BMC Palliative Care最新文献

{"title":"Together but still alone - A qualitative study exploring how family members of persons with incurable oesophageal or gastric cancer manage everyday life.","authors":"Sofia Kårmark, Marlene Malmström, Jimmie Kristensson","doi":"10.1186/s12904-024-01576-3","DOIUrl":"10.1186/s12904-024-01576-3","url":null,"abstract":"<p><strong>Background: </strong>Cancer affects not only the person with the disease but those around them. Being a family member is described as strenuous and, often, associated with stress, anxiety and feelings of loneliness. There is a heightened risk of distress for family of those with fast-progressing, severe oesophageal or gastric cancer. Early palliative care involving family is vital yet often overlooked. In order to include family members in early palliative care their management in everyday life needs to be explored.</p><p><strong>Method: </strong>Qualitative inductive interview study using content analysis guided by Graneheim and Lundman.</p><p><strong>Result: </strong>The analysis resulted in the overarching theme \"Managing the disease together but still alone\". Three categories were identified: Adapting to the disease, Taking control of the situation, Processing emotions. Each category described family members management in various aspects of everyday life together with the ill person and alone.</p><p><strong>Conclusion: </strong>The results may contribute to an awareness of family members' management of large parts of everyday life and, further, their feelings of loneliness, and indicates that family members should be included early in oesophageal or gastric cancer palliative care. Further studies are needed to develop the content of such family-inclusive early palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"249"},"PeriodicalIF":2.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511161","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":"Addressing integration in the organization of palliative care in belgium: a multilevel ecosystems approach using the analytic hierarchy process (AHP) method.","authors":"Melissa De Regge, Paul Gemmel, Leen Ackaert, Let Dillen, Peter Pype, Nele Van Den Noortgate, Bert Meijboom, Kristof Eeckloo","doi":"10.1186/s12904-024-01585-2","DOIUrl":"10.1186/s12904-024-01585-2","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is becoming an essential component of healthcare, but there is insufficient research on how integration across different levels of care (micro, meso, and macro) is realized in practice. Without such integration, care may become fragmented, leading to suboptimal patient outcomes. While many studies have explored palliative care models, there is a gap in understanding how priorities for integrated care align across these levels within healthcare ecosystems. Specifically, it is unclear whether key actions at each level are shared, coordinated, and supported effectively, making it difficult to implement sustainable, cohesive care strategies. Our study aims to explore the extent to which important goals (i.e., priorities) are shared across the micro, meso, and macro levels of the palliative care ecosystem in Flanders, Belgium.</p><p><strong>Methods: </strong>We applied a multimethod study using the analytic hierarchy process method (AHP). This consists of three sequential steps: a broad literature search and interviews with Belgian stakeholders (n = 12) to determine the criteria for the organization of integrated care; focus groups (n = 8) with patients, their relatives and caregivers to establish the completeness and relevance of the criteria; and prioritization of the criteria using a questionnaire among 305 Flemish participants (patients, relatives, caregivers and policy makers).</p><p><strong>Results: </strong>Our findings revealed that integration is imbalanced, with priorities being most emphasized at the micro level (57%), followed by the meso (29%) and macro (14%) level. Functional enablers dominate at the macro (80%) and meso organizational level (67%), while normative enablers are emphasized at the meso professional (67%) and micro level (75%). Effective palliative care requires vertical coordination of these enablers: for instance, transparent communication with patients at the micro level depends on cross-organizational information exchange at the meso level, supported by a unified data system at the macro level.</p><p><strong>Conclusion: </strong>Achieving integrated palliative care requires deliberate alignment of priorities across all levels of the ecosystem. While each level plays a unique role, palliative care is comprehensive and effective only by sharing both functional and normative enablers across micro, meso, and macro level.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"250"},"PeriodicalIF":4.