BMC Palliative Care最新文献

{"title":"A scoping review of palliative care assessment tools.","authors":"Mona Aakataa, Hanan Khalil","doi":"10.1186/s12904-026-02099-9","DOIUrl":"https://doi.org/10.1186/s12904-026-02099-9","url":null,"abstract":"<p><strong>Background: </strong>Palliative care requires timely and accurate assessment to support patient-centred outcomes. However, existing tools vary widely in purpose, design, and implementation. Understanding the current landscape of available tools is essential to guide future innovation. This review aimed to systematically identify and map published literature on palliative care assessment tools, focusing on their purpose and domains assessed, with consideration of reported validation, usability, and implementation characteristics.</p><p><strong>Methods: </strong>Scoping review conducted using the Joanna Briggs Institute (JBI) methodology and reported according to the PRISMA-ScR checklist. Ovid MEDLINE, CINAHL, and the Cochrane Library were searched for peer-reviewed studies published in English from 2005 to 2024. Studies were included if they assessed tools used in palliative care populations for symptom assessment, quality of life, early identification, psychosocial evaluation, or caregiver support. Study screening, data extraction, and synthesis were completed in Covidence.</p><p><strong>Results: </strong>A total of 299 studies from over 40 countries were included, representing 813,819 participants. The Edmonton Symptom Assessment System (52.1%) was the most frequently used tool. Most tools focused on symptom assessment (27%) and quality of life (22%), with limited attention to caregiver burden (4%), spiritual wellbeing (4%), or social support (4%). Ninety-four studies (31%) reported positive perceptions of tool utility, and one reported a negative outcome. Key gaps included cultural adaptation, digital integration, multi-user access, and holistic scope.</p><p><strong>Conclusions: </strong>Although many tools support clinical assessment, few address the complexity of holistic, person-centred care. There is an urgent need for co-designed, culturally sensitive, and digitally enabled tools to support equitable palliative care delivery.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857606","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}

{"title":"A structured communication model for advance care planning in Chinese oncology nursing: a mixed-methods participatory action research study.","authors":"Yi-An Shih, Jing Sun, Qian Lu","doi":"10.1186/s12904-026-02011-5","DOIUrl":"https://doi.org/10.1186/s12904-026-02011-5","url":null,"abstract":"<p><strong>Background: </strong>Despite the global recognition of advance care planning as a critical component of patient-centred end-of-life care, its implementation remains challenged by skill-based deficiencies (e.g., inadequate training), cultural and communication barriers, and system-level structural impediments within healthcare settings. This study aimed to develop and implement a structured advance care planning communication model to improve nurses' communication practices and facilitate patient engagement in end-of-life care discussions.</p><p><strong>Methods: </strong>A participatory action research design with embedded mixed methods was conducted from September 2020 to September 2022 in an oncology palliative care unit at an oncology hospital in Beijing, China. The study integrated the Advance Directive Decision-Making Model with the Meaning-Making Intervention. Data collection included surveys, participant observation, and semi-structured interviews across three phases. Four iterative action cycles were used to co-develop and refine the communication model. Quantitative and qualitative data were triangulated through team debriefings to generate meta-inferences.</p><p><strong>Results: </strong>Initial assessments included surveys and observations. Nurses held a foundational knowledge of advance care planning principles (mean knowledge: 68.52%), but expressed hesitation to initiate end-of-life discussions. Iterative cycles developed a three-step communication model. The steps were: (1) Recognize the Present, (2) Life Review, and (3) Face the Future. Post-action data showed improvements in in all areas. Nurses' knowledge increased significantly (mean score increase: 1.90 points). Attitudes scores increased (mean increase = 0.90) Behaviours scores also increased (mean increase = 0.57). Paired t-tests confirmed significant differences for all measures (p < 0.001). Key improvements attributed to the model included the development of time-efficient communication strategies, structured support systems, and adaptive communication techniques tailored to patient needs.</p><p><strong>Conclusions: </strong>The structured three-step advance care planning communication model improves nurse-patient communication and patient engagement in end-of-life decision-making. This model provides a practical framework for initiating and guiding advance care planning conversations in oncology care. Future research is needed to evaluate its applicability in diverse settings and its long-term impact on patient outcomes.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857577","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}

