Palliative Care and Social Practice最新文献

{"title":"Unlocking compassion: expanding access to palliative care in Saudi Arabia.","authors":"Fhaied Almobarak","doi":"10.1177/26323524241290828","DOIUrl":"10.1177/26323524241290828","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is an essential element of the healthcare system. It has profound benefits for patients with life-limiting illnesses. The Saudi Arabian healthcare system lags in integrating this vital component effectively. Hence, estimating the palliative care needs of the Saudi Arabian population is crucial to understanding the country's demand for palliative care.</p><p><strong>Aim: </strong>To assess the past trends in adult palliative care needs in Saudi Arabia.</p><p><strong>Methods: </strong>The current research used population-based secondary data analysis by employing two palliative care needs estimation methods: the direct or fixed estimation method by Gómez-Batiste and the maximum or maximal method by Murtagh and Rosenwax. The estimated palliative care needs were stratified by gender.</p><p><strong>Results: </strong>An upward trend in the palliative care needs of the Saudi Arabian population is evident through the estimation techniques. The proportion of palliative care needs relative to deaths climaxed at 95% in the observed years. By 2022, the number of people requiring palliative care skyrocketed to 79,725 (fixed method) and 101,623 (maximal method).</p><p><strong>Conclusion: </strong>The need for palliative care in Saudi Arabia substantially rose in the observed years. It is inevitable to bridge the gap between palliative care needs and supply with advanced integration of palliative care services in the national healthcare system.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241290828"},"PeriodicalIF":2.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476751","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":"Assessment of sleep characteristics using Fitbit Charge 4 in head and neck cancer patients undergoing palliative chemotherapy and radiotherapy: a prospective observational study.","authors":"Anuj Jain, Jha Suryavanshi, Vaishali Waindeskar, Manish Gupta, Ashutosh Kaushal, Harish Kumar","doi":"10.1177/26323524241283067","DOIUrl":"10.1177/26323524241283067","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbance is prevalent among cancer patients. The quantification of this sleep disturbance is missing, especially in palliative care settings.</p><p><strong>Aim: </strong>The aim of this study was to study the sleep patterns of the patients undergoing palliative chemotherapy and radiotherapy for head and neck cancer (HNC) using a Fitbit Charge 4 sleep-tracking device.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>A total of 110 HNC patients undergoing palliative chemotherapy and radiotherapy at a tertiary care teaching hospital in Central India.</p><p><strong>Results: </strong>Forty-four percent of patients had a poor sleep score (less than 60). Average sleep duration was 218.66 ± 139.05 min; non-rapid eye movement (NREM) sleep duration 197.7 ± 115.91 (light NREM 171.36 ± 104 and deep NREM 23.36 ± 16.73); REM sleep duration was 30.44 ± 34.14 min. The Pittsburgh Sleep Quality Index was 10.23 ± 3.45, which indicated sleep deprivation over the past 1 month. Moderate levels of anxiety, depression, confusion, and distress existed in the cohort. Statistically significant but weak correlation existed between sleep score, anxiety, and depression. Strong correlation existed between distress score and sleep score. Confusion score did not have a significant correlation with sleep score.</p><p><strong>Conclusion: </strong>HNC patients in palliative care settings were chronically sleep deprived. Sleep architecture was also disturbed. Moderate levels of anxiety, depression, confusion, and distress existed in the studied cohort; these psychosocial disturbances had a weak correlation with the sleep score and are likely to be multifactorial.</p><p><strong>Trial registration: </strong>Institutional Ethics Committee number: IHEC-LOP/2020/IM0349. The study has been registered with clinical trial registry of India with registration number CTRI/2021/03/032400 (http://www.ctri.in).</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241283067"},"PeriodicalIF":2.7,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393925","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":"Gender and couple status differences in advance care planning: a cross-sectional study.","authors":"Kristin R Baughman, Ruth Ludwick, Ashley Audi, Laura Harlan","doi":"10.1177/26323524241287221","DOIUrl":"https://doi.org/10.1177/26323524241287221","url":null,"abstract":"<p><strong>Background: </strong>Past studies have shown mixed results on how gender and living with a spouse or partner impact advance care planning (ACP). Few if any have tested for the interaction between these two variables.</p><p><strong>Objective: </strong>We examined how gender and couple status interact to impact the use of ACP practices including written instructions, designating a durable power of attorney for healthcare (DPOAHC), and discussing one's decisions with others.</p><p><strong>Design: </strong>We used cross-sectional data taken from the Health and Retirement Study, a longitudinal study of adults over the age of 50 in the United States.</p><p><strong>Methods: </strong>Data are from 632 respondents who died between the 2016 core survey and the 2018 exit survey. Participants had completed the 2016 survey and had a proxy informant complete the 2018 exit survey after their death. Generalized linear mixed models were used to test for main effects and interactions.