BMC Palliative Care最新文献

{"title":"The heart of palliative care is relational: a scoping review of the ethics of care in palliative medicine.","authors":"Sophie Bertaud, Dominic Wilkinson, Maureen Kelley","doi":"10.1186/s12904-025-01784-5","DOIUrl":"10.1186/s12904-025-01784-5","url":null,"abstract":"<p><strong>Background: </strong>Palliative care, perhaps more than any subspecialty in healthcare, is deeply relational and engages patients and families at times of great vulnerability. Ethics of care, or relational ethics, developed through contributions from feminist ethics, offers conceptual tools and ways of thinking that seem especially suited to palliative care practice.</p><p><strong>Aim: </strong>To identify and describe studies and theoretical analyses applying the ethics of care to palliative care (both adult and paediatric), specifically, its use to guide and improve practice and education for palliative care practitioners.</p><p><strong>Design: </strong>We conducted a scoping review of six databases covering clinical, social science and normative ethics scholarship and conducted a thematic analysis of the findings and ethical discussions or arguments.</p><p><strong>Data sources: </strong>Databases searched included PubMed, CINAHL, PsychINFO, EMBASE, Web of Science and Philosopher's Index from 1982 to November 2024.</p><p><strong>Results: </strong>30 publications meeting our inclusion criteria were identified. Major themes reflected the relational obligations, attributes and character traits ideally developed in palliative care providers in their work and relationships with patients and families, including responsiveness, connectedness and hope, as well as in caring for ourselves and each other on palliative care teams. An emerging literature recognises the special guidance for palliative care for children.</p><p><strong>Conclusions: </strong>Clinical and ethical scholarship in palliative care reveals a valuable but still underexplored connection between the ethical commitments within the ethics of care tradition and palliative care training and practice. Ethics of care addresses important gaps in training, particularly having to do with practitioners' relationships and ways of being with patients, families, colleagues and themselves.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"150"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152591","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":"First generation migrants' experiences of terminal illness: a systematic review of diasporic dying.","authors":"Tim Sedgley, Joanne Alexander, Liz Forbat","doi":"10.1186/s12904-025-01789-0","DOIUrl":"10.1186/s12904-025-01789-0","url":null,"abstract":"<p><strong>Background: </strong>Migration is an established global phenomenon. While many newly arrived migrants have better health than the general population of the country they have moved to, migrants also have their own healthcare needs and face particular issues when diagnosed with a terminal illness. First generation migrants are less likely to have social, financial, and medical supports when faced with a terminal illness. These factors make first generation migrants an important group to understand in order to inform service commissioning and delivery.</p><p><strong>Methods: </strong>The systematic review was an international qualitative evidence synthesis of English language papers from 2000 to 2023. The primary research question underpinning this novel review was: What are the experiences of first-generation migrants who live with or who are supporting a relative with a terminal illness in the country to which they have moved? Databases (MEDLINE; CINAHL; PsycINFO; SocIndex; Web of Science) were searched in August 2023. Records of 1593 publications were screened, resulting in 39 included papers. CASP was used to inform quality appraisal.</p><p><strong>Results: </strong>First generation migrants struggled with accessing suitable health services and treatments. Structural barriers, such as lack of support for translation/interpreting and for navigating care was visible alongside limited social support networks. Financial precarity ran as a thread through the data, with participants needing to work while unwell, and being unable to return to their country of origin for their own death or to bear witness to the deaths of relatives. First generation migrants experienced caregiving through the lens of difference; maintaining autonomy in the country they would die in, intersected with cultural practices and expectations such as not sharing the prognosis, and mis-matched ideas regarding quality of care provided. The identity of 'migrant' is heterogenous, poorly defined, and may have resulted in identifying studies conducted in the global north.</p><p><strong>Conclusions: </strong>Diasporic dying is not a new phenomenon, yet services and policies fail to meet people's needs. Services urgently need to identify and dismantle structures which uphold and perpetuate inequality, including this population who suffer multiple disadvantages and risks.</p><p><strong>Protocol registration: </strong>CRD42023457054.