Palliative & Supportive Care最新文献

{"title":"The impact of a children's palliative care education and mentoring program (Project ECHO) on healthcare providers' knowledge, confidence, and attitudes in Bhutan.","authors":"Tara Devi Laabar, Spandana Rayala, Anisha Lynch-Godrei, Purushotam Bhandari, Megan Doherty","doi":"10.1017/S1478951525000033","DOIUrl":"https://doi.org/10.1017/S1478951525000033","url":null,"abstract":"<p><strong>Background: </strong>Palliative care services are unavailable for the vast majority of children in Bhutan. Children's palliative care has not been incorporated into training programs for health professions, leading to limited knowledge and awareness of how best to support children facing serious or life-threatening conditions.</p><p><strong>Objectives: </strong>To describe the impact of the Project ECHO children's palliative care course on participants' knowledge, comfort, and attitudes and to evaluate the overall acceptability of an online training to support palliative care training in Bhutan.</p><p><strong>Methods: </strong>Before-and-after surveys of program participants were conducted, assessing changes in knowledge, comfort, and attitudes. Participants' overall experiences and acceptability of the learning program were assessed through an end-of-program survey.</p><p><strong>Results: </strong>Participants were primarily nurses (49%) or physicians (34%). Most participants (68%) worked in pediatric and/or neonatal care. Participants' knowledge of core palliative care concepts improved significantly between the beginning and end of the course. Participants' comfort and attitudes toward palliative care also improved, with significance effect sizes in most domains (11/18). Satisfaction with the program was high, with 100% of participants agreeing that the training was applicable to their clinical practice. Although most participants (56%) identified a personal need for additional clinical training to support practice change.</p><p><strong>Significance of results: </strong>Project ECHO can be used to deliver palliative care education, with improved palliative care knowledge, comfort, and attitudes among program participants. A short online training program can generate interest in palliative care, which can be leveraged to further develop palliative care services in settings where palliative care is currently unavailable.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e89"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posthumous dignity therapy: Challenges and opportunities in the Brazilian cultural context.","authors":"Ana Carolina Kotinda Bennemann, Carlos Eduardo Paiva, Bianca Sakamoto Ribeiro Paiva","doi":"10.1017/S1478951525000276","DOIUrl":"https://doi.org/10.1017/S1478951525000276","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e91"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helping Her Heal-Ghana: A pilot feasibility study of a culturally adapted educational counseling intervention for spouse caregivers of women with breast cancer.","authors":"Brenda Adei Osei-Assibey, Frances Marcus Lewis","doi":"10.1017/S1478951524002153","DOIUrl":"https://doi.org/10.1017/S1478951524002153","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the leading cancer in Ghana, Africa, accounting for 31% of all cancers in women. The effects of breast cancer are not limited to the woman but also impact the spouse's anxiety, depressed mood, and coping behavior. Helping Her Heal (HHH)-Ghana is a culturally adapted evidenced-based intervention with potential to improve health outcomes of spouse caregivers.</p><p><strong>Objectives: </strong>The purpose of the study was to ascertain the feasibility, acceptability, and short-term impact of HHH-Ghana, a culturally adapted evidenced-based intervention for spouses of women with breast cancer in Ghana.</p><p><strong>Methods: </strong>The study used a single group pre-post design. Participants (<i>n</i> = 14) were recruited from medical care providers and were eligible if they were spouse caregivers of wives with Stage I, II, or III breast cancer, were 18 years or older, and had been living with their wives for at least 6 months. Data were obtained by spouse self-report on standardized measures of depressed mood, anxiety, self-care skills, self-efficacy to support their wife, self-efficacy to carry out their own self-care, and the quality of marital communication about breast cancer. Exit interviews were additionally obtained to describe the gains spouses attributed to their participation in the study.</p><p><strong>Results: </strong>The HHH-Ghana study was feasible and acceptable. Spouses actively engaged in each intervention session and completed the at-home assignments; retention was 87.5%. Spouses significantly improved on standardized measures of anxiety (<i>p</i> = 0.010), depressed mood (<i>p</i> = 0.002), self-care skills (<i>p</i> = 0.006), and their self-efficacy in supporting their wife (<i>p</i> = 0.001) and in carrying out their own self-care (<i>p</i> = 0.011). Although there was no statistically significant change in marital communication, spouses reported in their exit interviews that the intervention enabled them to communicate better and be more attentive listeners to their wives.