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511157","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":"Family caregivers' administration of medications at the end-of-life in China: a qualitative study.","authors":"Fei Yang, Pusheng Wang, Yong Tang, Min Song, Jun Jing, GuiJun Lu, Bee Wee","doi":"10.1186/s12904-024-01575-4","DOIUrl":"10.1186/s12904-024-01575-4","url":null,"abstract":"<p><strong>Background: </strong>Effective medication management is crucial for ensuring timely pain and symptom control at the end of life. Dying in pain is a major concern for patients, yet some find less effective pain control at home. Family caregivers (FCGs) play a vital role in managing pain and symptom control for dying patients. However, the experience of administering medications at home for terminal-stage patients has not been widely recognized or understood. Our study aimed to explore the experiences of FCGs in administering medications to adult dying patients.</p><p><strong>Methods: </strong>We conducted a directed content analysis of data from 73 semi-structured interviews with FCGs across 19 Chinese provinces from 2021 to 2023. FCGs were recruited through the Voluntary Cooperative Network Research. We asked, \"Could you recall the end-of-life care process for the patients?\" We aligned the themes with the five issues identified by Wilson et al. (2018): administration, organizational skills, empowerment, relationships, and support.</p><p><strong>Results: </strong>FCGs in China exhibit concerns about over-engagement and empowerment in medication administration, concealing medication information from the patient, and medication accessibility. FCGs faced significant challenges in accurately identifying and addressing pain and symptoms, determining appropriate dosages, accessing effective medications, and managing the emotional stress associated with potential medication errors. Financial burden, medication regulatory restrictions, geographical inequality, and travel restrictions during COVID impeded patients and FCGs from accessing medication. A culturally specific finding is the use of alternative medicine at the end of life.</p><p><strong>Conclusion: </strong>Our findings build upon Wilson et al.'s framework and extend their insights on empowerment, highlighting the need for policies to support home-based palliative care professionals in training FCGs for effective medication administration.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"248"},"PeriodicalIF":2.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511158","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":"My virtual escape from patient life: a feasibility study on the experiences and benefits of individualized virtual reality for inpatients in palliative cancer care.","authors":"Christina Gerlach, Laura Haas, Anja Greinacher, Jonah Lantelme, Melanie Guenther, Julia Thiesbonenkamp-Maag, Bernd Alt-Epping, Cornelia Wrzus","doi":"10.1186/s12904-024-01577-2","DOIUrl":"10.1186/s12904-024-01577-2","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients benefit from Virtual Reality (VR) in burdensome situations, but evidence is scarce for palliative situations. Based on earlier work in palliative care, individualized VR interventions like seeing the patient's home may address a patient's wish to be at home and thus have a greater effect compared to standard VR content. Yet, some patients and relatives may be concerned about their privacy. Also, patient stakeholders raised concerns about triggering depressed mood or homesickness.</p><p><strong>Aim: </strong>To test the feasibility and safety of individualized vs. standard 360°video VR interventions in palliative cancer inpatients.</p><p><strong>Methods: </strong>Prospective observational study with patient-reported outcome measurement using validated instruments of well-being (MDBF), symptoms and psychosocial burden (IPOS), cybersickness (SSQ), presence experience (SPES), subjective benefit (2 items), content analysis of interviews, and field notes. Individualized VR content was recorded with action camcorder-technology to protect the patients' privacy.</p><p><strong>Results: </strong>Seventeen patients participated, median age 65 years (range 20-82), 9 women (53%), 8 single or widowed (47%), 4 childless (23.5%), 4 academics (23.5%), with a median length of stay of 9 days (1-75) in the hematology (10), palliative care (3), or radiotherapy (2) unit of a German university hospital. Eight patients (53.3%) chose their own home environments or family for individualized VR-content. All participants enjoyed the intervention. Compared to standard VR content the individualized VR tended to have a stronger effect on well-being and emotional touch. It was not inferior in terms of psychosocial burden and cybersickness. No subjective and relevant side effects occurred. The patients well tolerated the assessments. However, most patients demanded a lighter headset and a desire for more interactivity.</p><p><strong>Conclusions: </strong>Individualization of VR content shows potential for enhancement of immersion, which improves the VR experience and does not harm in terms of depressed mood or worsening of symptoms. The patients' and family desire for privacy is feasible with the support of family members who recorded the individualized videos, which is easily manageable today. We suggest a pragmatic randomized clinical trial to compare the effects of individualized vs. standard VR-content.</p><p><strong>Trial registration: </strong>Registered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11/07/2023.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"247"},"PeriodicalIF":2.