{"title":"Pre- and post-bereavement experiences and support needs of family caregivers in hospital settings in Türkiye: a qualitative interview study.","authors":"Çiğdem Fulya Dönmez, Mustafa Karaağaç, Ercan Bakır, Cara Bailey, Muzeyyen Seckin","doi":"10.1186/s12904-026-02125-w","DOIUrl":"https://doi.org/10.1186/s12904-026-02125-w","url":null,"abstract":"<p><strong>Background: </strong>Timely and adequate bereavement support is associated with better mental health and psychosocial outcomes for bereaved individuals. There is limited research focusing on how the pre- and post-death process in the hospital setting influences family caregivers' perceptions and support needs before and after bereavement. The aim of this study is to explore the pre-and post-bereavement experiences and support needs of family caregivers in hospital settings in Türkiye.</p><p><strong>Methods: </strong>A qualitative exploratory study using semi-structured in-depth interviews analysed thematically was conducted to provide a detailed understanding of the bereavement experience in the context of bereaved family caregivers' in hospital settings. Purposive sampling was used to recruit bereaved family caregivers (n = 21) who had experienced caring for an adult patient with life-threatening conditions in hospital.</p><p><strong>Results: </strong>Twenty-one bereaved family caregivers participated, over half of the participants (62%) were female and, participant age ranged between 20 and 52 years, with the average age being 39.8 years. Four themes were generated: (1) Pre-bereavement process, (2) Communication during the dying stages, (3) Post-bereavement process and, (4) Bereavement support needs of family caregivers. Many caregivers reported that the lack of information about the disease process of their close person, unfinished business, and cultural barriers to the discussion of death made the bereavement process more difficult. Social support, culturally specific coping strategies, support from psychiatric consultation liaison nurses and empathetic communication were identified as facilitators of the bereavement process for family caregivers.</p><p><strong>Conclusions: </strong>We recommend a culturally sensitive family-centered approach, compassionate and empathetic communication, and the integration of psychiatric consultation liaison nurses into hospital bereavement care systems to provide dignified and culturally adapted bereavement support care in hospitals. The insights gained from the perspective of family caregivers may be utilised by mental health professionals and policy makers to improve hospital-based bereavement care. By exploring the perspectives of family carers in a middle-income country, our research contributes to a more inclusive understanding of bereavement support needs globally, particularly in culturally diverse contexts where research has been limited.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844987","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}

{"title":"Access to hospice and palliative care for people with a migration background: a qualitative study on challenges and recommendations in end-of-life care.","authors":"Sabahat Ölcer, Annika Albert, Maximiliane Jansky, Friedemann Nauck, Christian Banse","doi":"10.1186/s12904-026-02116-x","DOIUrl":"https://doi.org/10.1186/s12904-026-02116-x","url":null,"abstract":"<p><strong>Background: </strong>Systemic inequalities shape healthcare access, disproportionately affecting people with a migration background in Germany. Empirical studies on this group in hospice and palliative care are quite limited and highlight a gap in understanding the challenges and potential solutions.</p><p><strong>Objectives: </strong>To explore, from the perspectives of healthcare providers, the challenges faced by patients with a migration background, their families, and healthcare providers in hospice and palliative care. The aim was to improve accessibility, reduce barriers, and ensure that hospice and palliative care services are accessible and inclusive to them.</p><p><strong>Methods: </strong>A qualitative study was conducted employing directed content analysis of healthcare providers' responses to open-ended questions on end-of-life care. The analysis was guided by a system-facing social determinants of health framework, emphasising systemic and structural factors influencing care services. Healthcare providers recruited from hospice and palliative care facilities across Germany (n = 332).</p><p><strong>Results: </strong>Language barriers, cultural insensitivity, and systemic inequalities were identified by healthcare providers as major obstacles hindering access to hospice and palliative care for patients with a migration background. Healthcare providers emphasised the need for tailored support services, community-based networks and other innovative solutions to improve accessibility and outcomes. Moreover, they highlighted that the emotional burden on all actors involved in hospice and palliative care is exacerbated by language barriers, cultural misconceptions, and the structural complexity of end-of-life care.</p><p><strong>Conclusion: </strong>Prioritising equitable and culturally sensitive care as part of broader support services and innovative solutions can enable broad participation in hospice and palliative care, including patients with a migration background and their families, based on mutual trust. Further research is needed to overcome logistical and financial challenges and facilitate the implementation of actionable recommendations within hospice and palliative care services.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845027","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}

