BMC Palliative Care最新文献

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Evaluation of using a graphic novel Vivian in nursing curriculum from the perspectives of nurse educators: a three-country qualitative study. 从护理教育工作者的角度评价绘本小说《薇薇安》在护理课程中的应用:一项三国质性研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-24 DOI: 10.1186/s12904-025-01907-y
Ashwini Deshmukh, Alison Gayton, Lisa Williams, Carina Werkander Harstäde, Jane Nicol, Tatiana Tavares, Susan Waterworth, Natalie Anderson, Merryn Gott, Ping Guo
{"title":"Evaluation of using a graphic novel Vivian in nursing curriculum from the perspectives of nurse educators: a three-country qualitative study.","authors":"Ashwini Deshmukh, Alison Gayton, Lisa Williams, Carina Werkander Harstäde, Jane Nicol, Tatiana Tavares, Susan Waterworth, Natalie Anderson, Merryn Gott, Ping Guo","doi":"10.1186/s12904-025-01907-y","DOIUrl":"https://doi.org/10.1186/s12904-025-01907-y","url":null,"abstract":"<p><strong>Background: </strong>Graphic novels - full-length stories published in comic-strip format are a proven method for putting student nurses 'into the shoes' of health service users and offer nurse educators an alternative to traditional modes of instruction. Their use can support the teaching of palliative care related topics, which remains a challenge in nurse education. This study aimed to explore the views and perspectives of nurse educators about how the graphic novel Vivian could be used to prepare undergraduate nursing students for palliative care and beyond.</p><p><strong>Methods: </strong>Focus groups and individual interviews were conducted with 12 nurse educators at universities in the United Kingdom, New Zealand and Sweden and analysed using thematic analysis.</p><p><strong>Results: </strong>Four themes were generated: (1) impact of visual storytelling, (2) arts-based learning in palliative care, (3) refinement of the graphic novel, (4) recommendations about future graphic novels. Participants noted Vivian's usefulness for teaching issues related to palliative care and the health care system, including gender inequities, ageing, and economic crises.</p><p><strong>Conclusions: </strong>There is scope to use arts-based learning when engaging audiences from diverse backgrounds. The educators stressed Vivian could help students think 'outside of the box' and stressed the importance of a teaching and learning approach that extended beyond textbooks to include other interactive forms. Future research is needed to adapt and refine the graphic novel by considering social and cultural contexts and evaluate how the graphic novel is implemented in nurse education across different settings and countries.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"270"},"PeriodicalIF":2.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence-based approaches for advance care planning: a scoping review. 基于人工智能的预先护理计划方法:范围审查。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-23 DOI: 10.1186/s12904-025-01827-x
Umut Arioz, Matthew John Allsop, William D Goodman, Suzanne Timmons, Kseniya Simbirtseva, Izidor Mlakar, Grega Mocnik
{"title":"Artificial intelligence-based approaches for advance care planning: a scoping review.","authors":"Umut Arioz, Matthew John Allsop, William D Goodman, Suzanne Timmons, Kseniya Simbirtseva, Izidor Mlakar, Grega Mocnik","doi":"10.1186/s12904-025-01827-x","DOIUrl":"https://doi.org/10.1186/s12904-025-01827-x","url":null,"abstract":"<p><strong>Background: </strong>Advance Care Planning (ACP) empowers individuals to make informed decisions about their future healthcare. However, barriers including time constraints and a lack of clarity on professional responsibilities for ACP hinder its implementation. The application of artificial intelligence (AI) could potentially optimise elements of ACP in practice by, for example, identifying patients for whom ACP may be relevant and aiding ACP-related decision-making. However, it is unclear how applications of AI for ACP are currently being used in the delivery of palliative care.</p><p><strong>Objectives: </strong>To explore the use of AI models for ACP, identifying key features that influence model performance, transparency of data used, source code availability, and generalizability.</p><p><strong>Methods: </strong>A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA-ScR guidelines. Electronic databases (Scopus and Web of Science (WoS)) and seven preprint servers were searched to identify published research articles and conference papers in English, German and French for the last 10 years' records. Our search strategy was based on terms for ACP and artificial intelligence models (including machine learning). The GRADE approach was used to assess the quality of included studies.</p><p><strong>Results: </strong>Included studies (N = 41) predominantly used retrospective cohort designs and real-world electronic health record data. Most studies (n = 39) focused on identifying individuals who might benefit from ACP, while fewer studies addressed initiating ACP discussions (n = 10) or documenting and sharing ACP information (n = 8). Among AI and machine learning models, logistic regression was the most frequent analytical method (n = 15). Most models (n = 28) demonstrated good to very good performance. However, concerns remain regarding data and code availability, as many studies lacked transparency and reproducibility (n = 17 and n = 36, respectively).