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511159","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":"Palliative care knowledge and self-efficacy: a comparative study between intensive care units and general units nurses.","authors":"Sahar Fadaei, Mansooreh Azizzadeh Forouzi, Mitsunori Miyashita, Asmaa Jumaa Faleh, Mahlagha Dehghan","doi":"10.1186/s12904-024-01580-7","DOIUrl":"https://doi.org/10.1186/s12904-024-01580-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>The growing number of terminally ill patients has underscored the importance of equipping healthcare workers with adequate palliative care knowledge and self-efficacy. This study aimed to compare the palliative care knowledge and self-efficacy of nurses in intensive care units (ICUs) with those in general wards at hospitals affiliated with Kerman University of Medical Sciences in 2023.</p><p><strong>Methods: </strong>This descriptive-comparative cross-sectional study involved nurses from intensive care units and general wards of three hospitals affiliated with Kerman University of Medical Sciences, for a total sample size of 300 nurses (150 in each group). The samples were selected using convenience sampling. The data collection tools included a demographic information questionnaire, the Palliative Care Knowledge Test (PCKT), and the Palliative Care Self-Efficacy Scale (PCSES). Convenience Sampling method was used. The data were analyzed using SPSS 23. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, Mann-Whitney U test and multivariate stepwise regression) were employed. Statistical significance was determined by a p-value of ≤ 0.05.</p><p><strong>Findings: </strong>The mean score for palliative care knowledge was 10.59 (± 2.10) for nurses in intensive care units and 10.43 (± 2.33) for nurses in general wards, with no significant difference between the two groups (P = 0.53). Similarly, the mean score for palliative care self-efficacy was 28.01 (± 10.29) for nurses in intensive care units and 27.98 (± 10.33) for nurses in general wards, with no significant difference between the groups (P = 0.98). Variables such as the history of caring for dying patients in the hospital (P = 0.004) or at home (P = 0.01), workplace (P = 0.002), and work experience (P = 0.03) were identified as the main predictors of palliative care knowledge and palliative care self-efficacy was affected by age (P < 0.001), history of participation in palliative care training courses (P = 0.008), and palliative care knowledge score (P = 0.01).</p><p><strong>Discussion and conclusion: </strong>This study revealed no significant difference in total scores of palliative care knowledge or self-efficacy between nurses in intensive care units and general wards It is suggested that more efforts be made to increase the knowledge and self-efficacy of all nurses, especially nurses in ICU departments, till providing a standard palliative care setting.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"246"},"PeriodicalIF":2.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511160","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":"Symptom- and function-based trajectories of patients with dementia in hospital and community palliative care settings in the last two weeks of life: a retrospective cohort study.","authors":"Minghui Tan, Xiwen Simon Qin, Claire E Johnson, Lin Xiao, Angus Cook, Jinfeng Ding, Juan Wang","doi":"10.1186/s12904-024-01565-6","DOIUrl":"10.1186/s12904-024-01565-6","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of dementia is increasing worldwide and many people with the condition require some level of palliative care. However, the trajectories of function and symptom burden in palliative care services at the end of life remain unclear. This study aimed to describe and compare the longitudinal trajectories of function and symptom burden among patients with dementia between hospital versus palliative community care services in the last two weeks of life.</p><p><strong>Methods: </strong>A retrospective cohort study used data from the Australian Palliative Care Outcomes Collaboration. Patients with dementia who died between 1 January 2013 and 31 December 2020 from the Australian Palliative Care Outcomes Collaboration. Four validated clinical instruments were used to collect outcomes on each individual's function and symptom distress and severity. Multilevel models were used to estimate the differences in clinical trajectories between hospital and community-based palliative care in the last two weeks of life.</p><p><strong>Results: </strong>Patients with dementia tended to have low levels of distress for most symptoms but increasing levels of functional impairment. There were no or only marginally significant differences in the symptom trajectories between the community and hospital groups (OR ranged from 0.57 to 1.97). Although clinical trajectories of function were relatively similar between two groups, statistically higher functional indicators were observed for people when admitted to community palliative care services (OR = 0.42 and 2.27, respectively).