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"152"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152583","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":"Machine learning model for prediction of palliative care phases in patients with advanced cancer: a retrospective study.","authors":"Junchen Guo, Yunyun Dai, Sishan Jiang, Junqingzhao Liu, Xianghua Xu, Yongyi Chen","doi":"10.1186/s12904-025-01785-4","DOIUrl":"10.1186/s12904-025-01785-4","url":null,"abstract":"<p><strong>Background: </strong>Developing an accurate predictive model for palliative care phases is crucial for improving cancer patient management, enabling healthcare providers to identify those in need of specific care plans and streamlining decision-making process for patients and caregivers. This study aims to identify symptom and functional indicators from Palliative Care Outcomes Collaboration (PCOC) data and develop a predictive model capable of accurately categorizing palliative care phases in advanced cancer patients.</p><p><strong>Methods: </strong>A retrospective cohort study design was adopted in this study. Data on PCOC information were collected and analyzed from patients admitted to a palliative care unit at a cancer hospital in China between April 2023 and December 2024. The Gradient Boosting Decision Tree in the machine learning algorithm to establish a palliative care phase prediction model and evaluated the prediction performance of this model.</p><p><strong>Results: </strong>A total of 9,787 assessments from 793 patients were included in the analysis of this study. Significant differences were identified among the four PCOC phases of care in terms of the symptom distress, palliative care problem severity, functional status and daily living activities. The machine learning model developed in this study achieved areas under the curve (AUCs) of 0.997, 0.996, 0.999, and 0.999 for predicting the stable, unstable, deteriorating, and terminal phases in the training group, respectively. In the testing group, the corresponding AUCs were 0.976, 0.965, 0.971, and 0.998.</p><p><strong>Conclusions: </strong>The prediction model developed in this study based on the machine learning algorithm showed good performance, offering significant potential for facilitating timely interventions, enhancing symptom management, and optimizing palliative care resource allocation in advanced cancer patients in mainland China.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"148"},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144182","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":"Early experiences of the End of Life Choice Act 2019 amongst assisted dying practitioners in Aotearoa New Zealand.","authors":"Aida Dehkhoda, Rosemary Frey, Melissa Carey, Jacqualine Robinson, Frederick Sundram, Nicholas Hoeh, Susan Bull, Gary Cheung","doi":"10.1186/s12904-025-01747-w","DOIUrl":"10.1186/s12904-025-01747-w","url":null,"abstract":"<p><strong>Background: </strong>The global trend of legalising assisted dying (AD) has reshaped end-of-life care practices, and Aotearoa New Zealand's adoption of the End of Life Choice Act (the Act) in 2019 represents a significant shift. Limited empirical research on AD in New Zealand after the enactment of the Act underscores the need for investigation. Conducting research in the early stages of AD implementation is crucial to building a strong knowledge base and laying the foundation for future research. This would ensure equitable and suitable service provision for the service users.</p><p><strong>Aim: </strong>This research captured the experiences of health practitioners directly involved in providing AD under New Zealand's End of Life Choice Act 2019.</p><p><strong>Design: </strong>Using the \"memorable case\" approach, 22 participants reflected on the process of assessing, treating, and delivering AD services in the first 12 months of implementing the new AD law.</p><p><strong>Results: </strong>Thematic analysis identified four major themes underlying the experiences of assisted dying practitioners/providers (ADPs). The themes focused on three aspects of ADPs' experience: KNOWING: prior personal experience (personal beliefs, clinical background, and AD training) and reflective experiences of DOING assessments, service delivery, and patient/family experiences and BEING an ADP (personal, professional, emotional, and social impacts). Additionally, the themes highlighted the overarching influence of health system infrastructure, challenges, and resources that shaped ADPs' overall experience.</p><p><strong>Conclusion: </strong>These findings contribute to new knowledge by uncovering gaps in understanding, competency, service implementation, and the emotional impact on ADPs. The findings could inform the development of an educational, supportive, and culturally safe program, including resources for workforce development.