Palliative & Supportive Care最新文献

{"title":"Factors associated with caregiver burden in home-based palliative care in Bogotá, Colombia: A cross-sectional study.","authors":"Xiomara Andrea Hernández-Bernal, Johana Benavides-Cruz, Hector Fabio Rojas Espitia, Angel Alberto Galindo Pérez, Caticza Nathaly Beltrán-Acosta","doi":"10.1017/S1478951526103368","DOIUrl":"https://doi.org/10.1017/S1478951526103368","url":null,"abstract":"<p><strong>Objectives: </strong>To identify factors associated with caregiver burden among caregivers of patients enrolled in a home-based palliative care program in Bogotá, Colombia.</p><p><strong>Methods: </strong>This analytic cross-sectional study included 208 caregivers of patients receiving home-based palliative care in Bogotá between 2022 and 2024. Data were collected on caregivers' sociodemographic, psychological, and caregiving-related characteristics. Caregiver burden was assessed using the <i>Zarit Burden Interview</i> (<i>ZBI</i>), while depression, anxiety, and stress symptoms were assessed using the Depression, Anxiety and Stress Scale-21. Patient sociodemographic and clinical data were also collected. Multiple linear regression analysis was used to identify caregiver- and patient-level variables associated with caregiver burden.</p><p><strong>Results: </strong>The median age of caregivers was 56 years. Most caregivers were women (86%) and relatives (74%). Although 69.2% had higher education, 79.8% lacked formal caregiving training and 73.6% provided care without financial compensation. The mean ZBI score was 42.5 ± 12.9, with 40.4% of caregivers experiencing mild to intense burden. Additionally, 40.4% reported depressive symptoms, 38.9% anxiety, and 47.1% stress. Caregiving support (<i>β</i> = -6.31; <i>P</i> = 0.009) was associated with lower burden scores, whereas caregiver motor limitations (<i>β</i> = 4.78; <i>P</i> = 0.045) and caregiver depression (<i>β</i> = 3.81; <i>P</i> = 0.034) were associated with higher burden scores.</p><p><strong>Significance of results: </strong>Caregiver burden was associated with caregiver depression and motor limitations. Interventions aimed at strengthening caregiving networks, providing psychological support, and addressing caregivers' physical health are essential to reduce burden and improve the well-being of both caregivers and patients.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e247"},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224896","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 effectiveness of meaning-based interventions in reducing suicide-related vulnerability: A systematic review.","authors":"Tae Kyun Gwon, Hyun Ok Jung","doi":"10.1017/S1478951526103599","DOIUrl":"10.1017/S1478951526103599","url":null,"abstract":"<p><strong>Objectives: </strong>Existential factors such as loss of meaning play a central role in suicide-related vulnerability, yet most prevention interventions target symptom reduction. We aimed to systematically review the effects of meaning-based interventions on suicide-related outcomes and characterize the mechanisms through which these effects operate.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA 2020 guidelines. Six databases (PubMed, Web of Science, CINAHL, PsycINFO, Research Information Sharing Service, and Korean Studies Information Service System) were searched from inception to April 2026. Studies were included if they evaluated meaning-based interventions and reported suicide-related outcomes. Risk of bias was assessed using RoB 2 for randomized trials and RoBANS for nonrandomized studies. Given heterogeneity across populations, interventions, and outcomes, findings were synthesized narratively by domain.</p><p><strong>Results: </strong>Ten studies were included (7 randomized controlled trials, 2 quasi-experimental studies, and 1 secondary analysis). Meaning-based interventions most consistently improved existential outcomes, including meaning in life, spiritual well-being, and quality of life. Emotional outcomes showed partial and heterogeneous effects. Suicide-related outcomes, including hopelessness, demoralization, and suicidal ideation, generally showed reductions, although effects varied across studies. Mechanistically, most studies showed patterns of indirect pathways, whereby improvements in existential variables co-occurred with reductions in emotional and suicide-related outcomes.</p><p><strong>Significance of results: </strong>Meaning-based interventions may reduce suicide-related vulnerability primarily by enhancing existential resources rather than directly targeting symptoms. These findings support integrating meaning-centered approaches into suicide prevention strategies and highlight the need for longitudinal and mediation-based studies to examine causal mechanisms.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e276"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220946","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":"Exploring spiritual care: Insights from Hindu family caregivers in palliative care.","authors":"Nurul Syakila Izzati Mohd Romzi, Mohamad Firdaus Mohamad Ismail, Ferry Efendi, Siti Zuhaidah Shahadan","doi":"10.1017/S1478951526103575","DOIUrl":"https://doi.org/10.1017/S1478951526103575","url":null,"abstract":"<p><strong>Objectives: </strong>Family caregivers play a fundamental role in addressing the spiritual needs of patients receiving palliative care, particularly in cultures where spirituality is deeply embedded in daily life. This study explored how Hindu family caregivers perceived spiritual care, the ways they incorporated spiritual practices into caregiving, and the challenges they experienced while supporting relatives with palliative care needs.</p><p><strong>Methods: </strong>A descriptive qualitative study was undertaken with 12 Hindu family caregivers recruited through purposive and snowball sampling in Kuantan, Malaysia. Individual semi-structured interviews were conducted, and the data were analyzed using Braun and Clarke's thematic analysis to identify recurring patterns across participants' experiences.