BMC Palliative Care最新文献

{"title":"Setting the stage for communication skills training in Rwandan cancer care: a qualitative study of local priorities and key contextual factors.","authors":"Pacifique Uwamahoro, Ignace Girukubonye, Jean Bosco Bigirimana, Cyprien Shyirambere, Katherine Van Loon, Rebecca L Sudore, Justin J Sanders, Vincent K Cubaka, Rebecca J DeBoer","doi":"10.1186/s12904-025-01879-z","DOIUrl":"10.1186/s12904-025-01879-z","url":null,"abstract":"<p><strong>Background: </strong>The burden of advanced cancer is rising in Africa. Cancer care involves complex conversations between providers, patients, and families. International guidelines recommend communication skills training for all cancer care providers, and patient-provider communication and training needs are strongly influenced by culture. As oncology and palliative care capacity expand in African settings such as Rwanda, participatory research is needed to culturally adapt communication skills training to best fit local contexts.</p><p><strong>Methods: </strong>Guided by the Cultural Adaptation Process model, this study aimed to set the stage for adaptation and implementation of serious illness communication skills training in the Rwandan context. We conducted focus group discussions with interdisciplinary cancer care providers at Butaro Hospital in Rwanda to understand their communication training priorities and describe pertinent contextual factors. The focus groups were audio-recorded, transcribed, and analyzed using the framework method of thematic analysis.</p><p><strong>Results: </strong>A total of 17 cancer care providers participated in one of three focus groups, including six physicians, seven nurses, two psychologists, and two social workers. Participants identified delivering bad news and responding to emotion as the most challenging aspects of clinical communication and the highest priorities for training. They expressed concerns about the psychological toll of difficult conversations on providers, advocating for future trainings to include burnout mitigation strategies. Participants described several key contextual factors that should inform adaptations of communication training for Rwandan cancer care. These include barriers common to low-resource settings as well as several local assets: interdisciplinary collaboration, dedicated clinical psychologists, group counseling sessions, peer support among patients, and strong community networks. Several findings will be directly applied to the design of an initial pilot communication training in Rwanda. Areas requiring further investigation and opportunities to broaden the scope of communication interventions beyond patient-provider encounters were identified.</p><p><strong>Conclusions: </strong>This study sets the stage for adapted communication skills training in Rwanda that is guided by the priorities and recommendations of local cancer care providers. Several pertinent cultural and structural factors were identified that are common across diverse African settings. Therefore, our training adaptations, as well as the methodology used for adaptation, have the potential for widespread reach.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"240"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201654","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}

{"title":"\"Invisible, you are letting go of a lot, and you would do it again\": a qualitative interview study of the existential thoughts, feelings, and agency of healthy siblings with a sister or brother in palliative care in Denmark.","authors":"Sara Stage Voetmann, Dorte Ejg Jarbøl, Jens Søndergaard, Dorte Toudal Viftrup","doi":"10.1186/s12904-025-01858-4","DOIUrl":"10.1186/s12904-025-01858-4","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"239"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201656","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}

{"title":"Pain management in a patient with intestinal failure in the palliative care setting: case report.","authors":"Adarsh Das, Jayamangala Sampath Kondasinghe","doi":"10.1186/s12904-025-01878-0","DOIUrl":"10.1186/s12904-025-01878-0","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"241"},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201658","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}

{"title":"Efficacy of the \"PalliActive Caregivers\" intervention for caregivers of patients with cancer in palliative care.","authors":"Mauricio Arias-Rojas, Edith Arredondo-Holguín, Sonia Carreño-Moreno","doi":"10.1186/s12904-025-01885-1","DOIUrl":"10.1186/s12904-025-01885-1","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"235"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193581","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}

