Palliative Care and Social Practice最新文献

{"title":"The impact of area deprivation on access to and utilization of health services in the last year of life: A retrospective population-based cohort study.","authors":"Jackie Robinson, Bert van der Werf, Daniel Exeter, Jinfeng Zhao, Merryn Gott","doi":"10.1177/26323524251332302","DOIUrl":"10.1177/26323524251332302","url":null,"abstract":"<p><strong>Background: </strong>The healthcare needs of people living in areas of high deprivation are complicated by the cumulative effect of the sociodemographic factors known to impact on health outcomes, such as income, housing and education. Of note, for people living in more deprived areas, life expectancy is shorter and the onset of chronic disease and multimorbidity occurs much earlier. While the relationship between area deprivation and access to palliative care is becoming more widely researched, the vast majority of studies to date have focused on referrals to specialist palliative care services. This is problematic given the dominant model of generalist-specialist palliative care in high-income countries which assumes that most people will have a level of palliative care need that can be managed by non-specialist palliative care services.</p><p><strong>Objective: </strong>To identify associations between area deprivation and the use of generalist and specialist palliative care services in the last year of life.</p><p><strong>Design: </strong>A retrospective population-based cohort study.</p><p><strong>Methods: </strong>People aged over 18 years who died between January 2015 and December 2020 were identified within one geographical area of Aotearoa New Zealand. Using the National Health Identifier, deaths were matched to generalist and specialist palliative care service data.</p><p><strong>Results: </strong>A significant association was found between area deprivation and health service use in the last year of life. Of note, people living in rural areas of deprivation were significantly less likely to receive a hospital (<i>p</i> = <0.000) or inpatient hospice admission (<i>p</i> = <0.000). They were also less likely to have contact with their general practitioner (<i>p</i> = 0.007) or experience a specialist outpatient clinic appointment (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>This study has revealed inequities in health service use across generalist and specialist palliative care services for people living in areas of deprivation. Of note, findings have highlighted how rurality amplifies inequities in access to appropriate palliative care. Further research is needed to better understand the consequences of these apparent inequities.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251332302"},"PeriodicalIF":2.2,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245402","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":"Benefits and challenges of recording biographical audiobooks by incurably ill parents to their children: A semi-structured interview study.","authors":"Anja Greinacher, Sophia Enders, Lars Buschhorn, Beate Ditzen, Bernd Alt-Epping","doi":"10.1177/26323524251375079","DOIUrl":"10.1177/26323524251375079","url":null,"abstract":"<p><strong>Background: </strong>There is initial evidence that biographical audio recordings have a positive effect on people with advanced, incurable illnesses, but also that such recordings can represent a major challenge. Little is yet known about the interactions of positive and negative effects, as well as certain groups of patients with incurable illnesses.</p><p><strong>Objectives: </strong>The aim of this study is to identify positive and negative effects of a personal family audiobook recording on incurably ill patients with underage children, suggestions for improving the implementation, and feasibility in parallel with somatic treatment.</p><p><strong>Design: </strong>Qualitative, descriptive study.</p><p><strong>Methods: </strong>Semi-structured interviews, transcribed and analyzed using qualitative content analysis. The main categories were set deductively; the subcategories were developed inductively.</p><p><strong>Results: </strong>Twelve patients with advanced, incurable diseases (66.67% female; age in years <i>M</i> = 43.6, range: 38-55) with children (<18 years) after recording a personal family audiobook. Patients experienced positive (e.g., relief, gratitude), negative (e.g., insecurity, sadness), and neutral emotions (e.g., feeling emotional, ambivalent). They described positive (e.g., pleasant memories) and negative effects for themselves (e.g., self-criticism), for their family (e.g., creating a legacy, no understanding, respectively), as well as positive and negative effects within the process of recording the audiobook (e.g., grateful for support, time investment, respectively). Some patients mentioned unspecific positive effects. The recording was easy to implement, as planning and implementation were individually adapted to the patients' needs. All patients would recommend the audiobook.</p><p><strong>Conclusion: </strong>There was evidence that the audiobook strengthened coping strategies; the concept of generativity seems particularly important. Nevertheless, the process was described as exhausting and challenging. Therefore, patients should decide whether they want to record a family audiobook and should be in sufficiently good mental and physical condition when they start the recording.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS00029252); registration date: June 10, 2022.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251375079"},"PeriodicalIF":2.