Palliative & Supportive Care最新文献

{"title":"Frail community-dwelling older persons' advance care planning and end-of-life wishes and preferences: A qualitative interview study.","authors":"Myrthe van den Heuvel, Daisy Ermers, Marieke Perry, Yvonne Engels, Marianne Dees","doi":"10.1017/S1478951526103885","DOIUrl":"https://doi.org/10.1017/S1478951526103885","url":null,"abstract":"<p><strong>Objectives: </strong>Advance care planning (ACP), including end-of-life (EOL) conversations, helps frail older persons articulate goals and preferences for future treatments and care, ultimately enhancing quality of life. Nevertheless, a substantial gap exists between the many who wish to engage in such conversations and the minority who currently do so. To support earlier and broader engagement, we explored frail community-dwelling older persons' perspectives and attitudes regarding ACP and EOL discussions.</p><p><strong>Methods: </strong>We conducted a qualitative, purposively sampled, interview study of frail community-dwelling older persons (<i>N</i> = 16), identified from Dutch general practices. We analyzed the transcripts using reflexive thematic analysis.</p><p><strong>Results: </strong>We developed 5 themes regarding ACP and EOL conversations: (1) Personal identity as the foundation for ACP and EOL decision-making: personal values strongly shaped EOL preferences and decision-making; (2) external factors - including lived experiences, the social environment, and information channels - influenced EOL perspectives; (3) attitudes and motivations shaped engagement with ACP and EOL conversations, ranging from active engagement to reluctance; (4) organization and conditions of ACP and EOL conversations: the content of conversations varied across conversation partners; and (5) expectations regarding involvement of others in ACP, including EOL conversations: participants expressed a need for proximity to family, close friends, and healthcare professionals and for these others to be involved and take responsibility in supporting decision-making.</p><p><strong>Significance of results: </strong>When asked about ACP, participants focused predominantly on preferences and expectations regarding EOL care and the period surrounding death. These reflections, grounded in personal values and identity, were most often shared with family and close friends and less frequently with healthcare professionals. These findings highlight the central role of informal networks in ACP communication, suggesting that healthcare professionals should actively involve these networks in ACP discussions and decision-making. Furthermore, ACP conversations may benefit from starting from persons' underlying values and their priorities in life.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e254"},"PeriodicalIF":2.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137851","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":"Grief and bereavement care in pediatric palliative care: Gaps, global disparities, and a proposed integrated framework.","authors":"Karina Castillo, Maria Clara Landivar, Kevin Zambrano, Michella Dirani, Diego Montenegro, Giselle Maldonado, Valeria Macias, Luis Noboa, Emilia Valdivieso, Jose Maria Castillo, Victoria Cortez, Sabine Dueñas, Pablo Salas, Sebastian Garzon, Michelle Grunauer","doi":"10.1017/S1478951526103824","DOIUrl":"https://doi.org/10.1017/S1478951526103824","url":null,"abstract":"<p><strong>Objectives: </strong>Grief and bereavement care (GBC) remains an underrecognized component of pediatric palliative care (PPC), contributing to the emotional and psychological burden experienced by patients, families, and healthcare professionals (HCPs). This perspective review examines gaps in GBC, defines key types of grief in pediatric settings, and proposes a framework to improve patient- and family-centered grief support.</p><p><strong>Methods: </strong>We conducted a narrative perspective review using PubMed and Google Scholar to identify literature on GBC in PPC. Search terms included combinations of \"grief,\" \"bereavement,\" \"pediatric palliative care,\" \"children,\" \"caregivers,\" \"siblings,\" \"healthcare professionals,\" \"anticipatory grief,\" \"complicated grief,\" and \"prolonged grief disorder.\" Publications from 2020 onward were prioritized, with seminal earlier studies included when clinically or conceptually relevant.</p><p><strong>Results: </strong>GBC in PPC differs from adult models because of developmental considerations, prolonged illness trajectories, and family-centered decision-making. Relevant forms of grief include anticipatory, disenfranchised, complicated, and prolonged grief, affecting patients, families, and HCPs. Effective approaches include early palliative care integration, legacy-making activities, structured communication, and interdisciplinary psychosocial support. However, global disparities persist, and HCPs frequently report inadequate training and institutional support.</p><p><strong>Significance of results: </strong>GBC should be viewed as a longitudinal, culturally sensitive, system-wide responsibility extending from diagnosis through bereavement. Integrated frameworks emphasizing early communication, patient- and family-centered care, and formal grief training for HCPs may strengthen bereavement support and reduce unmet psychosocial needs across the pediatric illness trajectory.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e256"},"PeriodicalIF":2.