{"title":"Spiritual needs in palliative care inpatients: a four-year analysis of clinical data from a tertiary care center.","authors":"Valentin Frei, Simon Peng-Keller, Caroline Hertler, Stefan Pelz, David Blum, Markus Schettle","doi":"10.1186/s12904-026-02117-w","DOIUrl":"https://doi.org/10.1186/s12904-026-02117-w","url":null,"abstract":"<p><strong>Background: </strong>Spiritual needs are a core dimension of palliative care, yet their systematic documentation remains limited. This study explores the spiritual needs expressed by palliative care inpatients and examines how these needs vary in documentation based on gender, below and above the Swiss retirement age, religious affiliation, and specialty documenting them.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 747 electronic health records (EHRs) from the Acute Palliative Care Unit at the University Hospital Zurich (2019-2022). Documentation by psychological and pastoral care services was analyzed using qualitative content analysis along with chi-square test for explorative purposes. Identified needs were categorized according to an adapted four-domain framework (existential, psychological, social/relational, religious).</p><p><strong>Results: </strong>A total of 598 patients were analyzed (median age 68 years (20-97), 52.8% (n = 316) male). We identified 22 distinct spiritual needs. Overall, 61.2% (n = 366) of patients expressed existential needs, 78.9% (n = 472) psychological needs, 66.2% 396) social/relational needs, and 17.4% (n = 104) religious needs. The most common spiritual needs were life reflection (55.5%, n = 332), relationship and family dynamics (43.6%, n = 337), and history of illness (26.8%, n = 160). Women reported significantly more existential fears (p < 0.001), relational themes (p = 0.005), and requests for prayer (p = 0.028). Patients below the retirement age exhibited more needs, including fears (p = 0.019), grief (p = 0.002), and hope (p < 0.001) compared to older patients. Religious affiliation was associated with prayer (p = 0.003) and anointing of the sick (p = 0.036). Psychological services documented spiritual needs in 86.1% of cases (mainly existential and psychological needs), whereas pastoral care (53%) focused on religious themes, including all mentions of sacramental rituals.</p><p><strong>Conclusions: </strong>This is the first Swiss study to classify spiritual needs based on routine clinical documentation. The findings highlight the prevalence and multidimensionality of spiritual concerns, with psychological needs being most frequently documented, and significant differences observed by age, gender, and religious affiliation. Distinct documentation patterns emerged between psychological and pastoral care, underlining the need for structured assessment tools and interprofessional collaboration. Implementing standardized documentation and training could enhance the visibility and continuity of spiritual care and guide future research and clinical practice.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844997","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}

{"title":"Consequences of compassion fatigue in palliative care nurses: the experience of meaninglessness and emptiness in life.","authors":"Rezvan Ghafarzadegan, Zohreh Vanaki, Eesa Mohammadi, Anoshirvan Kazemnejad","doi":"10.1186/s12904-026-02120-1","DOIUrl":"https://doi.org/10.1186/s12904-026-02120-1","url":null,"abstract":"<p><strong>Background: </strong>Compassion fatigue, defined as the emotional and physical exhaustion resulting from prolonged exposure to patients' suffering, coupled with a diminished ability to empathize, is a significant occupational hazard in palliative care nursing, with potential adverse effects on nurses, healthcare organizations, and patient care quality. Despite its impact, the nuanced consequences of compassion fatigue from the perspective of palliative care nurses remain underexplored.</p><p><strong>Aim: </strong>Due to this issue, this study sought to explore and elucidate the perceived consequences of compassion fatigue among nurses providing palliative/end-of-life care in Iran.</p><p><strong>Methods: </strong>A qualitative study employing conventional content analysis was conducted. Seventeen Iranian palliative care nurses were recruited via purposive sampling. Data were collected through semi-structured interviews and analysed to identify emergent themes. Ethical approval was obtained from the Ethics Committee of Tarbiat Modares University, and written informed consent was secured from all participants.</p><p><strong>Results: </strong>Four subcategories emerged as key consequences of compassion fatigue: (1)reluctance to remain in the ward or continue nursing, (2)forgetfulness in care delivery, (3)emotional incapacity to manage personal and professional responsibilities, and(4)a pervasive sense of meaninglessness and hopelessness toward life. The overarching theme highlighted a profound existential impact, characterized by diminished motivation and hope, affecting both professional engagement and personal well-being.</p><p><strong>Conclusion: </strong>In conclusion, early identification and management of compassion fatigue consequences are critical for nurse managers to enhance resilience, address emotional needs, and reduce turnover intentions.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845017","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}

