Palliative & Supportive Care最新文献

{"title":"Remembrance programs in pediatric care: Transforming grief into community resilience.","authors":"Rikas Saputra, Raja Rahima Munawarah Raja Ahmad, Isnaria Rizki Hayati, Neni Noviza, Yenni Lidyawati","doi":"10.1017/S1478951525100679","DOIUrl":"10.1017/S1478951525100679","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e142"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838262","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":"Refractory symptoms and end of life midazolam use in cancer patients, a single center experience.","authors":"Anna-Maria Tolppanen, Annamarja Lamminmäki, Enni Järvenpää, Vesa Kataja, Kristiina Tyynelä-Korhonen","doi":"10.1017/S1478951525100461","DOIUrl":"https://doi.org/10.1017/S1478951525100461","url":null,"abstract":"<p><strong>Objectives: </strong>Cancer patients often suffer from refractory symptoms near death. The use of sedatives aims to relieve suffering caused by these symptoms. The practice varies broadly. The aim of this study was to evaluate the role and trends of midazolam use in cancer patients dying in a university hospital oncology ward.</p><p><strong>Methods: </strong>The study population of this retrospective registry-based study consists of patients who died in a university hospital oncology ward in Eastern Finland in 2010-2018 (n = 639). Information about treatment decisions, midazolam use, and background factors were gathered.</p><p><strong>Results: </strong>During the study period, 14.7 % of the patients dying in the ward received midazolam with sedative intent prior to death. 4.7 % (n = 30) of the whole study population had continuous infusion and the rest of the midazolam use was one or multiple single doses. Documented discussion of possible palliative sedation (PS) use was found in almost one third of all patients. Out of those, eventually receiving midazolam with sedative intent, two thirds had had this discussion. The most common symptoms leading to midazolam were dyspnea, pain, and delirium. In continuous use the median midazolam infusion rate was 4.0 mg/h. The continuous infusion started median of 23.25 h and multiple single doses 19 h before death. If only one dose of midazolam was needed, it was given median of 30 minutes prior to death and the most common symptom was dyspnea. Those who received midazolam were more likely to be younger (<i>p = 0.003</i>) and had had a palliative outpatient clinic visit (<i>p = 0.045</i>).</p><p><strong>Significance of results: </strong>This is the first study to report the trends and practices of midazolam use for refractory symptoms in Finland. Midazolam was used for approximately every 7^th dying cancer patient. Applying midazolam was supported by a history of palliative clinic visits and younger age.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e138"},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800624","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 - CORRIGENDUM.","authors":"Yi-Qi Wangliu, Run-Ping Che","doi":"10.1017/S1478951525100357","DOIUrl":"https://doi.org/10.1017/S1478951525100357","url":null,"abstract":"","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e140"},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795858","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":"Validity and reliability of the Turkish version of the peace, equanimity, and acceptance in the cancer experience (PEACE) scale.","authors":"Ömer Ödek, Mumin Savaş, Hakan Çelik, Gönül Taşcı, Ender Doğan, Handan Zincir","doi":"10.1017/S1478951525100588","DOIUrl":"https://doi.org/10.1017/S1478951525100588","url":null,"abstract":"<p><strong>Objectives: </strong>This study sought to examine the validity and reliability of the Turkish adaptation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) scale. The primary objective was to evaluate the scale's psychometric properties in measuring acceptance and coping among cancer patients.</p><p><strong>Methods: </strong>The study included 90 cancer patients who completed the 12-item PEACE scale. The scale consists of two distinct subscales: the 5-item Peaceful Acceptance subscale and the 7-item Struggle With Illness subscale. Reliability was examined using Cronbach's alpha and test-retest reliability (<i>r</i> = 0.916). Content validity was assessed using the content validity index (CVI = 0.84). Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to examine the underlying factor structure and evaluate model fit indices.</p><p><strong>Results: </strong>The internal consistency for both subscales was satisfactory (Cronbach's α = .78 for both). EFA indicated that the two subscales explained 53.169% of the total variance. CFA substantiated the two-factor model, demonstrating adequate model fit indices (χ²/df = 1.689,Root Mean Square Error of Approximation = 0.088). These findings collectively establish the Turkish version of the PEACE scale as a psychometrically sound tool.</p><p><strong>Significance of results: </strong>The PEACE scale is a valid and reliable instrument for assessing levels of acceptance and coping in cancer patients. Its use can help healthcare professionals better understand patients' emotional states and guide interventions aimed at improving their quality of life.