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128813","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":"Mental health struggles and coping strategies of individuals facing terminal illness of a loved one: A survey in a tertiary care hospital of Kolkata, West Bengal.","authors":"Tathagata Jha, Mohammad Orooj Azmi, Subhranil Mal, Suraj Shaw, Ankush Banerjee, Arup Chakraborty","doi":"10.1017/S1478951526103551","DOIUrl":"https://doi.org/10.1017/S1478951526103551","url":null,"abstract":"<p><strong>Objectives: </strong>Family caregivers of terminal cancer patients often experience substantial emotional burden. This study assessed depression, anxiety, stress, and coping-distress associations among caregivers in Eastern India to inform culturally sensitive interventions.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 100 adult caregivers of terminal cancer patients at a tertiary care hospital in Kolkata. Participants were recruited via systematic random sampling and interviewed using a structured proforma, the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief-COPE inventory. Descriptive statistics summarized demographics and caregiving characteristics. Spearman's rank correlation was used to assess associations between psychological distress and coping domains, with <i>p</i> < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Caregivers (median age 43 years; 70% male) were predominantly the patient's children (67%). Median DASS-21 scores indicated moderate depression (16), anxiety (14), and stress (16). Coping scores indicated low-to-moderate use of problem-focused (1.875 ± 0.321), emotional (1.871 ± 0.269), and avoidant coping (1.865 ± 0.266). Emotional coping correlated significantly with anxiety (<i>ρ</i> = 0.301, <i>p</i> = 0.002), depression (<i>ρ</i> = 0.317, <i>p</i> = 0.001), and stress (<i>ρ</i> = 0.293, <i>p</i> = 0.003). Depression also correlated with stress and problem-focused coping, while stress correlated with avoidant coping.</p><p><strong>Significance of results: </strong>Caregivers experienced considerable psychological burden, with emotional coping consistently linked to distress. These associations likely reflect reactive adaptation rather than inherent maladaptiveness. Results highlight an urgent need to recognize caregiver distress within oncology settings and to develop culturally informed psychosocial interventions in palliative care, particularly in low-resource environments. Such efforts could enhance both caregiver well-being and quality of end-of-life care.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e251"},"PeriodicalIF":2.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128788","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 final words to meaningful living: Reframing dignity therapy through culturally responsive counseling.","authors":"Agus Setiawan, Eka Sari Setianingsih, Shitarani Dewi, Arbin Janu Setiyowati, Punaji Setyosari, Nur Eva","doi":"10.1017/S1478951526103952","DOIUrl":"https://doi.org/10.1017/S1478951526103952","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e253"},"PeriodicalIF":2.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138226","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 cultural congruence: A transformative counseling perspective on repatriation at the end of life.","authors":"Amriana, Budi Purwoko, Bambang Dibyo Wiyono, Ragwan Albaar","doi":"10.1017/S1478951526103927","DOIUrl":"https://doi.org/10.1017/S1478951526103927","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e252"},"PeriodicalIF":2.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116697","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 study on the intervention effect of a structured grief counseling program on grief responses in family caregivers of patients with advanced cancer.","authors":"Feng Gong, Jia Yu","doi":"10.1017/S1478951526103794","DOIUrl":"https://doi.org/10.1017/S1478951526103794","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effect of structured grief counseling on grief responses in family caregivers of advanced cancer patients from the terminal phase through early bereavement, and may inform bereavement care in oncology and hospice settings.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial from October 2024 to November 2025 among family caregivers of patients with advanced cancer. Participants were assigned to structured grief counseling (intervention group, <i>n</i> = 55) or only psychological materials (control group, <i>n</i> = 56). Counseling began before the death and continued for 3 months after the death. Outcomes were assessed at enrollment, at the end of the intervention, and at 1 and 3 months after the death. Measures included grief, guilt, anxiety, depression, post-traumatic growth, and health-related quality of life. Linear mixed-effects models estimated group differences over time.</p><p><strong>Results: </strong>Compared with control, the intervention produced lower Anticipatory Grief Scale scores over time (estimates = -9.31, <i>P</i> < 0.001). The intervention also yielded higher Post-traumatic Growth Inventory scores and Short-Form 36 Health Survey scores (estimates = 6.02 and 5.97, respectively; <i>P</i> < 0.001). Between-group differences for Bereavement Guilt Scale scores, Self-Rating Anxiety Scale scores, and Self-Rating Depression Scale scores were not significant.</p><p><strong>Conclusion: </strong>Structured grief counseling provided to family caregivers from the patient's terminal phase through the early bereavement period effectively improves grief status, post-traumatic growth, and health-related quality of life. These findings support the integration of standardized, family-centered bereavement support systems into oncology and hospice care services.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e250"},"PeriodicalIF":2.