</p><p><strong>Conclusions: </strong>Our findings suggest that community-based palliative care services can be as effective as hospital-based care for many patients with dementia nearing the end of life. With appropriate support for families, community-based care could serve as a viable alternative to hospital-based care for some patients in the final stages of dementia.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"245"},"PeriodicalIF":2.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478540","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 cross-sectional study on advance care planning documentation attitudes during national advance care planning week in a South-East Asian country.","authors":"Chen Ee Low, Sounak Rana, Chun En Yau, Sheryl Yen Pin Tan, Jing Ni Ng, Noreen Chan, Mervyn Jun Rui Lim","doi":"10.1186/s12904-024-01505-4","DOIUrl":"10.1186/s12904-024-01505-4","url":null,"abstract":"<p><strong>Background: </strong>Through advocacy initiatives such as roadshows during \"National ACP Week\", the Agency for Integrated Care (AIC) had increased advance care planning (ACP) engagement since 2011. Project Happy Apples (PHA), a community initiative project led by medical students from the National University of Singapore, also conducted a public exhibition to raise ACP awareness during this period. This study aimed to investigate and identify predictors of attitudes towards ACP documentation among 'ACP Week' respondents which may be used to formulate strategies to increase ACP documentation in Singapore.</p><p><strong>Methods: </strong>A cross-sectional study on ACP documentation attitudes of 262 respondents during local roadshows were conducted. Multiple logistic regression models were built to investigate the associations between demographic variables and attitudes toward ACP documentation.</p><p><strong>Results: </strong>The mean age was 43.5 years (SD = 17.4), 79 (30.15%) were males and 49 (18.7%) were healthcare professionals (HCP). 117 (44.66%) respondents had prior experience with serious illness and 116 (44.27%) had heard of ACP. Age was a significant predictor of readiness to sign official papers naming nominated healthcare spokesperson (NHS) (OR = 1.04, 95%CI: 1.02-1.07). Experience with serious illness was a significant predictor of readiness to discuss end-of-life (EOL) care with healthcare professionals (HCP) (OR = 3.65, 95%CI: 1.36-11.61). Being female was a significant predictor for readiness to speak to their nominated healthcare spokesperson about EOL care (OR = 7.33, 95%CI: 2.06-46.73). Subgroup analyses revealed that those aged 20-39 were less likely to speak to their healthcare professional about or sign official papers regarding EOL care. We also found that being a healthcare professional does not necessitate better or worse attitudes.</p><p><strong>Conclusion: </strong>Advocacy programs tailored to targeting respondents of different age groups and prior experience with serious illness may improve the efficacy of advocacy efforts.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"244"},"PeriodicalIF":2.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478527","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":"Palliative care service provision and use among 2SLGBTQIA + individuals: a scoping review.","authors":"Anna De Jong, Kyle Swerhun, Peter Brink, Lynn Martin","doi":"10.1186/s12904-024-01560-x","DOIUrl":"10.1186/s12904-024-01560-x","url":null,"abstract":"<p><strong>Context: </strong>Health inequities exist across the healthcare continuum, significantly impacting 2SLGBTQIA + individuals. Palliative care presents unique challenges for sexual and gender minorities due to socio-cultural, psychological, and systemic barriers. The objective of this scoping review was to synthesize existing research on palliative care use among 2SLGBTQIA + individuals and identify common themes in the literature.</p><p><strong>Methods: </strong>A literature review was conducted, focusing on articles published between 2010 and 2023 from the PubMed and CINAHL databases. Arksey and O'Malley's methodological framework for scoping reviews was applied to guide the review process.</p><p><strong>Results: </strong>A total of 31 studies were identified. A significant portion of the research originated in North America, with little research from outside the USA. Palliative care and end-of-life care were most used to describe care, though these terms were often not clearly defined. All studies included a focus on sexual and gender minorities, but there was considerable variation in the terminology used and a noticeable paucity of literature specifically addressing the needs of transgender and gender non-conforming individuals, or use of an intersectional approach in analysis. Key themes identified in the literature include discrimination in palliative care settings, disenfranchised grief experienced by care partners, and a lack of training in palliative care settings concerning the unique needs of 2SLGBTQIA + people utilizing palliative care services.</p><p><strong>Conclusions: </strong>People identifying as 2SLGBTQIA + experience unique inequities in accessing and using palliative care services. To address these challenges, future initiatives should focus on developing identity-affirming palliative care settings, enhancing respect and support for care partners and found family, and ensuring healthcare providers are properly educated to provide care to this community. Future research is also needed that considers more diverse samples, as well as the impact of intersecting identities on the specific needs and challenges they face at end-of-life.