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"149"},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144181","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 Dutch clinical practice guideline for paediatric palliative care: a systematic review and recommendations on psychosocial care including preloss and bereavement care.","authors":"Kim C van Teunenbroek, Renée L Mulder, A A Eduard Verhagen, Leontien C M Kremer, Jeanette L Falkenburg, Petra Honig-Mazer, Esther M M van den Bergh, Marijke C Kars, Johannes M A Verheijden, Hester Rippen, Brigitt C M Borggreve, Eline M Kochen, Erna M C Michiels","doi":"10.1186/s12904-025-01763-w","DOIUrl":"https://doi.org/10.1186/s12904-025-01763-w","url":null,"abstract":"<p><strong>Background: </strong>Children with life-threatening and life-limiting conditions and their families are confronted with many uncertainties, incremental losses, and difficult decisions. Attentiveness to psychosocial care, including psychological, social, and spiritual concerns, is essential during the child's life until end-of-life and during bereavement and determines quality of life and wellbeing of child and family. However, use and integration of psychosocial care is found to be challenging. In this paper, we provide recommendations that aim to optimise psychosocial care including preloss and bereavement care in paediatric palliative care.</p><p><strong>Methods: </strong>A multidisciplinary guideline development panel of 25 experts in paediatric palliative care and nine parents was established to develop recommendations on psychosocial care including preloss and bereavement care. We performed a systematic literature search to identify evidence focussing on effectivity of interventions described in systematic reviews (SRs) of randomised controlled trials (RCTs) and RCTs. From the search, we also derived evidence from SRs of observational, qualitative, or mixed-method studies on preloss and bereavement care. The GRADE methodology was used for appraising evidence. We used existing guidelines to deal with lack of evidence. Recommendations were formulated based on evidence, existing guidelines, clinical expertise, and patient and family values.</p><p><strong>Results: </strong>We identified a total two SRs of RCTs and six RCTs that reported on the effect of psychological interventions, spiritual support interventions, and bereavement care intervention. The evidence showed that only some of the interventions improve certain psychosocial outcomes in children or parents. We were unable to draw conclusions on which intervention is most effective, due to the high variability in interventions and measured outcomes. The evidence from ten SRs of observational, qualitative, or mixed-method studies was used as a basis for preloss and bereavement care recommendations. In total, we formulated 48 recommendations.</p><p><strong>Discussion: </strong>With the provided recommendations, we aim to optimise psychosocial care for children with life-threatening and life-limiting conditions and their families. Psychosocial care should be tailored to the child and family. We found a lack of evidence on psychosocial care including preloss and bereavement care. Although very challenging, we propose implementing strategies to improve research and thereby further optimise quality of paediatric palliative care. These strategies include the development of a standard set of outcomes and to conduct well-designed multisite RCTs.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"147"},"PeriodicalIF":2.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210009","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 of clinicians on shared decision making in hospice care for advanced cancer patients in Nanjing: a descriptive qualitative study.","authors":"Tianyu Pang, Kairan Yan, Yujie Zhou, Lulu Sun, Ligui Wu, Ling Yuan, Zhi Zhou","doi":"10.1186/s12904-025-01770-x","DOIUrl":"10.1186/s12904-025-01770-x","url":null,"abstract":"<p><strong>Background: </strong>As the cancer burden increases in China, the need for hospice care is escalating. The right of informed consent to hospice care for patients with advanced cancer is still at the experimental stage, and patients still face numerous obstacles when it comes to participating in hospice care decision-making. In this context, we conducted a qualitative study to explore perspectives of clinicians on shared decision making (SDM) in hospice care for advanced cancer patients.</p><p><strong>Methods: </strong>This study employed a descriptive phenomenological research method. We conducted semi-structured interviews with clinicians recruited from 4 hospital in Nanjing, Jiangsu Province, China from January to March 2023. Two researchers used Colaizzi 7-step analysis method to analyze, summarize, integrate and refine the data.</p><p><strong>Results: </strong>A total of 17 clinicians participated. Three main themes were extracted: (1) Clinician attitudes regarding SDM; (2) Influencing factors are multidimensional; (3) Recommendations for implementing SDM in hospice care decision-making.</p><p><strong>Conclusion: </strong>SDM in hospice care for advanced cancer patients was affected by multiple factors in medical practice. It is highly desirable to focus on improving the decision support system, optimizing the SDM model of hospice care to ensure the informed choice of patients with advanced cancer.