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116615","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 self-compassion and spiritual well-being among caregivers of palliative care patients.","authors":"Gülsüm Kehribar, Hüsna Özveren","doi":"10.1017/S1478951526103502","DOIUrl":"https://doi.org/10.1017/S1478951526103502","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the predictive relationship between self-compassion and spiritual well-being among palliative care caregivers, exploring internal resources to mitigate care burden and existential distress in end-of-life settings.</p><p><strong>Methods: </strong>This descriptive, cross-sectional, and correlational study was conducted between March and September 2025 with 138 family caregivers in a palliative care unit. Sample size was determined via a priori power analysis ensuring 95% power. Data were obtained using the Introductory Characteristics Form, the Self-Compassion Scale (SCS), and the Spiritual Well-Being Scale. Data analysis involved descriptive statistics, Pearson correlation analysis, and simple linear regression.</p><p><strong>Results: </strong>The mean self-compassion score was 79.94 ± 11.68, and the mean spiritual well-being total score was 109.26 ± 13.59. Subscale scores were 63.05 ± 9.93 (transcendence), 28.10 ± 3.91 (harmony with nature), and 18.11 ± 5.28 (anomie). A positive, moderate correlation existed between total self-compassion and spiritual well-being (<i>r</i> = 0.349, <i>p</i> < 0.001). Significant associations were also identified across the transcendence (<i>r</i> = 0.217, <i>p</i> = 0.011), harmony with nature (<i>r</i> = 0.213, <i>p</i> = 0.012), and anomie (<i>r</i> = 0.333, <i>p</i> < 0.001) subscales. Regression analysis confirmed that self-compassion positively predicted spiritual well-being (<i>β</i> = 0.349, <i>t</i> = 4.349, <i>p</i> < 0.001), accounting for 11.2% of the total variance (<i>R</i>² = 0.112, <i>F</i> = 18.910, <i>p</i> < 0.001).</p><p><strong>Significance of results: </strong>Self-compassion is a critical internal resource for finding spiritual meaning amidst end-of-life stressors. Fostering compassionate attitudes can alleviate anomie and emotional burnout among caregivers. Palliative care nurses should integrate mindfulness-based self-compassion interventions into support programs to bolster caregiver well-being and enhance care quality.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e233"},"PeriodicalIF":2.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116627","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":"Spiritual self-care practice and mindfulness among patients with cancer: A cross-sectional study.","authors":"Asma Najmadini, Suad Dukhaykh, Wafaa Abed Ali Hattab, Juan Felipe Espinosa Cristia, Mansooreh Azizzadeh Forouzi, Mahlagha Dehghan","doi":"10.1017/S1478951526103745","DOIUrl":"https://doi.org/10.1017/S1478951526103745","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the correlation between spiritual self-care practices and mindfulness among cancer patients in southeast Iran.</p><p><strong>Methods: </strong>This descriptive, correlational, cross-sectional study was conducted on a convenience sample of 600 eligible cancer patients. Data were collected using three instruments: a demographic and clinical characteristics questionnaire, the Spiritual Self-Care Practice Scale, and the Relaxation, Meditation, and Mindfulness Trait Tracker (RMMtm 3.1). Data were analyzed using SPSS version 26, employing both descriptive and inferential statistical methods, including multivariate regression analysis.</p><p><strong>Results: </strong>The mean total score for spiritual self-care practice among cancer patients was 3.17 ± 1.15, which was above the questionnaire's midpoint. Mindful emotion had the highest mean score (3.78 ± 1.67), followed by mindful focus (3.20 ± 1.57) and mindful relaxation (3.14 ± 1.65). Multivariate regression analysis revealed that 63.9% of the variance in spiritual self-care was explained by variables including mindful emotion (<i>β</i> = 0.321, <i>p</i> < 0.001, 95% confidence interval [CI]: [0.122, 0.181]), mindful quiet (<i>β</i> = 0.213, <i>p</i> < 0.001, 95% CI: [0.065, 0.128]), and mindful transcendence (<i>β</i> = 0.163, <i>p</i> < 0.001, 95% CI [0.058, 0.139]). Income level, history of underlying disease, and disease stage also showed significant associations.</p><p><strong>Significance of the results: </strong>The study findings indicate a significant relationship between spiritual self-care practice and dimensions of mindfulness. Nurses can address patients' spiritual self-care practice needs by implementing the nursing process and empowering them through interventions that enhance mindfulness.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e249"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116658","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 avoidance paradox in palliative care: Extending terror management theory to multidisciplinary clinician resilience.","authors":"Igal Lifshits","doi":"10.1017/S1478951526103782","DOIUrl":"https://doi.org/10.1017/S1478951526103782","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e242"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070507","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":"Kerplunk.","authors":"Kate Murphy","doi":"10.1017/S1478951526103770","DOIUrl":"https://doi.org/10.1017/S1478951526103770","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"24 ","pages":"e243"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070486","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}