</p><p><strong>Results: </strong>Three interconnected themes emerged: Perceiving Spiritual Care as a Source of Meaning and Hope, Integrating Spiritual Practices into Family Caregiving, and Navigating Emotional and Practical Challenges in Spiritual Caregiving. Participants described spiritual care as fostering inner peace, hope, and acceptance through practices such as prayer, temple worship, chanting, and family support. Caregivers viewed themselves as facilitators of both spiritual and emotional well-being while simultaneously facing emotional exhaustion, caregiving demands, and limited access to spiritual support services.</p><p><strong>Significance of results: </strong>The findings demonstrate that spiritual care is a shared responsibility between healthcare professionals and family caregivers in palliative care. Recognizing and supporting culturally grounded spiritual practices may strengthen holistic nursing care, promote family-centered care, and enhance the quality of palliative services for culturally diverse populations.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e275"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220959","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":"When the tumor improves before the patient does: Keeping supportive care open after a good response.","authors":"Ching-Hsueh Cheng, Chuan-Yi Lin, Szu-Hsuan Yu, Yen-Ting Liu, Chao-Yuan Tu","doi":"10.1017/S1478951526103642","DOIUrl":"https://doi.org/10.1017/S1478951526103642","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e268"},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196952","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":"Patient characteristics and quality of life in relation to place of death in lung cancer patients treated with immunotherapy.","authors":"Amalie Rasmussen, Lotte Holm Land, Sören Möller, Pia Krause Møller, Ida Meklenborg, Birgitte Bjørnhart","doi":"10.1017/S1478951526103873","DOIUrl":"10.1017/S1478951526103873","url":null,"abstract":"<p><strong>Objectives: </strong>Studies show that cancer patients consider place of death (POD) an important factor influencing quality of life (QoL) at the end of life. The objectives of this study were to identify characteristics of real-world non-small cell lung cancer (NSCLC) patients based on POD and investigate how changes in health-related QoL (HRQoL) relate to POD.</p><p><strong>Methods: </strong>Newly updated data from a prospective single-center Danish cohort (NCT03870464) of patients with NSCLC who initiated immune checkpoint inhibitors (ICI) as monotherapy between April 1, 2018, and April 30, 2021, at the Department of Oncology, Odense University Hospital, were used for analyses. Clinical data were retrieved from electronic patient records. This included POD, which was categorized as <i>home, hospice/palliative care unit</i>, or <i>hospital</i>. HRQoL questionnaires were completed by patients prospectively at baseline and at predefined timepoints during treatment with ICI.</p><p><strong>Results: </strong>A higher percentage (63.6%) of patients dying at home were male, and a higher percentage dying in a hospice/palliative care unit were female (63%) (<i>p</i> = 0.041). Patients with hospital as POD had a statistically higher Global health status/QoL (GHS/QoL) at baseline (75.0; <i>p</i> = 0.034). Patients with home or hospice/palliative care unit as POD reported improved QoL during treatment with ICI, as opposed to patients with hospital as POD who had unchanged self-assessed QoL scores.</p><p><strong>Significance of results: </strong>Sex, baseline GHS/QoL, and change in HRQoL during treatment with ICI differed between patients based on POD. The predictive value of this is unknown, suggesting the need for further research on this topic, as it remains clinically relevant.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e271"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196504","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":"Examining spiritual needs, spiritual practices, ritual, and coping in palliative care: An Australian cohort study.","authors":"Chrystabel Butler, Dana Hince, Alexandra Gorelik, David Kissane, Natasha Michael","doi":"10.1017/S147895152610368X","DOIUrl":"https://doi.org/10.1017/S147895152610368X","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine religious and post-Christian spiritual orientations, types of spiritual and ritual activities, coping strategies of patients with advanced illness and explore associations between spiritual needs, practices, well-being, quality of life, and coping styles.</p><p><strong>Methods: </strong>One hundred and two patients completed validated instruments: Post-Christian Spirituality Scale, Spiritual Needs Questionnaire, Spiritual Practices Questionnaire, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Global Quality of Life Scale, and Brief-COPE Questionnaire. Descriptive statistics summarized participant characteristics and scale distributions. Spearman correlations (Bonferroni-adjusted) examined associations between spiritual needs, practices, and coping modes. Multivariate regression analyses assessed whether ritual practices predicted spiritual needs.</p><p><strong>Results: </strong>Inner peace (median, 1.4; IQR, 1, 2) and humanistic/prosocial practices (median, 66.6; IQR, 44.4, 83.2) were prominent spiritual needs and frequently used rituals, respectively. Strong correlations were observed between religious needs and religious rituals (rho = 0.87). Existential, inner peace, and giving/generativity needs correlated moderately with existentialistic practices (rho = 0.56-0.69). Humanistic/prosocial spiritual practices were moderately associated with giving/generativity (rho = 0.52) and inner peace needs (rho = 0.42). Emotion-focused coping, particularly acceptance and emotional support, was most consistently associated with spiritual needs and practices, reinforcing the centrality of relational and embodied forms of spirituality at the end of life. Regression analyses confirmed existentialistic practices predicted existential and inner peace needs, while humanistic practices predicted generativity needs.