{"title":"Working with Parry sound area local Canadian First Nations to describe a good death and ensure cultural sensitivity at the end-of-life.","authors":"C-M Latcu, L Allen, N Forfar, M Partyka-Sitnik, D Pegahmagabow, C Tryon, J Smith-Turchyn, J L Davis","doi":"10.1186/s12904-025-01880-6","DOIUrl":"10.1186/s12904-025-01880-6","url":null,"abstract":"<p><p>This study explores the culturally sensitive palliative and end-of-life care within First Nations communities in the Parry Sound area: Shawanaga, Wasauksing, and Moose Deer Point First Nations communities in Canada. The legacy of colonialism, particularly the Indian Act of 1876, has significantly disrupted Indigenous health practices, contributing to mistrust in Western healthcare systems. This research addresses gaps in culturally appropriate palliative and end-of-life care by identifying how First Nations communities define a \"good death\" and how Western healthcare providers can respect and integrate these traditions, particularly in rural and remote communities. Using a community-driven approach, three sharing sessions were conducted with 19 participants, exploring their insights into palliative and end-of-life care. Data analysis revealed five key themes: (1) Family members as primary caregivers, (2) Local healthcare providers support family in palliative and end-of-life care, (3) Make 'final journey' at home, (4) Community (the 'clan family') is involved in palliative and end-of-life care, and (5) Individual wishes for end-of-life care vary and should be followed by healthcare providers. These findings emphasize the role of family, community, and spiritual beliefs in shaping a \"good death.\" The study calls for healthcare providers to incorporate cultural sensitivity, support home-based care, and collaborate with community leaders to bridge gaps between Western medicine and Indigenous traditions. Recommendations include fostering trust with healthcare providers, ensuring care aligns with cultural values, and enhancing collaboration between healthcare systems and Indigenous communities. This research contributes to improving palliative and end-of-life care for First Nations communities by promoting culturally safe, person-centred care practices.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"234"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193601","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}

{"title":"Managing diffuse intrinsic Pontine glioma (DIPG) through japan's pediatric home medical care (PHMC) system, originally designed for medically complex children.","authors":"Tomoo Osumi, Miyuki Yamamoto, Naoko Inaba, Izumi Iikura, Masahiro Ikari, Hirotoshi Maeda","doi":"10.1186/s12904-025-01887-z","DOIUrl":"10.1186/s12904-025-01887-z","url":null,"abstract":"<p><strong>Background: </strong>Diffuse Intrinsic Pontine Glioma (DIPG) is one of the most aggressive and fatal pediatric brain tumors, with limited treatment options and a survival of less than two years. Therefore, palliative care plays a crucial role throughout the disease trajectory, yet home-based data remain scarce, particularly for pediatric patients. This study aims to describe the implementation of a pediatric home medical care system (PHMC) in Japan for children with DIPG, focusing on symptom management, care delivery patterns, and quality of life.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 22 children with DIPG who received PHMC services from a single clinic in Tokyo between 2017 and 2024. Data were extracted from detailed medical records kept by physicians during home visits. We examined demographics, disease progression, end-of-life symptoms, medications (opioids, steroids), respiratory support, nutritional care, and frequency of home visits.</p><p><strong>Results: </strong>The average age at diagnosis was 7.9 years, with a mean overall survival of 14.2 months. Most children (91%) died at home. Major end-of-life symptoms included dysphagia, paralysis, respiratory distress, and convulsions. Steroids and morphine were the primary agents used for symptom relief. High Flow Nasal Cannula (HFNC) was used in 59% of cases. The physicians' visiting frequency increased significantly toward the terminal phase, with a maximum of 14 visits per month. Many children continued to attend school or engage in outings until shortly before death.</p><p><strong>Conclusions: </strong>The Japanese PHMC system, with physicians' home visiting, enabled comprehensive, hospital-level palliative care at home for children with DIPG. This model may serve as a framework for enhancing pediatric end-of-life care, especially where direct physician involvement is feasible. Our findings suggest the importance of structured, multidisciplinary home care systems in maintaining quality of life for children with terminal conditions.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"236"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193638","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}