</p><p><strong>Results: </strong>Women were more likely than men to designate a DPOAHC and to discuss their wishes with others. Women living without a partner were more likely than men living without a partner and coupled households to discuss their wishes with family or others.</p><p><strong>Conclusion: </strong>Both gender and couple status are important variables associated with ACP practices. Healthcare providers may want to reach out to women living within a coupled household and men living without a partner to ensure that they know the benefits of ACP.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241287221"},"PeriodicalIF":2.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393926","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":"Where are the values in evaluating palliative care? Learning from community-based palliative care provision.","authors":"Sandy Whitelaw, Devi Vijay, David Clark","doi":"10.1177/26323524241287223","DOIUrl":"https://doi.org/10.1177/26323524241287223","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization Astana Declaration of 2018 sees primary healthcare as key to universal health coverage and gives further support to the goal of building sustainable models of community palliative care. Yet evaluating the benefits of such models continues to pose methodological and conceptual challenges.</p><p><strong>Objective: </strong>To explore evaluation issues associated with a community-based palliative care approach in Kerala, India.</p><p><strong>Design: </strong>An illuminative case study using a rapid evaluation methodology.</p><p><strong>Methodology: </strong>Qualitative interviews, documentary analysis and observations of home care and community organising.</p><p><strong>Results: </strong>We appraise a community palliative care programme in Kerala, India, using three linked 'canvases' of enquiry: (1) 'complex' multi-factorial community-based interventions and implications for evaluation; (2) 'axiological' orientations that foreground values in any evaluation process and (3) the status of evaluative evidence in postcolonial contexts. Three values underpinning the care process were significant: heterogeneity, voice and decentralisation. We identify 'objects of interest' related to first-, second- and third-order outcomes: (1) individuals and organisations; (2) unintended targets outside the core domain and (3) indirect, distal effects within and outside the domain.</p><p><strong>Conclusion: </strong>We show how evaluation of palliative care in complex community circumstances can be successfully accomplished when attending to the significance of community care values.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241287223"},"PeriodicalIF":2.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393927","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":"\"Backlash!\"? A qualitative exploration of hospice palliative care staff's ongoing experiences of \"living with covid\".","authors":"Rebecca Evans, John MacArtney","doi":"10.1177/26323524241283064","DOIUrl":"10.1177/26323524241283064","url":null,"abstract":"<p><strong>Background: </strong>\"Living with covid\" has meant that the SARS-CoV-2 virus has become a background concern for many in the United Kingdom. However, people with terminal conditions remain some of those at higher risk of Covid-19 affecting the quality-of-life left, as well as the amount of life. Little is known about how staff manage the ongoing risks and challenges-to themselves and those they seek to support-when providing palliative care in the context of an airborne transmissible virus.</p><p><strong>Objective: </strong>To explore the experiences of UK hospice staff of \"living with covid\" to identify how Covid-19 continues to affect their work and well-being.</p><p><strong>Design: </strong>An interpretivist qualitative interview study.</p><p><strong>Methods: </strong>Reflexive thematic analysis of semi-structured online interviews with 12 staff recruited from three hospices in the West Midlands, UK.</p><p><strong>Results: </strong>We explored how participants' accounts of \"living with covid\" included several ambivalences: Participants not only sought to assert the importance of not forgetting that time but also wished to \"move-on.\" This included moving Covid-19 to the \"background\" through embedding systemic adaptions and lessons learnt, while also recognizing that they had to address issues relating to Covid-19 \"case-by-case.\" Finally, participants' wish to move-on and a mostly reactive approach to mitigations meant that they were unable to meaningfully reconcile how asymptomatic transmission promotes patients' quality-of-life left.</p><p><strong>Conclusion: </strong>Recollections of the difficulties of the Covid-19 public health emergency were part of a \"backlash\" to any future consideration of mitigations for airborne transmissible viruses and helped justify a \"living with (getting) covid\" approach. However, this also created uncertainty of how best to support patients who are vulnerable to having the quality and amount of life left compromised by viral infection. The pandemic has brought renewed impetus to re-examine hospice palliative care's ideals and practices in the context of airborne transmissible viruses.