BMC Palliative Care最新文献

{"title":"Relationships between health personality and death anxiety: mediating role of death coping self-efficacy among Chinese clinical medical freshmen.","authors":"Junping Zhong, Xiao Li, Yiming Zhou, Huohuo Dai, Deling Zhang, Huili Chen, Tianya Wang, Enming Zhang, Zhijie Zou, Qiuxiang Chen, Qing Zhang","doi":"10.1186/s12904-025-01726-1","DOIUrl":"10.1186/s12904-025-01726-1","url":null,"abstract":"<p><strong>Background: </strong>Death anxiety in physicians is considered to be a possible factor affecting the quality of palliative care. As the reserve force of future medical careers, the level of death anxiety among clinical medical freshmen and its impact mechanism deserves attention. Previous studies have indicated that personality traits and self-efficacy may be factors influencing death anxiety. However, there is limited research on the current state of death anxiety among clinical medical freshmen, and the impact of health personality, death coping self-efficacy on death anxiety. The objectives of this study were to investigate the death anxiety levels of clinical medical freshmen, explore whether death anxiety is affected by health personality and death coping self-efficacy, and examine whether death coping self-efficacy mediates the association between health personality and death anxiety among clinical freshmen.</p><p><strong>Methods: </strong>A cross-sectional survey among 378 clinical medical freshmen was conducted at a university in Wuhan, Hubei Province, China between June and July 2023. Demographic questionnaire, the Chinese versions of the Health Personality Assessment (HPA), Death Coping Self-efficacy Scale (DCSS) and Death Anxiety Scale (DCS) were used. SPSS 25.0 statistical software was used for descriptive analysis, independent sample t-tests, one-way ANOVA, and Pearson correlation analysis. The mediating effect analysis was performed with PROCESS version 4.1 Model.</p><p><strong>Results: </strong>A total of 360 valid questionnaires were collected. Clinical medical freshmen exhibited high levels of death anxiety was (45.55 ± 7.57). Health neuroticism has a significant positive impact on death anxiety (β = 0.407, t = 2.323, P < 0.05). In contrast, death anxiety was significantly impacted negatively by death coping self-efficacy (β=-0.105, t=-3.441, P < 0.05). The association between health neuroticism and death anxiety was partially mediated by death coping self-efficacy; the mediating impact accounted for 18.44% of the total effect, with a 0.092 coefficient.</p><p><strong>Conclusions: </strong>This study revealed that clinical medical freshmen had high levels of death anxiety. Health neuroticism and death coping self-efficacy directly affected clinical medical freshmen' death anxiety. Death coping self-efficacy mediated the relationship between health neuroticism and death anxiety among clinical medical freshmen. Interventions by medical educators that focus on both individuals' health personality and death coping self-efficacy may be most effective in reducing death anxiety among clinical medical freshmen.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"86"},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744329","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":"Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources.","authors":"Maya Corman, Michaël Dambrun, Angeline Ginzac, Katell Ménard","doi":"10.1186/s12904-025-01719-0","DOIUrl":"10.1186/s12904-025-01719-0","url":null,"abstract":"<p><strong>Background: </strong>According to the concept of Total Pain proposed by Cicely Saunders (1967), the treatment of pain for patients in need of palliative care requires considering its multidimensional nature, encompassing physical, social, psychological, and spiritual aspects. The aim of this study was to update the concept of Total Pain and explore the resources used by patients with cancer.</p><p><strong>Methods: </strong>Fourteen semi-structured interviews were conducted in one oncology center and one oncology rehabilitation center (median age = 70.5, range [55-77]; 8 women). The interview guide explored various dimensions of suffering, including physical (e.g., pain), social (e.g., isolation), psychological (e.g., emotional state), and spiritual (e.g., the role of spirituality in illness experience), as well as connections to nature, and patients' internal and external resources related to each sphere of suffering. Interpretative Phenomenological Approach (IPA) was employed to analyze the interviews.</p><p><strong>Results: </strong>The findings highlight several important aspects of suffering: the unpredictability of pain (physical sphere), loss of social roles (social sphere), negative affects (psychological sphere), evocation of the end of life (spiritual sphere), and loss of contact with nature. Besides in terms of resources, the study identifies several key coping mechanisms, such as mind-body practices for relieving physical and psychological pain, distraction engaging with the environment, nature as a source of positive emotions, and the search for meaning.</p><p><strong>Conclusions: </strong>Despite experiencing total pain, some patients utilize internal and external protective resources in the face of life-threatening illness. These findings underscore the importance of viewing Total Pain under its multidimensional aspect and as a dynamic process involving the individual's connection with their community and environment.</p><p><strong>Trial registration: </strong>This study received approval from the Ethical Committee of CPP SUD EST 1 (National number: 2019-A02263-54).