{"title":"Healthcare needs of patients with metastatic cancer and impacts of social vulnerability: a multicentric cross-sectional study in France.","authors":"Marine Sahut d'Izarn, Pascale Vinant, Carole Bouleuc, Ingrid Joffin, Bruno Vincent, Claire Barth, Laure Serresse, Aurore Codogno, Florence Behal, Lucie Ya-de Rauglaudre, Madalina Jacota, Malamine Gassama, Matthieu de Stampa","doi":"10.1186/s12904-025-01882-4","DOIUrl":"10.1186/s12904-025-01882-4","url":null,"abstract":"<p><strong>Context: </strong>Understanding the healthcare needs of patients with metastatic cancer is necessary for reducing symptom burden and optimizing supportive care interventions. Little is known about the impact of social vulnerability on unmet patient needs and healthcare resources utilization in a healthcare system with universal health coverage.</p><p><strong>Objectives: </strong>This study aimed to describe the healthcare needs and resource utilization of patients with metastatic cancer in France, while also examining how social vulnerability influences these factors.</p><p><strong>Methods: </strong>We conducted an observational, multicentric, cross sectional study concerning inpatients and outpatients with incurable metastatic cancer. We assessed quality of life (EORTC-QLQC30), supportive care needs (SCNS-SF34), social vulnerability (EPICES score), and healthcare utilization.</p><p><strong>Results: </strong>361 patients were included; 67.9% had a good performance status (0 or 1), and 59.4% were undergoing their 1st or 2nd line of systemic treatment. They had numerous moderate to severe symptoms including fatigue (75.9%), sleep disorders (61.2%), dyspnea (56.4%), and pain (54.4%). The most important unmet needs were psychological needs (51.4% of moderate/severe needs). 26.8% of patients had visited the emergency room and 38.5% had been admitted to the hospital in the past three months for a cancer complication. 40.3% of patients were socially vulnerable. In multivariate analysis, patients with high social vulnerability had significantly higher cachexia, less surgical treatment in the past and less recent systemic treatment, and more frequent hospitalization at home.</p><p><strong>Conclusion: </strong>Even when fit, patients with metastatic cancer had numerous health issues and unmet needs. Despite universal healthcare coverage, socially precarious patients seem to have a later diagnosis and less systemic treatment. Nevertheless they have the same unmet needs and strenghted medical and social care at home. A systematic monitoring of healthcare needs could help to trigger supportive care interventions.</p><p><strong>Trial registration: </strong>This trial was registered in ClinicalTrial.gov PRS with the ID NCT05339945 on April 21, 2022.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"233"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193593","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}

{"title":"Perspectives, attitudes and experiences of introducing noninvasive medical technologies in end-of-life care: a scoping review.","authors":"Laila Hov, Reidun Førde, Simen Steindal, Hilde Tinderholt Myrhaug, Ingrid J Skogestad, Bjørn Erik Juel","doi":"10.1186/s12904-025-01890-4","DOIUrl":"10.1186/s12904-025-01890-4","url":null,"abstract":"<p><strong>Background: </strong>There is a strong tradition for withdrawing medical equipment from patients receiving end-of-life (EOL) care. However, the introduction of new noninvasive medical equipment could be acceptable provided that it improves the quality of care and patient comfort.</p><p><strong>Objectives: </strong>We aimed to systematically map published studies of the perspectives, attitudes and experiences of health care professionals, dying patients, and their next of kin, about introducing noninvasive medical technology in end-of-life care.</p><p><strong>Design: </strong>We conducted a scoping review. On January 27, 2025, systematic searches of five databases were carried out (Medline (EBSCO), CINAHL, Embase, Academic Search Elite, and Cochrane Library CDSR). Inclusion criteria were empirical studies published in English or Scandinavian languages. We searched for qualitative, quantitative or mixed method studies focusing on perspectives on, experiences of and attitudes toward introducing noninvasive medical technologies in end-of-life care from the view of health care professionals, dying patients, and their next of kin. Three pairs of researchers independently assessed potential eligibility and data extraction. Data would be summarized qualitatively.</p><p><strong>Results: </strong>The searches yielded 3288 unique articles, 3194 of which were excluded following an initial screening. Among the remaining 94 articles, none satisfied our inclusion criteria. Thus, we found no empirical articles addressing perspectives on, attitudes toward, or experiences with the use of noninvasive medical technology in end-of-life care.</p><p><strong>Conclusions: </strong>Empirical research exploring the perspectives on, attitudes toward, and experiences of, and use of noninvasive medical technology in end-of-life care is needed. This is important for understanding when and how it is feasible, useful, and ethical to introduce such technologies in the terminal phase of palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"238"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193588","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}