</p><p><strong>Conclusion: </strong>Most studies report models with promising results for predicting patient outcomes and supporting decision-making, but significant challenges remain, particularly regarding data and code availability. Future research should prioritize transparency and open-source code to facilitate rigorous evaluation. There is scope to explore novel AI-based approaches to ACP, including to support processes surrounding the review and updating of ACP information.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"268"},"PeriodicalIF":2.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Narrative identity at the end of life: a qualitative analysis of dignity therapy interviews from an existential perspective. 生命终结时的叙事认同:存在主义视角下尊严治疗访谈的定性分析。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-23 DOI: 10.1186/s12904-025-01876-2
Pia Devuyst, Richard E Leiter, Aimee Milliken, Josef Jenewein, David Blum, Annina Seiler
{"title":"Narrative identity at the end of life: a qualitative analysis of dignity therapy interviews from an existential perspective.","authors":"Pia Devuyst, Richard E Leiter, Aimee Milliken, Josef Jenewein, David Blum, Annina Seiler","doi":"10.1186/s12904-025-01876-2","DOIUrl":"https://doi.org/10.1186/s12904-025-01876-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Confronting terminal illness and the prospect of death and dying can severely undermine an individual's sense of identity, meaning and purpose in life, leading to existential suffering, increasing hopelessness, depressive symptoms, and death anxieties.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study explored how narrative approaches can alleviate existential suffering, promote emotional healing, and consolidate identity for individuals confronted with death and dying. Specifically, the study aimed to (1) analyze dimensions of identity reflected in Dignity Therapy (DT) legacy documents from a randomized controlled trial, applying Ricoeur's framework of selfhood and identity; (2) deepen the understanding of existential suffering in relation to identity and its potential transformation into meaningful adaptation; and (3) synthesize these findings into a conceptual Model of Narrative Identity at the End of Life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty-two DT interviews were analyzed using MAXQDA software for qualitative data analysis. An inductive category development approach was employed to construct a three-tiered coding system capturing key dimensions of identity. Drawing on Ricoeur's framework of selfhood and identity, a hermeneutic and existential-phenomenological approach was employed to deepen understanding of the lived experiences and narrative reconstruction of self and identity in the context of vulnerability, suffering, loss, and the approaching end of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The identified dimensions of narrative identity included \"origin\", \"family\", \"movement\", \"societal\", \"work\", \"recreation\", \"disruption\", \"experience of the now\", \"feelings\", \"sense of self\", and \"future\". Analysis of patients' narratives yielded an in-depth understanding of existential suffering, as well as the contrasting experiences of authenticity, integrity, and wholeness at the end of life. Three core mechanisms emerged through which narrative work may mitigate existential suffering while reaffirming selfhood and identity: (1) cultivation healing connections and embracing hope; (2) the search for coherence and meaning-making; and (3) inner growth and transformation. These findings informed the development of a conceptual Model of Narrative Identity at the End of Life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Confronting death and dying is challenging, yet it may serve as a catalyst for increased self-awareness, self-growth, and transformation towards greater authenticity. Storytelling is a simple yet powerful tool for reclaiming narrative identity and alleviating existential suffering during a time marked by loss of control and powerlessness. Our Model of Narrative Identity at the End of Life illustrates how narrative work facilitates depth work, through which healing connections and hope can be embraced, enabling meaning-based adaptation to terminal illness, thereby empowering individuals to retain a sense of control, agenc","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"269"},"PeriodicalIF":2.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Palliative care conditions managed at home and self-reported challenges experienced by informal home-based caregivers in Rwanda: a qualitative study. 在卢旺达,在家管理的姑息治疗条件和非正式家庭护理人员自我报告的挑战:一项定性研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-23 DOI: 10.1186/s12904-025-01905-0
Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende