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"145"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129262","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":"Pediatric palliative care in neonates: a cross-sectional study from a high-complexity hospital in Latin America. Neopalped study.","authors":"Karen Molina-Gómez, María Isabel Cuervo-Suárez, Kevin Mauricio Henao, Inés Elvira Gómez, Catalina Proaño, Natalia Duque, Martha Lucia Jaramillo, Mariana Marmolejo, Laura Sofía Burbano, Ximena García-Quintero","doi":"10.1186/s12904-025-01753-y","DOIUrl":"10.1186/s12904-025-01753-y","url":null,"abstract":"<p><strong>Background: </strong>Pediatric palliative care (PPC) aims to alleviate suffering, improve quality of life, and facilitate decision-making for patients, families, and healthcare professionals. Specifically, PPC in neonatal patients influences their quality of life by considering the fragility and complexity of their diagnoses when performing clinical interventions. However, to date, data on newborn patients and their specialized palliative care needs is limited. Therefore, this study aims to describe the clinical characteristics of neonatal patients requiring pediatric palliative care in a specialized center of health in a low- and middle-income country in Latin America.</p><p><strong>Methods: </strong>We conducted a cross-sectional study. Neonatal patients with at least 40 weeks of corrected gestational age were included. A review of medical records was conducted to obtain information about clinical outcomes and medical management. A descriptive statistical analysis was performed considering the sociodemographic and clinical characteristics of the patients. The therapeutic strategies implemented were described, comparing deceased and surviving patients using the Chi2 test, Mann-Whitney U test, or Fisher's Exact test.</p><p><strong>Results: </strong>263 individuals were included, of which 55.13% (n = 145) were males. The median gestational age was 35 weeks (IQR 28-38), and the median birth weight was 1,119 g (IQR 610-1760). The most frequent diagnosis was trisomy 21 in 30% (n = 79), followed by severe congenital heart disease in 25.5% (n = 67). The median length of hospitalization was 25 days (IQR 8-53), adherence to the established palliative care plan was 99.6% (n = 262), and 58% (n = 152) of patients required weekly follow-up by pediatric palliative care. Additionally, 81.37% (n = 214) received social work support, and 94.68% received spiritual support. Regarding clinical outcomes, 140 patients died. Among these, respiratory distress (n = 135, 96.42%) and seizures (n = 87, 54.37%) were the most frequent symptoms in the last 24 h of life. Deceased patients had a higher NEOMOD score and lower gestational age, which were statistically significant compared to surviving patients.</p><p><strong>Conclusions: </strong>The implementation of a palliative care program in a neonatal unit facilitates multidisciplinary care that provides comfort to patients with life-limiting conditions and supports their families. Our findings highlight the importance of strengthening advanced care planning both prenatal and postnatal, being essential strategies in care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"141"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129193","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":"Identifying the key components of providing spiritual care in the hospital: a scoping review study.","authors":"Parinaz Khalili Khouzani, Vahid Yazdi-Feyzabadi, Mohammad Setayesh, Mohammad Hossain Mehrolhassani, Rohaneh Rahimisadegh","doi":"10.1186/s12904-025-01762-x","DOIUrl":"10.1186/s12904-025-01762-x","url":null,"abstract":"<p><strong>Background: </strong>Spiritual health refers to activities and methods that improve the quality of life and the health of spiritual performance. This study was conducted to identify the key components necessary for providing spiritual care in hospitals.</p><p><strong>Methods: </strong>The Arksey & OMalley's framework was employed to conduct this scoping review. In this regard, we examined five English databases: Scopus, Web of Science, Embase, PubMed, and Cochrane, using the search strategy. The study period was from 2000 to May 25, 2024.</p><p><strong>Results: </strong>After screening the studies, 76 studies were finally reviewed. The study's findings were classified into three categories: the goals and principles of spiritual care, the components of the spiritual care system, and the interventions of spiritual care. The goals of spiritual care emphasise patients' physical, psychological, and social well-being while enhancing their quality of life. It considers ethical principles, patient-centered values, and tailored programs. Key components include management and leadership, providing the required resources, and service delivery process. A diverse range of interventions for spiritual care is offered depending on the patient's needs and circumstances.</p><p><strong>Conclusion: </strong>This study underscores the critical role of spiritual care in enhancing patients' physical, psychological, and social well-being, fostering resilience, and improving quality of life. Integrating spiritual care into healthcare systems promotes holistic treatment, faster recovery, and patient satisfaction. Emphasizing ethical principles, tailored programs, and interdisciplinary collaboration ensures effective implementation. The findings guide healthcare professionals in embedding spiritual care for comprehensive, patient-centered, and practical outcomes.