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233484","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":"'It's hard not to feel like somehow I fell short': A discourse analysis of palliative care providers' experiences with patients' nonphysical suffering.","authors":"Maxxine Rattner, Cheryl-Anne Cait","doi":"10.1177/26323524251379910","DOIUrl":"10.1177/26323524251379910","url":null,"abstract":"<p><strong>Background: </strong>The relief of patients' suffering is central to the philosophy and practice of palliative care. Few studies have focused on interdisciplinary palliative care providers' experiences in addressing patients' nonphysical suffering-suffering that is emotional, psychological, social, spiritual, and/or existential in nature. This study contributes to and expands the empirical knowledge base in this area.</p><p><strong>Objective: </strong>To identify existing discourses within how palliative care providers talk about their experiences working with patients' nonphysical suffering, and how these discourses may affect palliative care providers and impact clinical care.</p><p><strong>Design: </strong>This study's methodological approach was informed by discourse analysis, grounded in a poststructural theoretical framework. Discourse analysis guided by poststructural theory highlights that: discourses are constructed; discourses are imbued with tensions and/or contradictions; and discourses <i>do</i> things-they have <i>effects</i>.</p><p><strong>Methods: </strong>Twenty-four interdisciplinary palliative care providers across Canada participated in semi-structured phone interviews in 2020. Eligible participants had a minimum of 2 years' experience providing palliative care to adult patients in diverse settings, and self-identified as having experience working with patients' nonphysical suffering.</p><p><strong>Results: </strong>Two competing discourses shape providers' work with patients' nonphysical suffering: (1) 'Expectations of palliative care to relieve nonphysical suffering' and (2) 'Barriers to nonphysical suffering's relief'. The expectation that palliative care will relieve patients' nonphysical suffering emanates from patients and families, from medical teams outside of palliative care, and from providers themselves. Multiple barriers to nonphysical suffering's relief exist at the patient, provider, and systems levels. Providers may experience helplessness, and inadequacy, and can avoid patients' nonphysical suffering when they feel unable to relieve it.</p><p><strong>Conclusion: </strong>Palliative care has long ascribed nonphysical suffering's relief to the ability of a patient to transcend their own suffering, or a palliative care provider to facilitate/support that transcendence. Findings call into question and expand this long-standing discourse by pushing the field to consider how multiple intersecting barriers at patient, provider, and systems levels shape-and limit-palliative care's call for the relief of nonphysical suffering. Findings have implications for patient care, and interdisciplinary palliative care training, education, and research.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251379910"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214061","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":"Remote and rural communities face inequalities in access to specialist palliative care, could telemedicine enhance care? A qualitative study of patient, carer and healthcare professionals' experiences of video consultation.","authors":"Lorelle Dismore, Katherine Frew, Donna Wakefield, Charlotte Bryan, Katherine Swainston","doi":"10.1177/26323524251380632","DOIUrl":"10.1177/26323524251380632","url":null,"abstract":"<p><strong>Background: </strong>Living in remote and rural areas is associated with worse health outcomes and poorer end-of-life care. Inequality in access to high-quality palliative care due to rurality is a worldwide problem. There is a need to evaluate potential ways, such as using telemedicine, to enhance palliative care and support patients to remain within their communities.</p><p><strong>Objective: </strong>To understand the experiences of patients, carers and specialist palliative care professionals to receive/deliver video consultations in a rural setting.</p><p><strong>Design: </strong>Qualitative semi-structured interviews with reflective thematic analysis.</p><p><strong>Methods: </strong>Patients, their informal carers (family/friend) and members of the community specialist palliative care team were invited to qualitative interview to explore their experience of using video consultations.</p><p><strong>Results: </strong>Four themes were generated including: (1) interpersonal communication, (2) enhanced provision with subthemes: physical distance and reducing travel and quick and convenient access to care, (3) flexible blended models of care and (4) organisational and practical barriers.</p><p><strong>Conclusion: </strong>In many situations, video consultations were felt to be beneficial to enable convenient and reliable access to specialist palliative care for patients living remotely. They are feasible, acceptable and practical for patients, their families and healthcare professionals. However, video consultations must be offered as an option to enhance care rather than replace in-person home visits, which are required in some situations. Further research is needed to explore how to ensure this increased accessibility is inclusive and supports disadvantaged older patients and those of lower socio-economic position.