Palliative & Supportive Care最新文献

{"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":"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":"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":"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}

{"title":"Stress, mental health, and resources of palliative care professionals.","authors":"Isabelle Cuchet, Axelle Maneval, Michael Dambrun","doi":"10.1017/S1478951524002050","DOIUrl":"10.1017/S1478951524002050","url":null,"abstract":"<p><strong>Objectives: </strong>Palliative care (PC) professionals confront the suffering and mortality of their patients, adding to the conventional stressors related to work dynamics or personal life. However, the specific stressors inherent in end-of-life (EOL) care and their relation with the mental health of these professionals, remain inadequately explored. This study seeks to examine the respective roles of various stressors encountered by PC professionals and their associations with mental health. Additionally, it aims to elucidate the relationships between specific psychosocial factors (psychological resources or work environment perceptions) and mental health within the context of stress associated with PC.</p><p><strong>Method: </strong>An online questionnaire was developed and distributed to PC professionals in France (e.g., doctors, nurses, care assistants, psychologists). The questionnaire contained measures of stress experienced in the last 6 months (personal, professional, or EOL); measures of mental health; and measures of psychosocial factors (perceptions of work environment and psychological resources).</p><p><strong>Results: </strong>Three hundred and seventy-nine participants completed the entire questionnaire in November 2022. Among the various stress factors assessed, the accumulation of EOL care emerged as a robustly linked stressor to poorer mental health. In this specific context of EOL care stress, self-compassion and psychological flexibility are significantly related to well-being and mental health, even when other psychosocial factors related to the work environment are statistically controlled.</p><p><strong>Significance of results: </strong>This study is the first to highlight the main stressor affecting the well-being of PC professionals - the accumulation of EOL care - along with the key resources - psychological flexibility and self-compassion - that are associated with their well-being.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e34"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732314","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":"Communication training for effective Goals of Patient Care conversations in acute care: An integrative review of the literature.","authors":"Janie Brown, Phoebe Hu-Collins","doi":"10.1017/S1478951525000264","DOIUrl":"10.1017/S1478951525000264","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate and synthesize research that has investigated interventions to train registered health professionals to effectively communicate with patients in acute settings who are establishing their goals of care, to develop an understanding of current practices and their effectiveness.</p><p><strong>Design: </strong>Integrative review.</p><p><strong>Methods: </strong>Medline, Embase, PsycINFO, SCOPUS, CINAHL, and ProQuest, searched from the date each database was available to December 2023. Forty-seven (n = 47) research studies investigating interventions to train registered health professionals to effectively communicate with patients in acute settings who are establishing their goals of care were critically appraised for methodological quality using the Joanna Briggs Institute Quality Appraisal Framework. Minimum essential criteria and scores were agreed prior to appraisal.</p><p><strong>Results: </strong>Twenty-eight studies were excluded due to methodological quality. The 19 studies included comprised quasi experimental (n = 9), qualitative (n = 4), RCT (n = 2), text and opinion (n = 1), and mixed methods (n = 3). From these included studies 4 themes with embedded sub-themes were derived: (a) delivery of training programs, (b) clinician outcomes, (c) patient outcomes, and (d) system outcomes.</p><p><strong>Significance of the results: </strong>Communication training is essential and beneficial however its effectiveness depends on overcoming existing barriers, providing continuous learning opportunities, and embedding these into clinical practice. Addressing these factors will ensure that clinicians and healthcare organizations can improve patient and system outcomes. When clinicians and organizations prioritize regular, context-specific communication training, which promotes the use of conversation guides and available technologies, Goals of Patient Care conversations are more likely to be embedded in practice, promoting effective and patient-centered communication.