{"title":"Facilitators of palliative care provision for people with mental illness: a qualitative analysis from the perspective of mental healthcare staff.","authors":"Nasrin Rezaee, Mahnaz Ghaljeh, Sally Pezaro, Farzaneh Miri, Marjan Mardani-Hamooleh","doi":"10.1186/s12904-025-01889-x","DOIUrl":"10.1186/s12904-025-01889-x","url":null,"abstract":"<p><strong>Background: </strong>Mental illnesses can have fundamental negative effects upon people's quality of life. Whilst people with mental illness require mental health support, their physical health can often be neglected. As a result, they are often denied high-quality palliative care to which they are entitled. This study aimed to identify the facilitators of providing high-quality palliative care for patients with mental illness from the perspective of staff working in mental health services in Iran.</p><p><strong>Methods: </strong>A descriptive qualitative study was conducted. A total of 32 people participated, including nurses (n = 22), psychiatrists (n = 6), and psychologists (n = 4). Semi-structured and individual interviews were used to collect data. The data collected were analysed using the content analysis approach.</p><p><strong>Results: </strong>The analysis of participants' narratives resulted in 689 codes, which were organized into 5 subcategories and 2 categories. The facilitators of providing palliative care for patients with mental illness were identified in two categories: (1) expanding organizational support and (2) promoting a team and participatory approach. The first category included subcategories relating to the creation of appropriate infrastructure and educational empowerment of personnel. The second category encompassed subcategories addressing positive attitudes toward teamwork and the preference for collaborative practice over lone working. It also highlighted the importance of recognising the interdisciplinary nature of palliative care and encouraging family involvement, even in the presence of mental illness stigma.</p><p><strong>Conclusions: </strong>This study is the first of its kind. Findings support policy makers to enhance the provision of palliative care for patients with mental illness in order to improve their quality of life.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"237"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193673","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}

{"title":"Psychological distress interventions for family members in palliative care: a scoping review.","authors":"Haichen Wu, Pengxin Dong, Yidan Chai, Ping Huang, Huiqiao Huang","doi":"10.1186/s12904-025-01873-5","DOIUrl":"10.1186/s12904-025-01873-5","url":null,"abstract":"<p><strong>Background: </strong>With the rapid increase in demand for palliative care, patients' families face serious psychological distress; however, there are fewer intervention studies on psychological distress in family members.</p><p><strong>Objective: </strong>This study aimed to provide an overview of interventions and their effectiveness on psychological distress in family members of palliative care patients.</p><p><strong>Methods: </strong>This study utilized a scoping review methodology, based on the framework proposed by Arksey and O'Malley, by searching six databases (including PubMed, Cochrane, Embase, Ovid medline, Scopus, and Web of Sciences) to screen the eligible research literature. Studies on psychological distress interventions for family members of palliative care patients were included, and data on study design, intervention type, and intervention effect were extracted, summarized, and analyzed.</p><p><strong>Results: </strong>A search of six databases initially yielded 23,697 records. After deduplication and screening, 34 eligible studies were retained (n = 34). These reports originated from The USA (n = 13), Europe (n = 11), Asia (n = 6), and Australia (n = 4). Study designs comprised randomized controlled trials, pre- and post-test comparisons, and pilot studies. The interventions identified included psychological and psychosocial interventions; problem-solving and cognitive-behavioral interventions; web-based or mobile app interventions; relaxation, art, and music therapy interventions; communication, expression, and group interventions; dignity therapy; and structured family meetings. More than half of the studies demonstrated significant improvements in family caregivers' psychological distress.</p><p><strong>Conclusions: </strong>Although psychological distress interventions for family members of palliative care patients have been effective, there are still limitations in the study and further research is needed to meet the needs of different groups of family members and to better support their mental health.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"230"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179687","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}