</p><p><strong>Significance of results: </strong>Findings demonstrate strong alignment between spiritual needs and ritual activity, supporting development of personalized, ritual-based spiritual care frameworks. Determining individual orientations toward embodied, relational, and humanistic practices may offer an adaptable means of addressing spiritual suffering.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e273"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195988","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 relationship between caregiver burden, depression, suicidal thoughts, and quality of life in patients' caregivers in the adult palliative service.","authors":"Kamer Gül Sürücü, Eren Sezgin, Eda Ural Karaman, Merve Güner","doi":"10.1017/S1478951526103988","DOIUrl":"https://doi.org/10.1017/S1478951526103988","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to examine the relationships between caregiver burden, depression, suicidal ideation, and quality of life among caregivers of patients hospitalized in an adult palliative care unit and to identify factors associated with depressive symptoms.</p><p><strong>Methods: </strong>This descriptive cross-sectional study included 75 caregivers of patients hospitalized in the Adult Palliative Care Unit of Erzurum City Hospital. Data were collected using the Caregiver Strain Index, Hamilton Depression Rating Scale (HAM-D), Beck Scale for Suicide Ideation, (OPQOL)-Brief, and SF-36 Health Survey. Descriptive statistics, chi-square tests, Pearson's correlation analysis, and multiple linear regression were performed.</p><p><strong>Results: </strong>High caregiver strain was reported by 52% of participants. According to HAM-D scores, 24% had mild depressive symptoms, while none had moderate or severe depression. All participants were classified as having low suicidal ideation risk. Significant correlations were observed among physical and mental health, caregiver burden, depression, suicidal ideation, and quality of life (p < 0.05). Mental health was strongly negatively correlated with depression (r = -0.607, p < 0.01) and was the only significant predictor of depressive symptoms in the regression model (<i>β</i> = -0.511, p < 0.001), explaining 40.5% of the variance.</p><p><strong>Significance of results: </strong>Mental health was the strongest determinant of depressive symptoms among palliative care caregivers. Although all participants were categorized as having low suicidal ideation risk, continuous suicidal ideation scores were associated with greater caregiver burden, depression, and poorer quality of life. Routine mental health screening and psychosocial support for caregivers should be integrated into palliative care services.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e267"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196775","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":"Peanut butter crackers.","authors":"Lucy Zhao","doi":"10.1017/S1478951526103630","DOIUrl":"https://doi.org/10.1017/S1478951526103630","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e269"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196550","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":"Learning how to die.","authors":"Simon Wein","doi":"10.1017/S1478951526104027","DOIUrl":"https://doi.org/10.1017/S1478951526104027","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e270"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196452","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":"Relationships between supportive needs, perceived peer support, and well-being among unpaid cancer caregivers in regional, rural, and remote areas of Queensland, Australia.","authors":"Mehrnaz Keramatikerman, Enamul Kabir, Snezana Stolic, Bianca Viljoen, Anna Tynan, Leah East","doi":"10.1017/S1478951526103940","DOIUrl":"https://doi.org/10.1017/S1478951526103940","url":null,"abstract":"<p><strong>Objectives: </strong>To identify associations between supportive care needs, perceived peer support, and well-being among unpaid cancer caregivers (UCCs) in regional, rural and remote (RRR) Queensland, Australia.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among 202 adult UCCs for individuals with advanced cancer in RRR Queensland. Participants completed validated measures assessing unmet needs, perceived social support, psychological distress, caregiver burden, and spiritual need. Data were analyzed using descriptive statistics, Cronbach's alpha, Pearson correlations, multiple linear regression, and structural equation modeling (SEM).</p><p><strong>Results: </strong>CNAT-C, MSPSS, DASS-20, and CDS mean (SD) scores were 1.95 (0.48), 4.63 (1.30), 1.65 (0.59), and 2.66 (0.62), respectively. Practical support was the highest unmet need (M=2.04, SD=0.61), followed by hospital facilities/services (M=1.99, SD=0.59) and healthcare staff (M=1.98, SD=0.59). Internal consistency was high across measures (α=0.806-0.924). Higher unmet needs and perceived peer support were associated with greater distress and poorer well-being (all p<.001). CNAT-C and MSPSS predicted DASS-20 (R²=.236); CNAT-C predicted CDS (R²=.251), whereas MSPSS was not significant. The SEM demonstrated good model fit.</p><p><strong>Significance of results: </strong>UCCs residing in RRR Queensland reported substantial unmet needs, especially for related to PS and healthcare services. Greater unmet needs were associated with poorer caregiver well-being. The positive association between perceived social support and distress suggests support may be mobilized in response to heightened caregiver strain and highlights the importance of considering the appropriateness and quality of support, alongside availability, for caregivers in RRR settings.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e266"},"PeriodicalIF":2.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185245","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}