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251380632"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233435","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":"An impossible dream?","authors":"Barbara Pesut","doi":"10.1177/26323524251381400","DOIUrl":"https://doi.org/10.1177/26323524251381400","url":null,"abstract":"<p><p>The extension of assisted dying to those whose natural death is not reasonably foreseeable has very real implications for how we think about life-limiting illness and the systems of care we design to palliate suffering. We now have a new idea of a life-limiting illness; dying is a result of an illness's impact on quality of life, not length of life. In this article, I tell the story of \"Sam,\" whose complex illness and suffering led her to choose an assisted death. I reflect on my own responses to Sam and conclude with a dream for a palliative system of care designed uniquely to support those choosing death over a life of suffering.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251381400"},"PeriodicalIF":2.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201550","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":"Innovative palliative care research in Europe: which horizons are we exploring?","authors":"Richard Harding, Lieve Van den Block","doi":"10.1177/26323524251368903","DOIUrl":"https://doi.org/10.1177/26323524251368903","url":null,"abstract":"","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251368903"},"PeriodicalIF":2.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087593","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 professionals' perceptions of their skills and the implementability of evidence-based bereavement care guidance: A cross-sectional survey study.","authors":"Sina Gyarmathy, Marco Riguzzi, Rahel Naef","doi":"10.1177/26323524251369119","DOIUrl":"10.1177/26323524251369119","url":null,"abstract":"<p><strong>Objective: </strong>Bereavement support is recommended in specialised palliative care, but it is often underdeveloped. This study assessed palliative care professionals' (PCPs') skills in family care, their attitudes towards evidence-based practices, and their perceptions of a new, evidence-based bereavement care guidance before its implementation.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between September and December 2023 in specialised palliative care services in two Swiss hospitals. Seven validated instruments were used to assess PCPs' skills in family care (FNPS, EPCS, and ICS-Nurse), attitudes towards evidence-based practices (EBP-B), and perception of a newly developed, evidence-based bereavement care guidance (acceptability AIM, appropriateness IAM, feasibility FIM). The data were analysed using descriptive and nonparametric methods.</p><p><strong>Results: </strong>The 39 participants (response 63%; 28 nurses, 6 physicians, 5 others) rated their skills in family care as high (median ⩾75% of scale range) and had an open attitude towards evidence-based practices (median 64%). They perceived the bereavement care guidance as highly acceptable and appropriate (median 75%) and rather feasible (median 68%). A more favourable attitude towards evidence-based practices was associated with higher perceived acceptability (Spearman's rho, <i>p</i> = 0.038), appropriateness (Spearman's rho, <i>p</i> = 0.029), and feasibility (Spearman's rho, <i>p</i> = 0.0019) of the guidance. Acceptability, appropriateness, and self-assessed skills (FNPS) depended on the local context (Mann-Whitney <i>U</i> test, <i>p</i> ⩽ 0.022).</p><p><strong>Conclusion: </strong>This study shows that PCPs rate their skills in working with families at the end of life as high and perceive evidence-based bereavement care as implementable. An open attitude towards evidence-based practices supports more favourable perceptions of new bereavement care guidance before its implementation.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251369119"},"PeriodicalIF":2.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114420","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":"Death and dying in Ghana: Implications for palliative and end-of-life care.","authors":"Joshua Okyere","doi":"10.1177/26323524251376029","DOIUrl":"10.1177/26323524251376029","url":null,"abstract":"<p><p>In Ghana, death and dying are not simply biomedical endpoints but are deeply rooted in cultural, spiritual, and communal ideologies. These beliefs shape how individuals and families perceive terminal illness, respond to end-of-life (EoL) trajectories, and interact with palliative care (PC) services. Unlike Western medical models that prioritize institutionalized and medicalized death, the Ghanaian perspective is influenced by communalism, ancestral continuity, and religious doctrines that emphasize divine healing and spiritual deliverance. This commentary examines how Ghanaian cultural norms, particularly the conception of good and bad death, the taboo surrounding discussions of dying, and the centrality of family in care decision-making, create both opportunities and challenges for PC and EoL care delivery. While spiritual beliefs offer coping mechanisms that foster resilience, they may also foster unrealistic expectations and delay the initiation of PC services, thereby undermining symptom management and psychosocial support. At the same time, the family's pivotal role in caregiving, decision-making, and bereavement provides a strong foundation for culturally sensitive PC models. The paper calls for healthcare providers and policymakers to develop family-centered and culturally congruent care frameworks, invest in community-based education to destigmatize PC, and integrate bereavement care into the continuum of support. Training providers in culturally competent communication and embedding PC into national health policy and curricula are also recommended.