Focus group research.</p><p><strong>Methods: </strong>In 2022, six focus groups and two individual interviews were held with 30 coordinators of regional palliative care networks in the Netherlands.</p><p><strong>Results: </strong>This study showed that coordinators of regional palliative care networks consider collaboration with the welfare domain to be important. There are major differences between the regional palliative care networks regarding knowledge about and collaboration with the welfare domain. Coordinators themselves can function as catalysts for collaboration between palliative care and the welfare domain.</p><p><strong>Conclusion: </strong>In the Netherlands, collaboration between the welfare domain and the healthcare domain in the field of palliative care is limited and differs considerably between regions. The Dutch municipal welfare domain is relevant for a large group of people confronted with an incurable disease, but it does not provide them with tailored services. Collaboration between palliative care and the municipal welfare domain has great potential, both on the patient level and on the level of the sustainability of palliative care, but it currently seems underexplored.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326188"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754839","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":"What functions do palliative care bereavement services deliver? A scoping review.","authors":"Kathleen E Jurgens, David C Currow, Jennifer Tieman","doi":"10.1177/26323524251326947","DOIUrl":"10.1177/26323524251326947","url":null,"abstract":"<p><p>Following someone's death, bereaved people may struggle with their grief. When a patient receives palliative care, bereavement support for the patient's family is an expected function of specialist palliative care services. To date, detailed descriptions of the purpose, function and provision of support from bereavement services are limited. This study examined how specialist palliative bereavement services self-defined their functions and described any support and interventions they offer. The aim was to synthesise how services satisfied their responsibilities for continuity of support to the family following a patient dying. A scoping review was undertaken to examine the literature on bereavement support within palliative care services to codify how they initiated post-death contact, the purpose of contact and what interventions were offered. Seven databases were interrogated in 2020 using search terms developed by CareSearch (www.caresearch.com.au) with refinement. Items needed to be in English and detail the aims and functions of service-initiated contacts and support. Information was thematically analysed using an inductive approach. Bereavement contact from palliative care services had an overall aim of offering guidance through the provision of information, access to a risk assessment and counselling. The analysis demonstrated the provision of bereavement information, describing support pathways and delivery of accessible grief interventions provided a 'safety net'. Other themes revealed services often monitored adjustment through scheduled reviews, were aware of their limitations and completed referrals to other services as needed. This study adds to our understanding of palliative care bereavement services and provides valuable information about their intended functions. To improve understanding of bereavement functions, services need to clearly define their primary purpose and how this meets the needs of bereaved people and national standards. Ideally, future research would interview bereavement staff directly to ensure accurate descriptions of service aims and model.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326947"},"PeriodicalIF":2.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732161","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 mixed methods pilot study of a serious illness communication training curriculum among medical residents.","authors":"Megan Smith-Uffen, Shilpa Jyothi Kumar, Oren Levine, Daryl Bainbridge, Jeff Myers, Leah Steinberg, Nadia Incardona, Maggie Civak, Hsien Seow","doi":"10.1177/26323524251326949","DOIUrl":"10.1177/26323524251326949","url":null,"abstract":"<p><strong>Background: </strong>It is crucial that clinicians develop skillful communication to support patients to improve their illness understanding. A strong understanding of illness is associated with improved quality of life and care that is consistent with patient priorities. Unfortunately, many clinicians lack these skills, and residents, in particular, feel unprepared. The ABCs (All Providers, Better Communication Skills) is a virtual curriculum that teaches core communication skills to facilitate conversations with people who are living with serious illnesses.</p><p><strong>Objectives: </strong>We explored whether the ABCs curriculum increases self-efficacy and addresses self-reported weaknesses in communication training for internal medicine (IM) and family medicine (FM) residents.</p><p><strong>Design: </strong>We conducted a prospective sequential mixed methods cohort study.</p><p><strong>Methods: </strong>Residents completed pre-/post-curriculum self-assessment surveys and a post-curriculum semi-structured interview. Primary outcomes were changes in self-efficacy, whether the curriculum addressed self-identified training needs and feedback on its structure and delivery. Secondary outcomes included feedback on how the modules could be tailored to IM and FM-specific content.</p><p><strong>Results: </strong>Twelve residents completed the study. Most were in IM, female, and aged 26-30 years. Self-efficacy improved significantly as per the SE-12 summative score (mean difference 11.5 points (SD 10.35), <i>p</i> = 0.003). The study-created items showed a significant improvement in breaking bad news (0.83 (SD 0.84), <i>p</i> = 0.005), overall knowledge (0.67 (SD 0.65), <i>p</i> = 0.005), and confidence (0.67 (SD 0.50), <i>p</i> = 0.001). Key strengths of the curriculum were its structured approach, focus on allowing for silence, transferrable skills, and practical application. The virtual format was both a strength and a weakness, as residents appreciated its accessibility but valued real-time practice.