{"title":"Palliative care conditions managed at home and self-reported challenges experienced by informal home-based caregivers in Rwanda: a qualitative study.","authors":"Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende","doi":"10.1186/s12904-025-01905-0","DOIUrl":"https://doi.org/10.1186/s12904-025-01905-0","url":null,"abstract":"<p><strong>Introduction: </strong>A greater dependency on informal home-based caregivers to assist patients in their homes stems from Rwanda's rising palliative care needs and the burden of terminal illnesses. These caregivers play a critical role in addressing patients' physical and emotional needs and assisting with daily activities. However, in low-resource settings like Rwanda, limited attention has been given to understanding their lived experiences and the challenges they face. This study primarily aimed to explore the lived experiences and caregiving challenges of informal home-based caregivers providing palliative care. A secondary aim was to describe the range of life-threatening conditions being managed at home under their care.</p><p><strong>Methods: </strong>A qualitative descriptive study design was used to gain in-depth insights into the common palliative conditions managed at home, the caregiving practices employed, and the challenges experienced by informal caregivers. Twenty (20) participants were purposively selected from Nyamasheke and Rusizi districts in Rwanda, all of whom were providing home-based care to terminally ill patients. Data were collected through in-depth individual interviews and analyzed thematically using open coding in Atlas.ti software.</p><p><strong>Results: </strong>Informal home-based Caregivers managed an assortment of chronic and life-threatening illnesses, assuming challenging responsibilities like medication administration, wound care, mobility assistance, and emotional support. Analysis revealed a hierarchy of interrelated themes reflecting the multifaceted challenges of caregiving. These included Caregiver Burden, Financial and Material Constraints, and Structural and Systemic Challenges, each underscoring the intense physical, emotional, and logistical demands Informal home-based caregivers faced. Additional themes such as the Lived Experience of Illness, Coping Mechanisms, and Community and Informal Support highlighted how caregivers navigated these pressures, often with limited guidance or resources. Finally, the theme of Recommendations for Support emerged, offering insight into potential interventions to better assist caregivers. These themes were consistent across caregiving contexts, regardless of the specific illness involved.</p><p><strong>Conclusion: </strong>Unspecified wound cancer with multiple chronic diseases and advanced illnesses together with hypertension and stroke complications are among the major palliative conditions reported and managed at home. Informal home-based caregivers face substantial responsibilities and numerous challenges during the provision of palliative care at home. Caregiving in this context remains undervalued and under-supported. There is an urgent need for targeted support systems and policy reforms to strengthen home based caregiver to improve the quality of life of home-based caregivers in Rwanda.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"267"},"PeriodicalIF":2.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
LGBTIQ + people in palliative and end-of-life care contexts in Switzerland: a scoping review. LGBTIQ +人群在瑞士的姑息治疗和临终关怀环境:范围审查。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-22 DOI: 10.1186/s12904-025-01874-4
Michael J Deml, Clément Meier, Léïla Eisner, Tabea Hässler, Gaé Colussi, Jolanda Elmers, Philip Larkin, Claudia Gamondi
{"title":"LGBTIQ + people in palliative and end-of-life care contexts in Switzerland: a scoping review.","authors":"Michael J Deml, Clément Meier, Léïla Eisner, Tabea Hässler, Gaé Colussi, Jolanda Elmers, Philip Larkin, Claudia Gamondi","doi":"10.1186/s12904-025-01874-4","DOIUrl":"10.1186/s12904-025-01874-4","url":null,"abstract":"<p><strong>Context: </strong>Despite being a high-income country with universal health insurance coverage, disparities persist for LGBTIQ + people's mental health, substance use, sexual health, and physical health in Switzerland. Less research attention and public health efforts have focused on their palliative and end-of-life care (PEOLC) needs. This scoping review's objective is to explore, describe, and map the evidence related to PEOLC contexts for LGBTIQ + people in Switzerland.</p><p><strong>Methods: </strong>We conducted a scoping review in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and adhered to PRISMA-ScR guidelines. Inclusion criteria were defined using the Population-Concept-Context framework. We systematically searched peer-reviewed and grey literature published in English, German, French, and Italian in databases including APA PsychInfo, CINAHL, Cochrane, Embase, Google Scholar, Medline Ovid ALL, ProQuest, Web of Science, and various Swiss institutional repositories. Screening and data extraction were facilitated using Covidence, with titles and abstracts independently reviewed by at least two authors. Extracted data were organized to identify themes regarding patients' (anticipated) PEOLC needs, social support networks, healthcare professional (HCP) competencies, and existing initiatives or policies in Switzerland.