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251376029"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065385","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":"\"Help with rowing the boat\": Implementing and evaluating the Strengthening a Palliative Approach in Long-Term Care program in four Canadian provinces.","authors":"Sharon Kaasalainen, Genevieve Thompson, Lynn McCleary, Lorraine Venturato, Abigail Wickson-Griffiths, Paulette V Hunter, Tamara Sussman, Donny Li, Shane Sinclair, Thomas Hadjistavropoulos, Noori Akhtar-Danesh, Valerie Bourgeois-Guerin, Deborah Parker","doi":"10.1177/26323524251369121","DOIUrl":"10.1177/26323524251369121","url":null,"abstract":"<p><strong>Background: </strong>Despite high mortality rates in long-term care (LTC), LTC homes continue to struggle to implement a palliative approach to care.</p><p><strong>Objectives: </strong>The objective of this research was to implement and evaluate the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC; www.spaltc.ca) program. Specifically, we explored its feasibility, acceptability, and preliminary effects on resident comfort, use of emergency department at end-of-life (EOL), and location of resident death.</p><p><strong>Design: </strong>This study used an explanatory mixed method design in four LTC homes; one in each of four provinces (Ontario, Manitoba, Saskatchewan, Alberta) in Canada to assess acceptability, feasibility, and preliminary effects of the program.</p><p><strong>Methods: </strong>Quantitative and qualitative data were collected whereby the qualitative component was used to help explain or elaborate on the main quantitative components.</p><p><strong>Results: </strong>Of the 102 participating residents, 74.5% (76/102) had a Palliative Care Conference (PCC). However, of those who died, only 68.8% of them had a PCC. Rates of hospital use were reduced for study participants in terms of emergency department visits at EOL (relative risk reduction (RRR): 46%; 95% CI: -1.12, -0.10) and hospital deaths (RRR: 88%; 95% CI: -4.06, -1.12) compared to baseline. However, there were no significant differences in resident comfort. Family members stated that the PCCs were informative and thought that good communication was critical in providing quality care. They highlighted that close relationships and mutual respect among staff, residents, and families led to more meaningful care while the resident was alive as well as into bereavement. Staff stated that they found the SPA-LTC resources helpful and recognized the importance of having strong leadership using a Palliative Champion Team.</p><p><strong>Conclusion: </strong>The SPA-LTC program appears to be feasible on some key activities and supports a family-centered approach to care, which relies on strong communication. Future research is needed to confirm these initial results.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251369121"},"PeriodicalIF":2.2,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030853","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":"Chronic illnesses requiring home-based palliative care and their impact on families in an urban resettlement colony of Delhi, India.","authors":"Parth Sharma, Akshithanand Kuzhikkat Jayaprakasan, Shivani Rao, Himanshu Bachawandia, Surender, Geeta Sharma, Geeta Verma, Jyoti Rawat, Ranjana Kumari, Apurva, Yogesh Kumar, Sunny Yadav, Munabid Alam, Pushpender, Shees Zaidi, Mongjam Meghachandra Singh, Nandini Sharma","doi":"10.1177/26323524251368907","DOIUrl":"10.1177/26323524251368907","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases are a growing public health concern in India. However, limited knowledge of community-based need for palliative care has contributed to its poor access.</p><p><strong>Objective: </strong>To assess the community-based palliative care needs, social security access, and the economic burden on families requiring home-based palliative care.</p><p><strong>Design: </strong>A community-based cross-sectional study.</p><p><strong>Methods: </strong>The entire population of an urban resettlement colony was surveyed by trained field research workers to identify people requiring home-based palliative care, whose needs were confirmed by a physician trained in palliative care needs identification. Data were collected on sociodemographics, health status, disease details, access to social security schemes, and economic impact. People in need of home-based palliative care were referred for home-based care and social security guidance. Data were analyzed using R and geographically mapped with ArcGIS and Google My Maps.</p><p><strong>Results: </strong>Out of 43,267 individuals, 0.21% (2 per 1000) required home-based palliative care. The majority were elderly males (60%), with 51.11% illiterate and 55.56% previously unemployed. Neurological disorders, primarily stroke (67.8%), were the leading cause of disability. The average Barthel Index score was 33, indicating severe dependence in nearly 49% of participants. 62.22% of families reported a negative quality of life, and 34.44% incurred debt due to illness. 73.33% had ration cards, 50% received pensions, and only 15.56% had public health insurance. The mean out-of-pocket healthcare expenditure was 58.56% of their per capita income and 11.11% of their total family income.</p><p><strong>Conclusion: </strong>The study highlights the significant need for home-based palliative care in urban areas and the financial hardship families face. There is a need for community-based package development for palliative care service delivery followed by an evaluation of its effectiveness.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"19 ","pages":"26323524251368907"},"PeriodicalIF":2.2,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030824","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}