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e139"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785625","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":"Total suffering and will to live in persons with life-limiting diseases: Results from an Iberian multicenter study.","authors":"Miguel Julião, Bárbara Antunes, Carolina Simões, Maria Ana Sobral, André Oliveira, Carla Melo, Marco Mendonça, Milene Mendonça Lima, Giovanni Cerullo, Ana Carrancha, Duarte da Silva Soares, Daniela Artilheiro, Maria de Lurdes Pradinhos, Esperanza Begoña Garcia Navarro, Sonia García Navarro, Rosa Pérez Espina, Mathieu Bernard, Bianca Sakamoto Ribeiro Paiva, Marco Antonio de Oliveira, Harvey Max Chochinov, Eduardo Bruera","doi":"10.1017/S1478951525100278","DOIUrl":"10.1017/S1478951525100278","url":null,"abstract":"<p><strong>Objectives: </strong>The concept of total suffering is widely recognized in palliative care (PC), encompassing a range of interconnected and complex factors that collectively shape the evolving and individualized experience of a patient's illness journey. Studies on will to live (WtL) in terminally ill patients have demonstrated its variability over time and various factors that influence these changes.</p><p><strong>Methods: </strong>To objectively investigate the concept of total suffering and WtL; including their fluctuation over time and associations with sociodemographic, clinical, physical, and psychological symptoms in a sample of individuals with life-limiting conditions receiving PC. This multicenter Iberian study involved 3 centers in Portugal and 1 in Spain. A total of 107 individuals with life-limiting conditions consented to participate. To capture the dynamic and multifaceted components of total suffering, we had each participant completed the Edmonton Symptom Assessment Scale (ESAS) along an additional WtL visual analogue once daily over a 30-day period.</p><p><strong>Results: </strong>WtL demonstrated various patterns over time. While some patterns reflected relative stability, other demonstrated substantive fluctuation during the course of illness. Significant correlations were observed between WtL and all other ESAS items. Moderate positive correlations were found between WtL and total ESAS score and its physical and psychological sub-scores. Spearman's correlation coefficients between all physical and psychosocial items on the ESAS were statistically significant across all 45 correlations performed, with only 5 showing moderate strength; the remaining correlations were weaker.</p><p><strong>Significance of results: </strong>Evidence-based understanding of WtL is critical to improving care for patients who experience suffering toward end-of-life and their families. Further research is needed to inform and refine interventions targeting total suffering.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e137"},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754878","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":"Expressive writing interventions in patients with cancer: A scoping literature review.","authors":"Jowan Watson, Cynthia S Peng, Marie Desir, Manfred Nathan Mate-Cole, Hermioni Amonoo","doi":"10.1017/S1478951525100394","DOIUrl":"10.1017/S1478951525100394","url":null,"abstract":"<p><strong>Background: </strong>Expressive writing interventions (EWIs) are associated with important psychological and physical outcomes in patients with cancer. However, EWIs have not been widely integrated into routine psychosocial care of cancer populations. A review of the current literature on EWIs' impact on the cancer patient experience, including qualitative analyses of patient perspectives, will increase our understanding of barriers and facilitators to adoption in clinical settings.</p><p><strong>Objectives: </strong>To bridge existing gaps in the literature by examining quantitative and qualitative studies on EWIs for patients with cancer. To present recent data examining the benefits of EWI's for patients with cancer.To provide strategies for clinicians engaging in EWI's for their patients.</p><p><strong>Methods: </strong>Informed by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we completed a scoping review of relevant quantitative and qualitative articles published from 2015 to 2025 to assess the impact of EWIs on health-related outcomes (e.g., physical symptoms and quality of life [QOL]) as well as approaches to improve their use in patients with cancer.</p><p><strong>Results: </strong>Of the 28 studies with 3527 patients that we analyzed, 24 were quantitative and 4 were qualitative. Most studies were conducted in the USA (42.8%) or China (28.6%) and included patients with breast cancer (71.4%) or only included women (71.4%). Of the patients in the studies, 46.8% identified as White, 42.8% as Asian, 5.5% as Black, and 4.5% as Latino. Twenty-one of the quantitative studies found that EWIs were positively associated with cancer patients' QOL and/or physical health outcomes. Of the 4 qualitative studies, themes of narrative reconstruction, cultural disclosure norms, and intervention delivery format emerged. The characteristics of EWI methods can be tailored to maximize therapeutic benefits through cultural adaptation, timing, and privacy.