{"title":"Comparison of different proxy approaches to determine the need for specialized palliative care in patients with incurable cancer.","authors":"Nikola Reichel, Maria Heckel, Susanne Gahr, Christoph Ostgathe","doi":"10.1186/s12904-026-02106-z","DOIUrl":"10.1186/s12904-026-02106-z","url":null,"abstract":"<p><strong>Background: </strong>Patients suffering from cancer can benefit from a timely integration of palliative and end-of-life care. In the literature different approaches are discussed that can be used by health care professionals (as proxies) to determine cancer patients in need for specialist palliative care. Until now data on comparing different tools is scarce. This study compared published methods for detecting patients with advanced and incurable cancer in need for specialist palliative care.</p><p><strong>Methods: </strong>Data of three hundred and sixteen patients with incurable cancer-collected during a study validating the German version of a screening tool based on NCCN guidelines (Glare) - were used for secondary analysis. The data were used to test the performance of different tools in detecting patients with palliative care needs: two disease-specific classifications (Gaertner, Benthien), the Eastern Cooperative Oncology Group Performance Status (ECOG), the Surprise Question, as well as a combination of the Surprise Question and the German NCCN tool and the Surprise Question and the ECOG score. To quantify which tool performed best, survival, Integrated Palliative Outcome Scale (IPOS - staff version) (one or more items ≥ 3), and the information of a preexistent contact to palliative care served as indicators of real SPC needs in this patient group.</p><p><strong>Results: </strong>The combination of Surprise Question and the German NCCN Screening tool showed a sensitivity between 71.5%-94.3% and specificity between 56.0%-91.3%, while the combination of Surprise Question and ECOG score had a sensitivity between 37.4%-75.7% and specificity between 86.2%-100%. Benthien's classification performed a fair sensitivity (74.8%-91.5%) and a weak specificity (27.3%-39.4%), whereas the guidelines by Gaertner showed high sensitivity (92.2%-100%), but very low specificity in all standards (0.0%-9.9%).</p><p><strong>Conclusion: </strong>While the combination of the Surprise Question and the German NCCN screening tool showed the best results in terms of sensitivity and specificity overall, a combination of the Surprise Question and ECOG score proved to be highly specific and as time-efficient in identifying patients in need of SPC, which may be beneficial.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844949","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":"A complex intervention to support the use of sedative drugs in specialist palliative care: results from the iSedPall pilot study.","authors":"Christoph Ostgathe, Claudia Bausewein, Eva Schildmann, Maria Heckel, Saskia Kauzner, Carsten Klein, Stefanie Kolmhuber-Seibold, Sabine H Krauss, Alexander Kremling, Beatrice Odierna, Constanze Rémi, Manuela Schneider, Andreas Seifert, Kerstin Ziegler, Christian Jäger, Jan Schildmann","doi":"10.1186/s12904-026-02112-1","DOIUrl":"https://doi.org/10.1186/s12904-026-02112-1","url":null,"abstract":"<p><strong>Background: </strong>International studies show intentional sedation to relieve suffering to be a common and relevant treatment in specialist palliative care. The EAPC framework for using sedative drugs has currently been updated and national recommendations have been disseminated. However, there was a lack of hands-on materials targeted for healthcare professionals and of information materials for patients and informal caregivers to ensure patient-centred care. The iSedPall study group developed a complex intervention to further support the use of sedative drugs in specialist palliative care. The following pilot study aimed at examining the feasibility of the intervention being applied in different settings and by different professions.</p><p><strong>Methods: </strong>A sequential explanatory mixed-methods design was applied between 02/23 and 01/24. An online survey (pre-post-test) assessed quantitative data on the feasibility of the outcome indicator `confidence in professional skills`, primary feasibility outcomes, and the implementation process. Focus groups added to the quantitative results. Four specialist palliative care services (inpatient and home care) piloted the intervention for nine months.</p><p><strong>Results: </strong>Global mean scores of primary feasibility outcomes proved the intervention as acceptable, appropriate, and feasible for inpatient and home care settings. The outcome indicator seems to be adequate for measuring changes in healthcare professionals` confidence, especially for physicians. The relevance of the intervention, its impact on practice, and the implementation process have been judged heterogeneously. Promoting (e.g., personal exchange, educational materials) and inhibiting factors (e.g., lack of time and technical resources) for implementation have been stated.