Palliative & Supportive Care最新文献

{"title":"Migration as a transformative force shaping beliefs about and readiness for advance care planning among Thai immigrants in Australia: A qualitative exploration.","authors":"Pawita Limsomwong, Anna Collins, Peter Hudson, Supakorn Sripaew, Jennifer Philip","doi":"10.1017/S1478951526103836","DOIUrl":"https://doi.org/10.1017/S1478951526103836","url":null,"abstract":"<p><strong>Objectives: </strong>Advance care planning (ACP) engagement remains low among culturally and linguistically diverse populations, including immigrant communities, where cultural norms, family expectations, and migration may shape attitudes toward healthcare decision-making. Although Thai immigrants represent a growing population in Australia, little is known about how migration influences their perceptions of and readiness for ACP. This study aimed to explore how Thai immigrants in Australia perceive and engage in ACP within a new social and healthcare context.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological study was conducted in Victoria, Australia. Seventeen Thai immigrants were recruited through purposive and snowball sampling via Thai community networks. Semi-structured interviews were conducted in Thai or English, audio-recorded, transcribed, translated, and analyzed using reflexive thematic analysis informed by phenomenological techniques.</p><p><strong>Results: </strong>Four key themes were constructed through reflexive thematic analysis of the interviews: (1) the \"old Thai way,\" characterized by family-centered decision-making, deference to authority, and avoidance of death-related discussions; (2) migration as a disruptive force, with exposure to autonomy-based healthcare prompting reflection and adaptation; (3) tension between cultural values, highlighting challenges in balancing filial obligation with individual autonomy; and (4) reconstructing belief systems, wherein participants developed hybrid identities, integrating Thai and Australian values.</p><p><strong>Significance of results: </strong>Migration disrupts traditional Thai norms surrounding family roles, communication, and decision-making, thereby reshaping how participants understand and approach readiness for ACP. Thai immigrants reinterpret family roles, faith, and autonomy within a new cultural context, emphasizing the need for culturally responsive ACP approaches that respect family influence, indirect communication, and the role of community mediators.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e264"},"PeriodicalIF":2.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167606","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":"Beyond simulation centers: Adapting psychosocial end-of-life training to local workforce and culture.","authors":"Fathi Yasin Yusuf","doi":"10.1017/S1478951526103897","DOIUrl":"https://doi.org/10.1017/S1478951526103897","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e246"},"PeriodicalIF":2.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172332","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 harder right.","authors":"Lea Harper","doi":"10.1017/S1478951526104039","DOIUrl":"https://doi.org/10.1017/S1478951526104039","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e260"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167028","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":"Holistic suffering in patients with cancer: A qualitative study informed by descriptive quantitative assessment.","authors":"Ana Cláudia Mesquita Garcia, Eliza Mara das Chagas Paiva, Angela Bezerra Soares Perlamagna, Tais Rodrigues Caproni, Silvana Maria Coelho Leite Fava, Everson Meireles, Talita Prado Simão Miranda, Seng Beng Tan","doi":"10.1017/S1478951526103769","DOIUrl":"https://doi.org/10.1017/S1478951526103769","url":null,"abstract":"<p><strong>Objectives: </strong>To explore how holistic suffering manifests and is experienced by adults with cancer through qualitative inquiry, supported by descriptive quantitative assessment.</p><p><strong>Methods: </strong>This qualitatively driven study combined semi-structured interviews with embedded descriptive quantitative data from the Suffering Pictogram-Brazilian version (SP-BR). A total of 222 adults with cancer completed the SP-BR, and a subsample of 20 participated in interviews. The qualitative component had methodological priority and underwent thematic analysis; SP-BR scores were analyzed descriptively to contextualize self-reported levels and dimensions of suffering.</p><p><strong>Results: </strong>Overall suffering was moderate (mean=4.44, standard deviation=3.22), with substantial variability; worry and physical discomfort were the most prominent concerns. Thematic analysis revealed 4 interrelated themes: Disruption of the self and the search for meaning after diagnosis; Anchoring suffering: faith, relationships, and the ambivalence of coping; Concealed suffering and the fragile work of acceptance; and Meaning as responsibility: enduring suffering for oneself and others. Suffering coexisted with adaptive processes, including meaning-making, relational commitment, and spiritual coping. Spirituality and social support functioned both as protective resources and, in some cases, as mechanisms for concealing distress.</p><p><strong>Significance of results: </strong>Holistic suffering in cancer is an integrated, dynamic experience that can be understood as a nonlinear existential trajectory, in which participants moved back and forth between disruption of the self, the anchoring of faith and relationships, emotional concealment, and meaning-making. The proposed interpretive model synthesizes this trajectory and may serve as a conceptual starting point for designing interventions addressing holistic suffering.