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"243"},"PeriodicalIF":2.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407081","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":"Challenges and coping strategies among caregivers of children with cancer receiving care at a national referral hospital in Kenya.","authors":"Doris Val Wanja Machaki, Albanus Kyalo Mutisya, Jostine Mutinda, Sherry Oluchina, Samwel Maina Gatimu","doi":"10.1186/s12904-024-01573-6","DOIUrl":"10.1186/s12904-024-01573-6","url":null,"abstract":"<p><strong>Background: </strong>The number of children diagnosed with cancer is expected to increase by 2050. The caring aspect of these children is usually left to members of the family, more so the mothers. Caregivers are usually faced with various challenges, such as financial issues, social stigma, and emotional and psychological issues. Caregivers use various coping strategies to manage the challenges they experience in the caring process, which can be positive or negative coping strategies.</p><p><strong>Objective: </strong>To explore the challenges and coping strategies of caregivers of children with cancer receiving care at a national referral hospital in Kenya.</p><p><strong>Methods: </strong>This study employed a descriptive phenomenological approach to explore the challenges and coping strategies of caregivers of children with cancer receiving treatment at a national referral hospital in Kenya. Purposive and snowball sampling techniques were used to select 44 participants for five focus group discussions (FGDs) conducted between October and December 2023. The data were analysed via inductive thematic analysis.</p><p><strong>Results: </strong>Four themes arose from the challenges experienced, which included psychological, financial, treatment-related, and social/family-related issues. These eleven subthemes included stress, depression, lack of transport, lack of food, loss of employment, treatment delays, and marital issues, among others. Two themes related to coping strategies were positive adaptation and denial, which were highlighted as negative coping strategies. Positive coping included praying, crying, talking to people, and seeking help.</p><p><strong>Conclusion: </strong>Caregivers of children with cancer undergo various challenges and apply various coping strategies to try and adapt to their new normal. Reinforcing positive coping strategies and helping caregivers utilize other coping strategies, such as the use of support groups, could help them better care for their children.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"242"},"PeriodicalIF":2.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401698","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 professionals' experiences of providing palliative care for patients with diabetes - a qualitative study.","authors":"Signe Seim, Ragnhild Elisabeth Monsen, Beate-Christin Hope Kolltveit, Marit Graue","doi":"10.1186/s12904-024-01567-4","DOIUrl":"10.1186/s12904-024-01567-4","url":null,"abstract":"<p><strong>Background: </strong>At present, there are no specific guidelines for the treatment of diabetes in palliative care in Norway. The aim of this study was therefore to explore healthcare professionals' experiences of providing palliative care to individuals with diabetes in specialist as well as primary care settings.</p><p><strong>Methods: </strong>We interviewed 12 healthcare professionals from two palliative care units in specialist healthcare, one hospice unit in a nursing home, and one dietary care unit providing counselling in the municipality in the eastern part of Norway. Thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>Our analysis generated three main themes: 1) \"Quality of life is the main focus\", which showed that the healthcare professionals' main focus was on comforting patients through engagement and communication; 2) \"An individualized approach\", emphasizing that the treatment was tailored to the unique circumstances of each individual and considered factors such as life expectancy, difficult blood glucose control, and multidisciplinary collaboration, and 3) \"Diabetes in the background\", which highlighted that they had a modest focus on diabetes. Diabetes was seen as another aspect of health that they had to be aware of, but their limited knowledge of diabetes guidelines, technical tools, and treatment choices underscored that attentiveness to the diabetes treatment was not prominent.</p><p><strong>Conclusion: </strong>The findings show that a lack of guidelines allowed for diverse approaches to the treatment of patients with diabetes in palliative care. Attentiveness to diabetes was based on the individual healthcare professionals' experience and expertise, professional views, and the circumstances of each individual.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"241"},"PeriodicalIF":2.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401699","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}