</p><p><strong>Significance of results: </strong>Despite promising associations between EWIs and health-related outcomes in patients with cancer, EWIs for cancer populations are heterogeneous and randomized clinical trials are limited. Larger trials that establish the efficacy of EWIs in diverse cancer populations are warranted.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e132"},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676170","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":"Formative evaluation of an employee-driven approach to improve care in the dying phase in hospitals.","authors":"Sophie Meesters, Sukhvir Kaur, Viola Milke, Christin Herrmann, Aneta Schieferdecker, Nikolas Oubaid, Karin Oechsle, Holger Schulz, Holger Pfaff, Raymond Voltz, Kerstin Kremeike","doi":"10.1017/S1478951525100400","DOIUrl":"https://doi.org/10.1017/S1478951525100400","url":null,"abstract":"<p><strong>Objectives: </strong>The hospital setting is often perceived as slow to change. While employee-driven approaches offer a promising alternative to traditional top-down methods, guidance is limited. This study provides a description and formative evaluation of an employee-driven working group (WG) approach to tailor ward-specific measures to improve care in the dying phase. The aim is to evaluate the WG process and offer practical insights for transferability to other hospitals.</p><p><strong>Methods: </strong>Formative mixed-methods evaluation of a WG process to tailor ward-specific evidence-informed measures on 10 wards outside specialized palliative care at 2 German medical centers. To analyze factors relevant for the WG process, the <i>Consolidated Framework for Implementation Research 2.0</i> was applied. Data included baseline evaluation (medical record analysis, staff survey and focus groups, informal caregiver interviews), WG protocols, and an online survey with WG participants.</p><p><strong>Results: </strong>Multiprofessional WGs were established on all hospital wards, with an average of 7 meetings per ward within 1 year and 4 participants per meeting. Adapting the process to participants' wishes and needs were crucial, particularly regarding the desired degree of external input. We identified 4 barriers (e.g. declining participation, institutional limits) and 7 facilitators (e.g. involvement of staff in leading positions, multiprofessional composition). The WGs tailored 34 measures, e.g. team meetings to improve communication within the team. Participants' views were generally positive: 91% felt able to share their thoughts, 66% were satisfied with the outcome, and 77% would participate again.</p><p><strong>Significance of results: </strong>The employee-driven approach was feasible and useful for tailoring ward-specific measures. However, integrating top-down elements proved to be beneficial. The identified barriers and facilitators provide insights for transferring an employee-driven approach to other hospitals to improve care in the dying phase outside specialized palliative care settings.</p><p><strong>Clinical trial registration: </strong>The study was registered in the German Clinical Trials Register (DRKS00025405).</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e135"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660802","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":"Empower GBM: A pilot study of a patient-caregiver supportive intervention for patients with glioblastoma.","authors":"Karena Leo, Laura S Porter, Jodie Lisenbee, Katherine Ramos","doi":"10.1017/S1478951525100436","DOIUrl":"10.1017/S1478951525100436","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this article is to develop and pilot test a new supportive care intervention, Empower GBM, designed for patients with glioblastoma and their family caregivers to reduce psychological distress and improve quality of life.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with patients diagnosed with glioblastoma and their caregivers to obtain information about their experiences and needs in coping with glioblastoma. We also gathered their feedback about the supportive care intervention we were proposing (Phase I). Following Phase I, we conducted a single-arm pilot to evaluate the feasibility and acceptability of the 6-session intervention (Phase II).</p><p><strong>Results: </strong>During interviews (<i>N</i> = 14), patients and caregivers reported having the most difficulty and distress surrounding disease progression and management, maintaining dignity and autonomy, negotiation of roles and responsibilities, and maintaining connection with one another. Participants endorsed that an intervention like Empower GBM with skills focused on managing symptoms to increase independence, increasing caregiving efficacy and support, and coping with dyadic challenges would be of potential benefit. Preliminary results from the pilot study (<i>N</i> = 11) suggested the intervention is both feasible (e.g., 82% completed all 6 sessions and post-treatment surveys) and acceptable (88.9% reported a mean satisfaction score of 3 or higher; mean score of 3.57/4.0). Improvements in psychological outcomes, functional well-being, and caregiving efficacy from pre- to post-treatment survey results suggested the potential benefits of the intervention.