</p><p><strong>Significance of results: </strong>Results warrant a larger clinical trial in Ghana.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e88"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance care planning discussions - Perspectives from oncology patients with advanced-stage disease.","authors":"Delinda Pendleton, Brian L Egleston, Carolyn Y Fang","doi":"10.1017/S1478951525000069","DOIUrl":"https://doi.org/10.1017/S1478951525000069","url":null,"abstract":"<p><p>Evidence in the literature confirms that advance care planning (ACP) discussions, assumed to benefit patients, their caregivers, and clinicians, occur at various rates, lower than intended and not as early as thought to be beneficial. The literature, however, provides limited reasons why this trend continues. When ACP discussions do occur, particularly between clinicians and patients with advanced-stage cancer, we have even less understanding of the ACP experience. Thus, the goal of our study was to characterize patient beliefs and experiences pertaining to ACP discussions, and to explore factors that may be associated with patient experiences. One hundred adults with advanced cancer participated in this cross-sectional survey study. The majority (63%) had heard about ACP, and 81% believed that health care providers should have ACP discussions with their patients. However, only 23% of participants in this sample had an ACP discussion. Among those who reported having an ACP discussion, 74% indicated that they spoke with family members about ACP, and 48% reported having spoken with their oncologist about ACP. Among those who had not had an ACP discussion with a health care provider, commonly reported reasons for not doing so included the respondent's desire to speak with family members first and the perception that one was not sick enough to need such a discussion yet. These findings can be used to inform the development of future interventions to improve provider communication about ACP and enhance patient experiences around ACP discussions.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e90"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"War stories.","authors":"James Seymour Huntley","doi":"10.1017/S1478951524002013","DOIUrl":"https://doi.org/10.1017/S1478951524002013","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e93"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral and philosophical frameworks for discussing Voluntary Assisted Dying (VAD).","authors":"John Attia, Brian Kelly, Megan Best","doi":"10.1017/S1478951525000331","DOIUrl":"https://doi.org/10.1017/S1478951525000331","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e92"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of coping and pre-death grief among dementia family caregivers.","authors":"Yi-Qi Wangliu, Run-Ping Che","doi":"10.1017/S1478951525000082","DOIUrl":"https://doi.org/10.1017/S1478951525000082","url":null,"abstract":"<p><strong>Objectives: </strong>Research on grief among family caregivers of individuals with dementia has seen a notable increase. Our objective was to synthesize the relationship between coping factors and pre-death grief (PDG).</p><p><strong>Design: </strong>(Prospero protocol: CRD42024560208) We conducted a systematic review of literature from PubMed, Web of Science, Scopus, PsycInfo, and Medline up to July 2024. Included studies encompassed quantitative, qualitative, and mixed methods approaches. During the study selection process, we excluded data on intervention effectiveness and studies not published in English. The quality of the studies was evaluated using the Mixed Methods Appraisal Tool. Evidence was summarized narratively.</p><p><strong>Participants: </strong>Participants in this study are family caregivers who take care of dementia patients.</p><p><strong>Methods: </strong>We included data from 12 studies in our analysis. The majority of these investigations were carried out in Western countries. The research primarily involved spousal or adult child caregivers and centered on PDG. We included validated measures of PDG in each study.</p><p><strong>Significance of results: </strong>Among the reviewed studies, five reported on coping strategies, while seven addressed coping resources. Overall, the findings indicated that the application of coping strategies, specifically positive coping strategies, is effective in alleviating PDG and mitigating the effects of caregiving burden on PDG. Coping resources - including self-efficacy, sense of coherence, and support from friends and family - appear to have a beneficial impact in reducing PDG. Additionally, the quality of relationships with friends and family members was found to be a significant factor. Moreover, spiritual and religious beliefs, along with community faith, have been identified as crucial elements in alleviating grief experienced by caregivers.