</p><p><strong>Results: </strong>Our search yielded 454 potential references, from which 35 were included after screening and eligibility assessments. The majority (n = 32, 91.4%) were grey literature sources, reflecting limited peer-reviewed empirical research. Nine references presented empirically collected data directly related to LGBTIQ + populations and their social support or HCP experiences in ageing, palliative, or end-of-life contexts. Findings highlighted significant health disparities, elevated chronic disease prevalence, and persistent fears of discrimination among ageing LGBTIQ + people, negatively impacting healthcare access and engagement. Social networks primarily composed of chosen families underscored vulnerabilities related to informal caregiving and decision-making in PEOLC contexts. HCPs were generally reported as lacking sufficient competencies and preparedness for providing culturally sensitive and inclusive care. Initiatives designed to promote awareness-building and inclusion remain fragmented, underscoring the need for coordinated efforts to address gaps in care provision for LGBTIQ + people in Switzerland.</p><p><strong>Conclusions: </strong>A stronger empirical basis is needed to effectively respond to PEOLC needs for LGBTIQ + people in Switzerland. Collaborative research efforts will lay the groundwork to build trust and capacity between people, communities, and healthcare professionals.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"266"},"PeriodicalIF":2.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical appraise of inter-professional clinical practice guidelines for the spiritual care of patients with chronic illness: a systematic review. 对慢性疾病患者精神护理的跨专业临床实践指南的批判性评价:系统回顾。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-21 DOI: 10.1186/s12904-025-01908-x
Maryam Moghimian, Alireza Irajpour, Melika Shams
{"title":"Critical appraise of inter-professional clinical practice guidelines for the spiritual care of patients with chronic illness: a systematic review.","authors":"Maryam Moghimian, Alireza Irajpour, Melika Shams","doi":"10.1186/s12904-025-01908-x","DOIUrl":"10.1186/s12904-025-01908-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical guidelines for spiritual care play a crucial role in ensuring standardized care for patients with chronic illnesses. The development of these guidelines is complex and necessitates comprehensive evidence; therefore, a critical appraisal of existing guidelines is instrumental in summarizing and aiding the integration of evidence-based knowledge for healthcare providers, as well as in adapting clinical guidelines to local contexts. This study was designed and executed to address the question: \"What constitutes the structure and content of an appropriate guideline for inter-professional spiritual care for patients with chronic illness?\"&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This systematic review involved searching the databases of esteemed guideline developers and registrants, including the Agency for Healthcare Research and Quality, the International Guidelines Network, the National Institute for Health and Care Excellence, the National Guidelines Clearinghouse, the New Zealand Department of Health, the Scottish Inter-University Guidelines Network, the National Health Service, the Royal Flying Doctor Service, the National Consensus Project, the Comprehensive Cancer Centre/Netherlands, and various international databases such as Science Direct, PubMed, ProQuest, CINAHL, the Cochrane Library, Elsevier, and MEDLINE, covering the period from 2007 to 2024. The primary outcome of this research is the evaluated quality of the clinical guidelines. The quality of the guidelines that satisfied the inclusion criteria was evaluated using the Assessment of Guidelines, Research, and Evaluation II (AGREE II) tool by two teams of five inter-professional experts from fields including medicine, nursing, psychology, and spiritual counseling, along with two independent raters. Descriptive statistics were employed to quantify the quality of the guidelines. The secondary outcomes of this study included the titles of the clinical recommendations provided. Any contradictory or duplicate recommendations across the guidelines were compared. A narrative synthesis was also provided to elucidate the findings associated with each guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study critically evaluated 8 clinical guidelines. Utilizing the AGREE tool for the assessment, the guidelines titled Spiritual Care Matters, Spiritual Care guideline, and Religious and Spiritual Care of Patients achieved acceptable scores across all 6 domains of the tool and are strongly endorsed. The content review of these guidelines highlighted similar care practices, including methods for gathering a spiritual history, ways to offer spiritual support to patients through family and healthcare teams, effective communication principles with patients, and assisting patients in coping with grief and loss, emphasizing the importance of collaboration among medical, nursing, psychological, and spiritual professionals. The differing care approaches primarily focused on the re","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"265"},"PeriodicalIF":2.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Palliative care perceptions and well-being in nurses across healthcare settings: a comparative study from Reggio Emilia, Northern Italy. 姑息治疗的观念和福祉的护士在整个医疗环境:从雷焦艾米利亚,意大利北部的比较研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-21 DOI: 10.1186/s12904-025-01911-2