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241283064"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381873","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 social work contribution in end-of-life care: incorporating critical spirituality.","authors":"Fiona Gardner","doi":"10.1177/26323524241282683","DOIUrl":"https://doi.org/10.1177/26323524241282683","url":null,"abstract":"<p><p>This article outlines how a framework for critical spirituality incorporated into a social work perspective, can contribute to work in end-of-life care. This is based on my experience of working in interdisciplinary teams, including pastoral care workers or chaplains, nurses, doctors, a range of carers and other allied health professionals. Traditionally, social workers have focused on the holistic well-being of the dying person and their families but tended not to actively include the spiritual. However, there is increased recognition in social work of the value of integrating critical spirituality: understanding the person's own sense of meaning and the social assumptions that might influence how this can be expressed. This might mean working with individuals and families on understanding how societal expectations of the dying process are undermining the person's desire to die in a particular way. To do this, workers must themselves recognise their own internalised societal assumptions and be willing to challenge these. The article explores the potential value of how such a social work approach can integrate critical, postmodern, green and relational theories as well as indigenous worldviews with key qualities of practice such as humility, deep listening and waiting, and the ability to be critically reflective. Key ideas are used to help focus practice and the inclusion of critical spirituality. These include (1) exploring the influence of the person's history and social context; (2) the value of particular relationships and networks, including community and environmental connections and activities and processes that are an intrinsic aspect of the person's well-being; (3) challenging workers to be critically and reflectively aware of their own assumptions and values to ensure the dying person can truly express their preferences related to death and dying. Examples from my experience are used to illuminate how such perspectives can be actively included in practice across professional boundaries to shift perceptions of 'how things are done here' to what can be more life enhancing for those in palliative care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241282683"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394024","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 Café conversations: evaluating the educational potential for university students in palliative care teaching.","authors":"Ignacio Borque, Elena Oliete, María Arantzamendi, Carlos Centeno","doi":"10.1177/26323524241273490","DOIUrl":"10.1177/26323524241273490","url":null,"abstract":"<p><strong>Background: </strong>Discussing death, particularly among future healthcare professionals, remains a challenge. The \"Death Café\" initiative offers a relaxed setting for such conversations, and this study investigates its educational potential for medical students.</p><p><strong>Objectives: </strong>To assess the effectiveness of \"Death Café\" as an educational tool for medical students in palliative care, and to understand students' perceptions and reflections on death and end-of-life topics post-participation.</p><p><strong>Design: </strong>An exploratory qualitative design was employed, analyzing reflections submitted by medical students following voluntary participation in a Death Café session.</p><p><strong>Methods: </strong>Medical students from a course on palliative care participated in the \"Death Café,\" a structured yet informal discussion about death in a relaxed café setting. Subsequently, participants submitted written reflections on their experiences. These reflections were analyzed using a thematic analysis method, identifying emerging themes related to the students' perceptions of death, the event, and its impact on their future medical practice.</p><p><strong>Results: </strong>Forty-two students attended the Death Café. Twenty-one reflections were collected from 29 medical students who participated. Most students found the \"Death Café\" environment conducive to open conversations about death. Key themes included recognizing the fragility of life, the role of medical professionals in end-of-life care, and the personal and professional growth derived from such reflections. The students also highlighted the transformative nature of the event, shifting from discussing death in general to pondering on their roles as future healthcare professionals. Positive feedback indicated the absence of negative comments about the activity, with suggestions provided for future iterations.</p><p><strong>Conclusion: </strong>The \"Death Café\" serves as an innovative pedagogical approach to medical education, particularly in palliative care teaching. It offers students a platform for sincere dialogue on death and reinforces the significance of integrating innovative methods in medical training. This initiative not only enriches personal understanding but also emphasizes the commitment to holistic patient care.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241273490"},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509741","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":"Re-living trauma near death: an integrative review using Grounded Theory narrative analysis.","authors":"Nikki Johnston, Michael Chapman, Jo Gibson, Catherine Paterson, Murray Turner, Karen Strickland, Wai-Man Liu, Christine Phillips, Kasia Bail","doi":"10.1177/26323524241277851","DOIUrl":"https://doi.org/10.1177/26323524241277851","url":null,"abstract":"<p><strong>Background: </strong>Symptoms of emotional and physical stress near death may be related to previous experiences of trauma.</p><p><strong>Objective: </strong>To investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life?</p><p><strong>Design: </strong>This integrative review was conducted per Whittemore and Knafl's guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation.</p><p><strong>Methods: </strong>This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT).</p><p><strong>Results: </strong>Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life.</p><p><strong>Conclusion: </strong>This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241277851"},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355690","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":"How to support caregivers in general practice: development of the Caregiver Care Model.","authors":"Anna Mygind, Sara Marie Hebsgaard Offersen, Mai-Britt Guldin, Kaj S Christensen, Mette Kjærgaard Nielsen","doi":"10.1177/26323524241272103","DOIUrl":"https://doi.org/10.1177/26323524241272103","url":null,"abstract":"<p><strong>Background: </strong>Caring for a family member can be demanding, particularly when caregivers experience profound distress. Supportive interventions may help prevent mental and physical illness in the caregiver. General practice plays a key role by regularly engaging with patients and caregivers, thereby being able to identify their support needs, offer talk therapy and refer to care initiatives.</p><p><strong>Objective: </strong>This study aimed to develop and pilot-test the Caregiver Care Model to mitigate grief reactions among caregivers in general practice.</p><p><strong>Design: </strong>A participatory intervention development study.</p><p><strong>Methods: </strong>A prototype was developed in a workshop with healthcare professionals. The prototype was refined based on a pilot-test among 40 caregivers from 5 general practice clinics and a workshop with general practitioners. The data were obtained from workshops, feedback questionnaires completed by healthcare professionals, and interviews with caregivers and general practitioners. The analysis focused on model development and mechanisms of impact.</p><p><strong>Results: </strong>The prototype was refined by focusing the dialogue questionnaire, minimising the grief facilitation tools and expanding the target group. The prototype seemed to accommodate the needs among caregivers by acknowledging their situation. The final model includes up to seven caregiver consultations in general practice. A dialogue questionnaire filled in by the caregiver serves as a fixed starting point and preparation for the first consultation. If needed, talk therapy in general practice or referrals to other services are used.</p><p><strong>Conclusion: </strong>The model offers promising support for caregivers. Its flexible structure allows for customisation. The viability of the model should be further tested.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241272103"},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355689","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 evaluating Compassionate Workplace Programs to promote health and wellbeing around serious illness, dying and loss in the workplace (EU-CoWork): a transdisciplinary, cross-national research project.","authors":"Steven Vanderstichelen, Deborah De Moortel, Karina Nielsen, Klaus Wegleitner, Malin Eneslätt, Tiziana Sardiello, Daniela Martos, Jennifer Webster, Irene Nikandrou, Ellen Delvaux, Carol Tishelman, Joachim Cohen","doi":"10.1177/26323524241281070","DOIUrl":"https://doi.org/10.1177/26323524241281070","url":null,"abstract":"<p><strong>Background: </strong>Most employees will experience serious illness, caregiving, dying and loss (End-of-Life (EoL) experiences) at multiple points throughout their working lives. These experiences impact affected employees but also their colleagues in terms of health and wellbeing, and the workplace as a whole in terms of workplace safety, productivity and labour relations. The impact of EoL experiences on employees means that workplaces are called to play a more active role in providing support for EoL experiences.</p><p><strong>Aim: </strong>To describe how the EU-CoWork (2024-2028) project addresses its main aims to (1) create Compassionate Workplace cultures, practices and policies and improve health and wellbeing for employees dealing with EoL experiences in different national work contexts in Europe; (2) describe and evaluate the process of co-creation and implementation of Compassionate Workplace Programs (CWPs) and how these influence the programs' outcomes.</p><p><strong>Design: </strong>EU-CoWork employs a facilitated and co-creative Developmental Evaluation approach to the development of 12 tailored CWPs across four European countries (Belgium, Austria, Sweden and Greece).</p><p><strong>Methods: </strong>To evaluate the outcomes and processes leading to these outcomes, a mixed-methods Realist Evaluation methodology is applied, formulating and testing Context-Mechanism-Outcomes configurations and combining longitudinal quantitative and qualitative data collections.</p><p><strong>Results: </strong>EU-CoWork will generate evidence to support an expanded model of occupational health and safety risk factors sensitive to the specific challenges related to employees' EoL experiences. In doing so, several challenges will have to be navigated: involving employees with EoL experiences while avoiding overburdening them, avoiding tokenistic engagement, managing power differentials, balancing the need for scientific rigour with the flexibility required in co-creation, reconciling different epistemologies and disciplinary traditions and organisational resistance to change.</p><p><strong>Conclusion: </strong>There are potential long-lasting broader societal impacts through the stimulation of open discourse on EoL topics, the reconciliation of work and care, and changes in gendered work and care patterns.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"18 ","pages":"26323524241281070"},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476749","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}