</p><p><strong>Conclusion: </strong>The ABCs improved self-efficacy among IM and FM residents. We will use results from this study to inform future iterations of the platform that are tailored to resident-specific learning needs and improving patient-centered outcomes.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326949"},"PeriodicalIF":2.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693769","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":"Impact of neonatal palliative care on neonates, their parents, and nurses: a systematic review.","authors":"Arman Mohammadi, Mostafa Gholami, Mohammadamin Jandaghian-Bidgoli, Fatemeh Abdi","doi":"10.1177/26323524251326103","DOIUrl":"https://doi.org/10.1177/26323524251326103","url":null,"abstract":"<p><strong>Background: </strong>Neonatal palliative care (NPC) is a comprehensive approach that addresses the physical, mental, social, and spiritual well-being of neonates in need of palliative care.</p><p><strong>Objective and design: </strong>The objective of this systematic review was to examine the impact of NPC on the management of symptoms and conditions in neonates admitted to the neonatal intensive care unit, as well as its effects on their parents and nurses.</p><p><strong>Methods: </strong>This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases, including Scopus, PubMed, Web of Science (WoS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library, were searched up to July 30, 2024. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>A total of 10 studies that met the inclusion criteria were included in the review. The results indicated that the implementation of an NPC program led to an increased use of analgesic drugs, a reduction in invasive therapeutic and diagnostic procedures for newborns, an increase in withdrawal of life support, more do-not-resuscitate orders, and greater parental involvement in the care of newborns. These findings suggest that providing NPC can improve parents' quality of life, as well as enhance symptom management and pain relief in newborns.</p><p><strong>Conclusion: </strong>The implementation of an NPC program can benefit both neonates and parents. It can improve the quality of life and reduce stress for parents, enhance the quality of newborn care, foster better inter-team collaboration, and prevent unnecessary invasive procedures, leading to greater comfort for newborns and improved pain and symptom management.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251326103"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651331","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":"Is there a role for hypnosis in palliative care?","authors":"Petra Vayne-Bossert, Janet Hardy","doi":"10.1177/26323524251321852","DOIUrl":"10.1177/26323524251321852","url":null,"abstract":"<p><p>Hypnosis has gained popular interest over the last few decades and has become increasingly subject to research study. Evidence of benefit in the palliative care setting is largely lacking, but it has been shown to have a favourable impact on psychological symptoms, especially anxiety, as well as chronic pain conditions. As a personalised approach, hypnotherapy is an excellent example of individual-centred care. Moreover, in the absence of significant adverse effects, it offers great promise as a complementary therapy.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251321852"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516357","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":"Establishing a common definition for care provided by hospice societies in British Columbia, Canada: a Delphi process.","authors":"Simon Anderson, Rachel Z Carter, Della Roberts, Pablita Thomas, Eman Hassan","doi":"10.1177/26323524251320104","DOIUrl":"10.1177/26323524251320104","url":null,"abstract":"<p><strong>Background: </strong>Currently, there are over 70 hospice societies spread across urban, rural, and remote communities in BC. However, these societies are not utilized to their fullest potential, primarily due to a lack of awareness of the unique role they play in their communities and common misconceptions about the types of care they provide.</p><p><strong>Objectives: </strong>To develop a consensus-based definition of the care provided by hospice societies in BC, suitable for use across government, healthcare, community organizations, and the public.</p><p><strong>Design: </strong>A modified Delphi approach, guided by an environmental scan, was used to reach consensus on a standard definition of care among a panel of experts.</p><p><strong>Methods: </strong>Following an environmental scan of gray and published literature for attributes and components of care delivered by hospice societies, the expert panel participated in a modified Delphi process of iterative surveys asking questions about content, wording, and structure of the definition. The 56-member panel consisted of hospice society experts, palliative care experts, and people with lived experience. Consensus was defined as 75% agreement across the entire panel (all) and 75% agreement across hospice society representatives (hospice).</p><p><strong>Results: </strong>After six survey rounds, consensus was met on a common definition with three different length versions: full- and medium-length versions (85% all, 85% hospice) and a short version (94% all, 100% hospice). Differing opinions within our expert panel about components of care supported the need for this common definition.</p><p><strong>Conclusion: </strong>Our consensus-based definition provides unprecedented clarity and a shared understanding about the care provided by hospice societies in BC. Hospice societies are expected to benefit from this clarity by maximizing their use and access. It is also expected that this definition will guide advocacy efforts, ultimately contributing to the quality and sustainability of hospice care across the province.