Chiara Bevini, Riccardo Mazzoli, Vanessa E Privitera, Mirta Rocchi, Lucia Palandri, Anna Laura Santunione, Tommaso Filippini
{"title":"Palliative care perceptions and well-being in nurses across healthcare settings: a comparative study from Reggio Emilia, Northern Italy.","authors":"Chiara Bevini, Riccardo Mazzoli, Vanessa E Privitera, Mirta Rocchi, Lucia Palandri, Anna Laura Santunione, Tommaso Filippini","doi":"10.1186/s12904-025-01911-2","DOIUrl":"10.1186/s12904-025-01911-2","url":null,"abstract":"<p><strong>Background: </strong>Nurses play a crucial role in palliative care. They are employed across all settings including home care and hospitals, with potential differences in the perception of care, emotional burden and coping strategies. This study aims to explore the experience of nurses within the palliative care network of an Italian province.</p><p><strong>Methods: </strong>From January to March 2024, we carried out a tailored survey on nurses from three palliative care settings in Reggio Emilia (Northern Italy), namely home care, hospice and hospital ward. We investigated emotional and occupational experience, knowledge of palliative care and organizational challenges.</p><p><strong>Results: </strong>The study included 39 nurses, nearly 90% of whom female. Of these, 20 worked in hospices, 10 in hospital wards and 9 in home care. In relation to occupational issues, most participants believed that newly-graduated nurses need additional training before working independently in both hospital ward and home care. Home care seemed adequate to palliative care demands for most participants, who nonetheless remained skeptical about work in hospice. Major emotional challenges included supporting patients' families and feeling alone during emergencies or during sensitive communication, especially in home care. Emotional support was reported as adequate by 61.5% of nurses. However, 35.9% felt it was insufficient, while two thirds of participants admitted to having cried in front of patients. Almost all nurses frequently witnessed patients' deaths and noted that patients' preferences for their place of death were sometimes overruled by caregivers or doctors.</p><p><strong>Conclusion: </strong>Palliative care nursing requires strong emotional resilience, effective communication and comprehensive clinical training. This is true regardless of the setting. Our findings suggest that nurses in home care may need additional organizational support to manage emergencies and reduce emotional stress. This could improve quality of care for patients as well as caregivers, and reduce burnout risk in healthcare professionals in the palliative care network.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"264"},"PeriodicalIF":2.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges in opioid therapy implementation: national survey of palliative care consultation services. 阿片类药物治疗实施的挑战:姑息治疗咨询服务的全国调查。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-20 DOI: 10.1186/s12904-025-01921-0
Evelyn Mueller, Susanne Gahr, Annette Schnell, Eva Schildmann, Christopher Boehlke, Carmen Roch
{"title":"Challenges in opioid therapy implementation: national survey of palliative care consultation services.","authors":"Evelyn Mueller, Susanne Gahr, Annette Schnell, Eva Schildmann, Christopher Boehlke, Carmen Roch","doi":"10.1186/s12904-025-01921-0","DOIUrl":"10.1186/s12904-025-01921-0","url":null,"abstract":"<p><strong>Background: </strong>Palliative care consultation services in hospitals can improve symptom control in patients with advanced illness by recommending or prescribing WHO step III opioids. However, effective treatment depends on the attending ward team which implements these therapies. While deviations from the opioid therapy recommended by the palliative care service and also treatment errors are often an issue in everyday life, there is no current data on the extent of the problem. This study explored the experiences of palliative care consultation services with the implementation of opioid recommendations by the attending ward team.</p><p><strong>Methods: </strong>The questionnaire was developed through a multi-step process, including e.g. literature analysis and pre-testing with cognitive interviews. A closed national online survey was conducted via the SoSci Survey platform. All palliative care consultation services registered with the German Association for Palliative Medicine were invited to participate in November 2024, with a reminder sent three weeks later.