</p><p><strong>Significance of results: </strong>We developed a novel supportive care intervention informed by the dyadic illness model that is designed to meet the individual and interpersonal needs of patients with glioblastoma and their caregivers. Unique features include its flexibility to be delivered to patients and/or their family caregivers individually or jointly, while providing skills and strategies to meet the needs of both individuals and the dyad as the unit of care in coping with glioblastoma.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e136"},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attachment insecurities, continuing bonds, and grief among family caregivers of terminally ill cancer patients: A longitudinal study.","authors":"Wan-Lin Lee, Yaw-Sheng Lin, Emily T Liu, Chih-Tao Cheng, Shu Kao","doi":"10.1017/S1478951525100412","DOIUrl":"https://doi.org/10.1017/S1478951525100412","url":null,"abstract":"<p><strong>Objectives: </strong>The present study investigated the associations among pre-loss grief, relational closeness, attachment insecurities, continuing bonds (CBs) with the deceased person, and the post-loss adjustment of the caregivers of patients with terminal cancer.</p><p><strong>Methods: </strong>Data were collected in the hospice department of a cancer center in northern Taiwan; 66 bereaved caregivers completed both pre-loss and post-loss scales. The measures used for the pre-loss phase included the Hogan Grief Reaction Checklist (HGRC; pre-loss version), the Experiences in Close Relationship - Relationship Structures Questionnaire (ECR-RS), and the Inclusion of Other in the Self Scale. The measures used 6-12 months after the death of the patients were the HGRC (post-loss version) and the Continuing Bond Scale (CBS).</p><p><strong>Results: </strong>Pre-loss grief and externalized CBs had a significant impact on the amount of post-loss grief, indicating that pre-loss grief and ongoing transformation of relationships after patients' death may be predictors of caregivers' post-loss grieving.</p><p><strong>Significance of results: </strong>This longitudinal study provides preliminary evidence that pre-loss grief and the relationship with the patient are key to caregivers' post-loss adjustment, suggesting that psychosocial intervention focuses on caregivers' pre-loss grief and relationship quality with the patient during palliative care.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e131"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660799","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":"Effects of web-based interventions on cancer caregivers' burden and quality of life: A systematic review and meta-analysis.","authors":"Myoungsuk Kim, Kelly R Tan, Lorinda Adaire Coombs","doi":"10.1017/S1478951525100370","DOIUrl":"10.1017/S1478951525100370","url":null,"abstract":"<p><strong>Objectives: </strong>As cancer incidence and survival rates rise, caregivers responsible for providing diverse support face increased burden and reduced quality of life (QoL). Although research on web-based interventions for this group is expanding, the impact of these interventions on caregiver burden and QoL remains unclear. This study aims to investigate the effects of web-based interventions on the caregiver burden and QoL of caregivers of patients with cancer.</p><p><strong>Methods: </strong>Searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsycINFO from database inception to 10 June 2024. Two reviewers independently assessed each study and extracted data. The risk-of-bias in the studies was evaluated using Cochrane's Risk-of-Bias tool for randomized controlled trials. The intervention effects were calculated using R package Meta version 4.0.3, utilizing standardized mean differences (SMD; Hedge's ĝ) to calculate pooled effect sizes with 95% confidence intervals (CI). Publication bias assessment and sensitivity analysis were conducted to ensure the robustness of the results.</p><p><strong>Results: </strong>We reviewed 13 randomized controlled trials; our analysis indicated a small effect size of web-based interventions on caregiver burden (SMD = -0.19, 95% CI: -0.36 to -0.01). However, sensitivity analysis concluded that the effect was very small or nearly absent. Additionally, there was no statistically significant effect on QoL (SMD = 0.15, 95% CI: -0.05 to 0.36).</p><p><strong>Significance of results: </strong>Web-based interventions did not significantly reduce caregiver burden or improve caregivers' QoL. To improve caregiver burden and QoL in the future, comprehensive and tailored web-based interventions for this population are needed.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":"23 ","pages":"e134"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660800","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}