</p><p><strong>Conclusion: </strong>Knowing what coping strategies and resources are beneficial to decrease PDG experiences among dementia caregivers.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e86"},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating ACP into Nigeria's culture and healthcare system for improved end-of-life care.","authors":"Rizky Andana Pohan, Dian Oktary, Riza Amalia, Rikas Saputra, Samudra Mutiara Hasanah, Adellia Wardatus Sholeha","doi":"10.1017/S1478951525000197","DOIUrl":"https://doi.org/10.1017/S1478951525000197","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e87"},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the current state of the research literature examining the impact of the motor neurone disease journey on the couple's relationship? A scoping review.","authors":"Ella Malloy, Sarah Corrie, Noreen Cushen-Brewster","doi":"10.1017/S1478951524002141","DOIUrl":"https://doi.org/10.1017/S1478951524002141","url":null,"abstract":"<p><strong>Background: </strong>Motor neurone disease (MND) results in complex and disabling symptoms that give rise to significant and challenging care needs. While much of the care required is typically provided by the partner of the individual who has been diagnosed with MND, there are few studies that have investigated the impact of MND on the couple's relationship.</p><p><strong>Objectives: </strong>To establish the current state of the research literature examining the impact of MND on the couple's relationship.</p><p><strong>Methods: </strong>A scoping review was undertaken with thematic analysis used to synthesize the data.</p><p><strong>Results: </strong>The scoping review identified 15 studies that were thematically analyzed to identify prominent themes. The following 5 themes were identified: adjusting to new roles; changes in communication and values; spouse well-being and health; and changes to social relationships and intimacy changes.</p><p><strong>Significance of results: </strong>This scoping review highlighted the impact of the MND trajectory on the couple's relationship overall and on key areas of couple communication and functioning. These areas can be used to guide the development of interventions and services that are tailored to the needs of couple relationships. Further understanding of the factors impacting the couple's relationship on the MND journey and how to navigate these factors is critically warranted.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e85"},"PeriodicalIF":1.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of palliative care by people of Islamic faith and their preferences and decisions at the end of life: A scoping review.","authors":"Ibrahim Al Shhadat, Lisa-Maria Wobst, Gabriele Meyer, Rustem Makhmutov, Steffen Fleischer","doi":"10.1017/S1478951525000148","DOIUrl":"https://doi.org/10.1017/S1478951525000148","url":null,"abstract":"<p><strong>Objectives: </strong>The use of palliative care (PC) services from people of Islamic faith is seen limited. There are a fundamental lack of PC services appropriate to the target group and a lack of knowledge and acceptance. The transition from curative to PC is often perceived as problematic. Factors influencing PC use and end-of-life (EOL) decisions and preferences among people of Islamic faith are largely unclear.</p><p><strong>Methods: </strong>A scoping review was carried out using the methodology of the Joanna Briggs Institute. Studies of any design, published in English, German, or Arabic, and published by the end of August 2022, were eligible for inclusion. The systematic literature search was conducted in MEDLINE via PubMed, CINAHL, Cochrane Library, and Web of Science. Study statements were analyzed with a clear distinction between PC as EOL care and other EOL decisions, such as euthanasia, withdrawal, or withholding of one or more life-sustaining treatments or medications.</p><p><strong>Results: </strong>Sixty studies published between 1998 and 2022 were included. Only a few studies made statements about EOL care. The majority of studies focused on forms of euthanasia and indicated negative attitudes toward euthanasia, assisted suicide, and some other EOL decisions. Reasons for rejection include theological arguments, ethical and moral considerations, and others. Reasons for acceptance were principles of good death and dying, medical justifications, and others. The following barriers to the use of PC were identified laws and policies, lack of necessary resources, cultural norms and values, structure of the health-care system, communication and interaction between patients, relatives, and health-care staff, and others.</p><p><strong>Significance of results: </strong>This review identifies the preferences for and difficulties in making EOL decisions and identifies barriers to specific PC for the Muslim population. Findings suggest how these barriers might be overcome.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e84"},"PeriodicalIF":1.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}