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"142"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129169","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":"Meta-aggregation of facilitators and barriers to home-based palliative care.","authors":"Zixuan Liu, Hui Zhang, Yuxuan Zhang, Yuqing Dai, Yu Sheng","doi":"10.1186/s12904-025-01788-1","DOIUrl":"10.1186/s12904-025-01788-1","url":null,"abstract":"<p><strong>Background: </strong>Home-based palliative care is in the early stages of development, and its implementation continues to face numerous challenges.</p><p><strong>Objective: </strong>This study aims to systematically synthesize qualitative research on the facilitators and barriers to home-based palliative care, offering evidence-based recommendations to support the advancement of palliative care in China.</p><p><strong>Methods: </strong>A systematic search was conducted across multiple databases including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang,2222 and VIP Database for qualitative studies related to home-based palliative care, with the search covering studies published up to October 3, 2024. Quality assessment was performed using the JBI standards for qualitative research. Meta-Aggregation was performed using an aggregative integration approach, and the data were analyzed and managed using Nvivo software.</p><p><strong>Conclusions: </strong>Twelve studies involving 334 participants were included. Ninety-nine initial findings were extracted and categorized into eight groups. Facilitators included family support, collaboration within interdisciplinary teams, and community resource availability. Barriers comprised challenges in healthcare policies, cultural and social influences, lack of Knowledge and Attitudes of Healthcare Workers, lack of Knowledge and Attitudes of Patients and Families, and insufficient home care resources.</p><p><strong>Conclusion: </strong>To advance palliative care in China, it is critical to enhance policy support and financial backing, improve the education and training of healthcare professionals and the public in diverse cultural settings, strengthen community nursing capabilities, and explore the integration of information technology in care delivery.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"146"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129189","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":"Process evaluation of a self-compassion-based online group psychotherapy programme for bereavement-related grief: a thematic analysis of the COMPACT feasibility trial.","authors":"Haruka Tani, Misako Yamada, Shoko Sugao, Yasuhiro Kotera, Yu Uneno","doi":"10.1186/s12904-025-01780-9","DOIUrl":"10.1186/s12904-025-01780-9","url":null,"abstract":"<p><strong>Background: </strong>Bereavement-related grief and prolonged grief disorders are highly prevalent; however, standardised care approaches are lacking. To address this gap, the self-COMPAssion-based online group psyChoTherapy for bereavement-related grief (COMPACT) feasibility trial was developed; it showed promising participant engagement and potential effectiveness. This study aimed to elucidate the mechanisms underlying the impact, contextual factors, and implementation considerations of the COMPACT programme.</p><p><strong>Methods: </strong>Online semi-structured interviews were conducted and analysed using a deductive reflexive thematic analysis guided by the UK Medical Research Council process evaluation framework. The interviews involved 21 participants and 10 intervention personnel from the COMPACT feasibility trial. The Helpful Aspects of Therapy Form (HATF) was used to guide the interviews, ensuring a focus on identifying mechanisms of impact, contextual factors, and implementation considerations.</p><p><strong>Results: </strong>Four main \"mechanism of impact\" themes were identified: common humanity and self-awareness, perceived importance of self-care, deepening self-insights and personal growth, and amplified self-compassion. Two associated \"contextual factor\" themes (group therapy and a secure programme environment) were highlighted. Additionally, two \"implementation consideration\" themes (barriers and facilitators) were found, with related contextual themes of group therapy and online delivery.</p><p><strong>Conclusions: </strong>The core impact mechanisms of the COMPACT programme included accessible online delivery, group work enhancing common humanity, and a safe, supportive environment deepening self-insight, self-care, and self-compassion. Future research should prioritise refining programme content, improving participant assessment, and enhancing training for intervention personnel to enable a randomised controlled trial testing the effectiveness of the intervention.</p><p><strong>Trial registration: </strong>UMIN000048554, registered 2nd August 2022.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"144"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129265","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}