</p><p><strong>Results: </strong>The survey was fully completed by 39 of 85 consultation services (response rate: 46%; 21 university, 18 general hospitals). Thirty-one consultation services provide recommendations for opioids, eight provide prescriptions. Most (23 of 39) reported a rather high or very high need for improvement in implementing opioid recommendations (4-point Likert-scale, very low - very high). Common deviations included \"no implementation at all,\" \"lower dose,\" and \"non-implementation of medications to prevent side effects.\" \"Inexperience or reservations about opioid therapy among attending ward staff\" was the most frequently cited reason, named by 35 of 39 palliative care consultation services as occurring \"sometimes\" or \"often\" (5-point Likert-scale, \"(almost) never\" - \"(almost) always\"). Participants highlighted need for improvement in regard to symptom assessment, prescribing and use of PRN (pro re nata; on demand) medication, continuity of opioid therapy at discharge, and opioid treatment in the dying phase. Consultation services providing opioid recommendations reported significantly more frequent deviations from recommendations and a greater need for improvement compared to those prescribing opioids.</p><p><strong>Conclusion: </strong>Despite a 46% response rate, limiting generalizability, the frequent reporting of collaboration challenges between palliative care consultation services and attending ward teams regarding opioid-based symptom control highlights a relevant problem. Targeted training could improve implementation and symptom management.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"262"},"PeriodicalIF":2.5,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Dementia as a predictor of palliative care: uncovering patient patterns based on German claims data. 更正:痴呆作为姑息治疗的预测指标:基于德国索赔数据揭示患者模式。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-20 DOI: 10.1186/s12904-025-01898-w
Elena Rakuša, Constantin Reinke, Gabriele Doblhammer, Lukas Radbruch, Matthias Schmid, Thomas Welchowski
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引用次数: 0
How does the general public perceive hospice and palliative care? -an empirical study from China. 公众如何看待安宁疗护和缓和疗护?——来自中国的实证研究。
IF 2.5 2区 医学
BMC Palliative Care Pub Date : 2025-10-17 DOI: 10.1186/s12904-025-01891-3
Zhousiqi Tang, Yi Fan, Zhuojun Ye, Yuhan Lu, Xiaoyu Zhang, Youyang Tang, Limei Jing
{"title":"How does the general public perceive hospice and palliative care? -an empirical study from China.","authors":"Zhousiqi Tang, Yi Fan, Zhuojun Ye, Yuhan Lu, Xiaoyu Zhang, Youyang Tang, Limei Jing","doi":"10.1186/s12904-025-01891-3","DOIUrl":"10.1186/s12904-025-01891-3","url":null,"abstract":"<p><strong>Context: </strong>Global aging and rising chronic disease burden have made hospice and palliative care (HPC) a healthcare priority. China has initiated three rounds of HPC pilot programs covering two-thirds of its cities, yet public utilization remains low. Understanding public knowledge, attitude, and preference (KAP) toward HPC is essential to overcoming adoption barriers and fostering acceptance.</p><p><strong>Objectives: </strong>To empirically evaluate public KAP for HPC, pinpoint influencing factors, and offer targeted strategies to address challenges.</p><p><strong>Methods: </strong>This cross-sectional study assessed public KAP using the culturally adapted Public Knowledge, Attitude, and Preference of HPC Scale (P-KAPHPCs). Regression analysis was applied to identify factors associated with KAP. A structural equation model was constructed to test their interrelationship.</p><p><strong>Results: </strong>Among all the respondents, the mean score for HPC knowledge was 7.47 ± 2.14, with 41.10% of the respondents could explain HPC. Educational level and household income were associated factors of knowledge (p < 0.05). The overall attitude mean score rate was 84.18%. Public attitude toward end-of-life (EOL) arrangements for terminally ill patients was significantly influenced by age, attitude toward one's own EOL care were affected by educational level (p < 0.05). The majority (67.80%) declined life-sustaining treatment (LST), with preference linked to gender, occupation, experience of witnessing a patient's EOL process, primary family decision-makers, and family size (p < 0.05). Most respondents (47.30%) preferred home as the place for the EOL care. Structural equation modeling analysis showed that knowledge was positively associated with attitude (β = 4.97, p < 0.001) and knowledge was positively associated with preference (β = 0.22, p < 0.001).</p><p><strong>Conclusions: </strong>The public attitude toward HPC is generally positive, though there is a need to improve the quality of public knowledge, and preference varies. Knowledge has a positive influence on both attitude and preference. Traditional cultural values and ethics sometimes create conflicts in HPC decision-making. Therefore, it is recommended to strengthen HPC education, enhance legal protections for advance care planning (ACP) and advance directives (AD), introduce culturally appropriate family consensus communication tools, and establish a home-community hybrid care model.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"261"},"PeriodicalIF":2.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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