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251320104"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459835","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":"Developing and implementing a nurse-delivered and a web-based dyadic psychoeducational program for people with advanced cancer and their family caregivers: sharing experiences from a three-arm international randomized controlled trial (DIAdIC).","authors":"Aline De Vleminck, Vincent Van Goethem, Sigrid Dierickx, Orphé Matthys, Kim Beernaert, Mogens Gronvold, Philip Larkin, Monica Guberti, Erica Witkamp, Joanne Reid, Katherine Bristowe, Luc Deliens, Lore Lapeire, Peter Hudson, Joachim Cohen","doi":"10.1177/26323524241310458","DOIUrl":"10.1177/26323524241310458","url":null,"abstract":"<p><strong>Background: </strong>Each year millions are diagnosed with cancer, impacting both patients and caregivers. Few interventions target both patients and family caregivers together, despite their shared experiences. While dyadic psychoeducational programs are gaining attention, evidence on developing and implementing these in international trials is limited. The DIAdIC trial faced unique challenges requiring innovative solutions to maintain study integrity.</p><p><strong>Objectives: </strong>To present our experiences with the development and implementation of two dyadic psychoeducational home-based programs, FOCUS+ and iFOCUS in the context of a randomized controlled trial (RCT) in six European countries.</p><p><strong>Design: </strong>A case report detailing our experiences in the development and implementation of two dyadic psychoeducational home-based programs (one face-to-face and one web-based) across multiple countries, highlighting the challenges and mitigating strategies in an international context.</p><p><strong>Methods: </strong>A chronological narrative describing experiences with the development and implementation of iFOCUS and FOCUS+.</p><p><strong>Results: </strong>The FOCUS+ and iFOCUS programs were successfully developed for the European context through rigorous translation and adaptation processes. Despite recruitment challenges including COVID-19 restrictions and administrative hurdles, 431 patient-caregiver dyads were enrolled across 6 European countries. Quantitative and qualitative data assessed the outcomes of FOCUS+ and iFOCUS interventions, including the primary endpoints of emotional functioning and self-efficacy. Fidelity was evaluated using audio recordings, checklists, and user data. Challenges in trial management were addressed with flexible timelines and technical support.</p><p><strong>Conclusion: </strong>The international DIAdIC trial developed and implemented two psychoeducational dyadic programs for patients with advanced cancer and their family caregivers. Based on our experiences we share several insights for future similar studies. These relate to the attention needed for context-specific adaptations when using existing interventions or programs, the translation of human-facilitated programs to standalone eHealth versions, the challenges of adopting a dyadic focus in the study, the pragmatic challenges of conducting an RCT and evaluating implementation and effects, and the technology used for study management.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524241310458"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450504","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":"\"'<i>We don't want them to have to live out their lives in the hospital</i>\": mixed-methods study exploring palliative care needs amongst refugees'.","authors":"Priya Gupta, Ashlinder Gill, Michael Panza, Olive Wahoush, Humaira Saeed, Jehan Ara Chagani, Christiana Owoo, Christopher Klinger","doi":"10.1177/26323524251317539","DOIUrl":"10.1177/26323524251317539","url":null,"abstract":"<p><strong>Background: </strong>The increasing life expectancy and resultant chronic medical comorbidities have resulted in more people requiring palliative care. Unfortunately, palliative care is restricted to marginalized populations, including refugees. In Canada, refugees are only eligible for federal health insurance, which provides basic medical and social coverage until they can obtain provincial health insurance.</p><p><strong>Objectives: </strong>This study explored limitations in providing palliative care to refugees who had either federal or provincial health insurance in two care settings in Ontario, Canada.</p><p><strong>Design: </strong>An explanatory sequential mixed-methods approach guided the review of local administrative data and interview data to understand palliative care delivery for refugees.</p><p><strong>Methods: </strong>Local administrative data from a community health centre and an acute care hospital providing a palliative care approach were collected to review healthcare utilization for refugees with palliative care needs. Interviews from two focus groups with fourteen healthcare providers shared their care experiences in coordinating palliative care for refugees with either federal or provincial health insurance.</p><p><strong>Results: </strong>Refugee patients with palliative care needs appeared to be accessing acute care services frequently to meet their needs over a 5-year period. Due to a lack of citizenship or permanent residency status, many refugees have access to only federal health insurance. Compared to those with routine provincial coverage, federally insured patients were admitted more frequently. Furthermore, healthcare provider experiences revealed that refugees with only federal insurance coverage had significant barriers to accessing community palliative care support, leading to increased reliance on acute care for quality palliative care.</p><p><strong>Conclusion: </strong>This study highlights significant gaps in palliative care access for refugees, especially those with federal health insurance. Equitable access is essential in ensuring that patient-centred, quality palliative care is available to all.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251317539"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383852","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}