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e258"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168336","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 human washing machine.","authors":"Koichiro Yamamoto","doi":"10.1017/S1478951526104052","DOIUrl":"https://doi.org/10.1017/S1478951526104052","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e261"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170320","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":"Discharge from continuity: Teleconsultation and the limits of outpatient palliative care.","authors":"Patrick Theodore Souccar","doi":"10.1017/S1478951526104040","DOIUrl":"https://doi.org/10.1017/S1478951526104040","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e262"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165860","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":"Embodied relational dignity: An anthropology of personhood for clinical ethics.","authors":"Abel García Abejas","doi":"10.1017/S1478951526104015","DOIUrl":"https://doi.org/10.1017/S1478951526104015","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e263"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171284","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":"From voices to dignity: Empirical foundations of the DiRePal model in persons with advanced cancer.","authors":"Abel García Abejas, David Geraldes Santos, Helder Mota-Filipe, Fabio Costa Leite, Aida Cordero Botejara","doi":"10.1017/S1478951526104076","DOIUrl":"10.1017/S1478951526104076","url":null,"abstract":"<p><strong>Objectives: </strong>The DiRePal model understands dignity at the end of life as relational and temporal, shaped by recognition, narrative continuity, and prudent listening. This study explores how patients with advanced cancer, informal caregivers, and physicians understand and experience dignity, providing empirical foundations for the model.</p><p><strong>Methods: </strong>A multicentre qualitative study comprised six semi-structured focus groups involving oncology patients (n = 10), informal caregivers (n = 14), and pulmonology/oncology physicians (n = 15), conducted via a secure digital platform between April and November 2025 with IQVIA Portugal. Transcripts underwent reflexive thematic analysis, with independent initial coding, discussion-based consensus, and researcher reflexivity. Given participants' clinical fragility, member checking was not undertaken; credibility relied on triangulation, thick description, and an audit trail.</p><p><strong>Results: </strong>Six themes emerged: personal understanding of dignity, narrative flexibility, negotiating technical rationality and relational care, temporal sensitivity, professional reciprocity, and digital/structural integration. Dignity was inseparable from personal recognition, interpersonal gestures, and listening within time-constrained encounters. Physicians' emotional overload and insufficient institutional support compromised their dignity and, indirectly, patients'; caregivers frequently rendered themselves invisible. Patients associated dignity with respect, autonomy, and relief of suffering, while depersonalised or fragmented care eroded it.</p><p><strong>Significance of results: </strong>These findings ground a relational-temporal account of dignity in reciprocal recognition between patients, caregivers, and clinicians across shared, unevenly experienced time. Listening, temporal prudence, and recognition of clinicians' vulnerability should be clinical priorities, alongside cautious, relationally framed integration of digital tools.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e259"},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168762","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":"Hope and empathy as drivers of therapeutic response in cancer care: A psycho-oncological, narrative, and philosophical exploration of the HETR model.","authors":"Evgenia A Nikolopoulou, Georgios N Kanellopoulos, Nektarios Alevizopoulos","doi":"10.1017/S1478951526103903","DOIUrl":"https://doi.org/10.1017/S1478951526103903","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e255"},"PeriodicalIF":2.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171681","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":"Nursing-led predictive symptom management in oncology palliative care: Using laboratory indicators and clinical judgment to improve patient quality of life: A systematic review.","authors":"Ateya Megahed Ibrahim, Donia Elsaid Fathi Zaghamir, Humood AlShamrany","doi":"10.1017/S1478951526103964","DOIUrl":"10.1017/S1478951526103964","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer on palliative treatment often have dynamic and multidimensional symptoms like pain, fatigue, anorexia, cognitive changes, and emotional distress that significantly impact functional capacity and quality of life. Traditional symptom management is largely reactive, based on patient self-report or clinician recognition after deterioration, leading to delayed interventions and avoidable suffering.</p><p><strong>Aim: </strong>The aim of this systematic review was to review the evidence on nurse-led predictive symptom-management strategies in oncology palliative care, with a focus on the role of laboratory biomarkers and clinical judgment in the early detection of deterioration and better quality of care.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, CINAHL, Scopus, Embase, and the Cochrane Library through November 2025. Keywords included \"nurse-led,\" \"predictive symptom management,\" \"palliative care,\" \"oncology,\" \"biomarkers,\" and \"clinical judgment.\" Both qualitative and quantitative studies were included in the review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram: 1,482 records identified, 346 duplicates removed, 1,136 screened, 128 full texts assessed, and 14 eligible studies selected based on PRISMA 2020 statements. The review protocol was registered in advance in the International Prospective Register of Systematic Reviews (PROSPERO; Registration No. CRD420261432500).</p><p><strong>Results: </strong>The included studies (Randomised Controlled Trials (RCTs), cohorts, modeling studies, and telehealth interventions) demonstrated that biomarkers such as C-reactive protein, neutrophil-lymphocyte ratio, albumin, ferritin, and electrolytes predicted symptom exacerbation and clinical decline. Nurse-led approaches including biomarkers with clinical assessment improved the management of symptoms, decreased emergency department visits, and improved continuity of care. Predictive models were promising but limited in clinical integration.</p><p><strong>Conclusion: </strong>Nurse-led predictive approaches support a shift from reactive to proactive palliative care. Further research is needed to embed predictive tools into routine practice and to validate their effectiveness in real-world settings.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e257"},"PeriodicalIF":2.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138196","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}