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e81"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732309","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":"Talking about desire to die: Talking past each other? A framework analysis of interview triads with patients, informal caregivers, and health professionals.","authors":"Kathleen Boström, Thomas Dojan, Thessa Thölking, Leonie Gehrke, Carolin Rosendahl, Raymond Voltz, Kerstin Kremeike","doi":"10.1017/S1478951524002104","DOIUrl":"10.1017/S1478951524002104","url":null,"abstract":"<p><strong>Objectives: </strong>Up to 40% of seriously ill patients develop a (temporary) desire to die which can lead to requests for assisted dying. Health professionals often feel uncertain about addressing these topics, while informal caregivers may feel guilty and left out. Open and respectful communication proves beneficial. It remains unclear how this communication ideal realizes within the lived experience of all 3 parties. Therefore, we conducted in-depth analysis of communication strategies about desire to die from triangulated perspectives of patients, informal caregivers, and health professionals.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with purposefully sampled triads consisting of seriously ill patients, their respective informal caregivers and health professionals. Interviews were part of the qualitative evaluation of a 3-phase mixed-methods study on the effects of communication about desire to die on seriously ill patients. We followed a framework analysis approach to build communication types.</p><p><strong>Results: </strong>From the <i>N</i> = 13 patients, 54% suffered from oncological diseases. Health professionals (<i>N</i> = 13) were multiprofessional. Informal caregivers (<i>N</i> = 13) were partners, children, or another relation. All in all, we conducted <i>N</i> = 14 interview triads (<i>n</i> = 3 incomplete; <i>N</i> = 39 individual interviews).Four key themes emerged from analysis: (a) how open communication was perceived, (b) whether participants reported shared reality, (c) how they talked about death, and (d) their communication strategies.Ultimately, 3 communication types were inductively derived at from these key themes. Type 1 \"Between the Lines,\" type 2 \"Past each Other\" and type 3 \"Matter of Fact\" show differing expressions on the key themes, especially on (b) shared reality. Specific type characteristics produce suggestions for health professionals' communicative practice.</p><p><strong>Significance of results: </strong>Awareness of typical communication strategies is necessary to foresee potential pitfalls such as loss of information or acting on unchecked assumptions. To reduce distress and increase information flow, health professionals should actively approach informal caregivers for desire to die conversations.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e83"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693734","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":"Prognostic utility of Palliative Prognostic Index in advanced cancer: A systematic review and meta-analysis.","authors":"Si Qi Yoong, Hui Zhang, Dee Whitty, Wilson Wai San Tam, Wenru Wang, Davina Porock","doi":"10.1017/S1478951525000021","DOIUrl":"10.1017/S1478951525000021","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prognostic utility of Palliative Prognostic Index (PPI) scores in predicting the death of adults with advanced cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted. Six databases were searched for articles published from inception till 16 February 2024. Observational studies reporting time-to-event outcomes of PPI scores used in any setting, timing and score cutoffs were eligible. Participants were adults with advanced cancer residing in any setting. Random effects meta-analysis was used to pool hazard, risk, or odds ratios. Findings were narratively synthesized when meta-analysis was not possible.</p><p><strong>Results: </strong>Twenty-three studies (<i>n</i> = 11,235 patients) were included. All meta-analyses found that higher PPI scores or risk categories were significantly associated with death and, similarly, in most narratively synthesized studies. PPI > 6 vs PPI ≤ 4 (pooled adjusted HR = 5.42, 95% confidence intervals [CI] 2.01-14.59, <i>p</i> = 0.0009; pooled unadjusted HR = 5.05, 95% CI 4.10-6.17, <i>p</i> < 0.00001), 4 < PPI ≤ 6 vs PPI ≤ 4 (pooled adjusted HR = 2.04, 95% CI 1.30-3.21, <i>p</i> = 0.002), PPI ≥ 6 vs PPI < 6 (pooled adjusted HR = 2.52, 95% CI 1.39-4.58, <i>p</i> = 0.005), PPI ≤ 4 vs PPI > 6 for predicting inpatient death (unadjusted RR = 3.48, 95% CI 2.46-4.91, <i>p</i> < 0.00001), and PPI as a continuous variable (pooled unadjusted HR = 1.30, 95% CI 1.22-1.38, <i>p</i> < 0.00001) were significant predictors for mortality. Changes in PPI scores may also be useful as a prognostic factor.</p><p><strong>Significance of results: </strong>A higher PPI score is likely an independent prognostic factor for an increased risk of death, but more research is needed to validate the risk groups as defined by the original development study. Meta-analysis results need to be interpreted cautiously, as only 2-4 studies were included in each analysis. Clinicians and researchers may find this useful for guiding decision-making regarding the suitability of curative and/or palliative treatments and clinical trial design.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e80"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693708","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}