</p><p><strong>Conclusions: </strong>An implementation study would benefit from adaptations regarding the intervention, study design, and implementation strategy. Especially the nursing perspective has to be considered to a greater extent for strengthening the palliative care approach. Context-specific factors seem to play a key role in implementation. Therefore, training of in-group champions, considering local technical and personal resources, and actively engaging the team could mitigate potential barriers and foster the success. Our findings will inform a full-scale implementation study to further explore the use of the intervention by healthcare professionals in clinical practice.</p><p><strong>Trial registration: </strong>The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00027241; Date of registration: 10/12/2021; https://www.drks.de/drks_web/setLocale_EN.do ).</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844992","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":"Validation of the short-form quality care questionnaire - palliative care in Brazilian patients with heart failure eligible for palliative care.","authors":"José Kléber de Figueiredo, Aldair Darlan Santos-de-Araújo, Patrícia Martins Santos, Mariana Campos Maia, Victória Pereira Frutuoso, Daniel Santos Rocha, Renan Shida Marinho, Ellen de Souza Pereira, Audrey Borghi-Silva, Paulo Ícaro Paixão Silva, Almir Vieira Dibai-Filho, Daniela Bassi-Dibai","doi":"10.1186/s12904-026-02131-y","DOIUrl":"https://doi.org/10.1186/s12904-026-02131-y","url":null,"abstract":"<p><strong>Background: </strong>The Brazilian version of the Quality Care Questionnaire - Palliative Care (QCQ-PC) is an instrument developed to assess the quality of care provided in palliative care.</p><p><strong>Objective: </strong>To structurally validate the Brazilian version of the QCQ-PC for use in individuals with HF eligible for palliative care.</p><p><strong>Methodology: </strong>This study aimed to structurally validate the QCQ-PC, following the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN). Data were collected using the QCQ-PC, 36-Item Short Form Health Survey Instrument (SF-36), and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Internal consistency was calculated using Cronbach's alpha and, structural validity was assessed using confirmatory factor analysis (CFA). Construct validity was assessed by correlations between QCQ-PC and SF-36.</p><p><strong>Results: </strong>The study sample (n = 113) consisted predominantly of middle-aged to older adults mainly classified as NYHA class I (36.3%) or III (32.7%). The structural validity of the two-domain of the QCQ-PC was confirmed by adequate fit indices: χ²/df = 1.46; CFI = 0.979; TLI = 0.971; RMSEA = 0.064; SRMR = 0.067; and with factor loadings ≥ 0.30. Construct validity was demonstrated by correlations of less than 0.30 between the QCQ-PC and SF-36 domains. Reliability was adequate, with ICC values ​​above 0.80 for both domains, measurement error less than 10%, and Cronbach's alpha greater than 0.70.</p><p><strong>Conclusion: </strong>The internal structure with two domains is the most suitable for use in individuals with FH eligible for palliative care through the QCQ-PC. The constructs are valid and reliable, with adequate internal consistency.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845038","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}

{"title":"Impact of a shared pediatric palliative care program on end-of-life care trends among children: a 10-year retrospective study in Taiwan.","authors":"Chia-Wen Hung, Li-Min Wu","doi":"10.1186/s12904-026-02132-x","DOIUrl":"https://doi.org/10.1186/s12904-026-02132-x","url":null,"abstract":"<p><strong>Background: </strong>Early integration of pediatric palliative care (PPC) improves symptom control, communication, and goal-concordant decision-making. Despite these benefits, PPC remains underutilized in many Asian healthcare systems, where referrals are often delayed and most children die in intensive care units (ICUs).</p><p><strong>Methods: </strong>This retrospective cohort study included children aged 0-18 years who died between 2008 and 2017 at two medical centers in southern Taiwan (n = 294). A shared PPC program was implemented in 2011, embedding palliative specialists within primary care teams. Documentation of do-not-resuscitate (DNR) orders, family meetings, PPC consultations, cardiopulmonary resuscitation (CPR), and place of death were compared across pre-implementation, early post-implementation, and late post-implementation phases.</p><p><strong>Results: </strong>Following implementation, DNR documentation increased from 59.2% to 73.9% (p = .03). Documented family meetings rose from 4.1% to 18.2% (p < .001), and PPC consultations increased from 7.1% to 23.9% (p < .001), suggesting potential improvements in interdisciplinary communication and advance care planning. ICU deaths remained high (87.8%-89.8%), and CPR rates declined but did not reach statistical significance (p = .09). Cancer diagnosis (OR = 7.97, 95% CI 2.71-23.42) and increasing age at diagnosis (OR = 1.12 per year, 95% CI 1.06-1.18) were independently associated with PPC consultation.</p><p><strong>Conclusions: </strong>Integration of a shared PPC model was associated with improvements in advance care planning and interdisciplinary collaboration. Earlier referral triggers, clinician education, and expansion of community-based PPC services may be important to help reduce high-intensity end-of-life care and better align care delivery with family preferences.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844999","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}