</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"85"},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744135","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":"Experiences of healthcare professionals providing palliative care in home settings - a scoping review.","authors":"Luke Tan, Sonia Sheri, Yun Yao Goh, Raeanne Fong, Ranitha Govindasamy, Yun Ting Ong, Nur Amira Binte Abdul Hamid, Tessa Li Xiang Low, Lalit Kumar Radha Krishna","doi":"10.1186/s12904-025-01728-z","DOIUrl":"https://doi.org/10.1186/s12904-025-01728-z","url":null,"abstract":"<p><strong>Background: </strong>The growing preference for home-based end-of-life care accords a dignified death for terminally ill patients. However, for healthcare professionals (HCPs) involved, this caregiving approach is embedded with unique psychosocial, practical and emotional stressors. Without sufficient support, HCPs face higher risks of moral distress, compassion fatigue, vicarious trauma, secondary traumatic stress and burnout-collectively known as the costs of caring-that precipitate depersonalisation and compromised patient care. Despite its far-reaching implications, current understanding of the costs of caring amongst HCPs in home-based settings remains remiss. Thus, we conduct a scoping review to investigate the experiences of HPCs providing home-based palliative care to terminally ill adult oncology patients.</p><p><strong>Methods: </strong>Outlined by the Systematic Evidence-Based Approach and PRISMA guidelines, searches for relevant articles published between 1st January 2000 and 1st October 2024 were performed on PubMed, Embase, Scopus, PsycINFO and CINAHL databases. Selected articles underwent concurrent and independent thematic and content analyses. Central themes and categories were extracted and merged, forming key domains that framed the discussion.</p><p><strong>Results: </strong>Of 5676 titles and abstracts screened, 543 full-text articles were reviewed. 20 full-text articles were analysed for inclusion. Four key domains emerged: (1) motivations to practice palliative care; (2) impact on personhood of HCPs (3) challenges faced by HCPs; and (4) support systems for HCPs.</p><p><strong>Conclusion: </strong>Providing home-based palliative care to adult oncology patients is fulfilling for HCPs-fostering meaningful professional relationships with patients, a more holistic perspective of life and death and a heightened sense of personal accomplishment. However, HCPs may encounter dissonance amidst conflicts between their dominant beliefs and new experiences, leading to burnout, depersonalisation and poor care delivery that are further exacerbated by the costs of caring, if inadequately addressed. Longitudinal and accessible personalised and organisational support is key to sustaining HCPs' capacity to deliver compassionate and high-quality palliative care. The use of the Ring Theory of Personhood framework in this review provides an avenue for the structuring of such support systems.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"83"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744173","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":"Health-oriented leadership in specialized outpatient palliative care teams in Germany: a qualitative study with palliative care professionals.","authors":"Friederike Hess, André Klussmann, Volker Harth, Stefanie Mache","doi":"10.1186/s12904-025-01721-6","DOIUrl":"https://doi.org/10.1186/s12904-025-01721-6","url":null,"abstract":"<p><strong>Background: </strong>Palliative care leadership is characterized by diversity and collaboration, with an emphasis on interdisciplinary teamwork and shared responsibility. In the context of palliative care, the leadership role is subject to a distinctive set of stressors, which in turn necessitates the implementation of strategies that are conducive to the well-being of the team. The implementation of the Health-oriented Leadership approach (HoL) appears to be a crucial step in advancing the field and addressing the emotional aspects of end-of-life care. Given the growing global need for palliative care, the study aims to provide initial insights into how health-oriented leadership is understood in the field of specialized outpatient palliative care (SAPV),its potential benefits and the challenges to its implementation. Furthermore, the perceived advantages of this approach in the given context will be discussed, and the challenges inherent to its implementation will be presented.</p><p><strong>Methods: </strong>In this qualitative study, a total of 30 semi-structured interviews were conducted with palliative care professionals working in Northern Germany. The participants were distributed equally between leaders and employees, and the interviews were conducted in person. The participants included medical practitioners, nursing staff and a health scientist in palliative care. The data were subjected to an inductive analysis and interpretation in accordance with the qualitative content analysis proposed by Mayring. Exploratory analyses were conducted to identify and examine the differences between leaders and employees.</p><p><strong>Results: </strong>The findings of the study indicate that employees and managers in palliative care hold comparable yet distinct perspectives on the advancement of occupational health (HoL). Both groups emphasised the relevance of a supportive working environment, health promotion measures and effective communication. Employees focused on work-life balance and immediate benefits such as job satisfaction, while managers prioritised adaptive structures and long-term goals such as reducing absenteeism. Communication barriers and resource management were identified as challenges. Both groups emphasised the importance of appreciation, mental health and professional boundaries for a healthy working environment.</p><p><strong>Conclusion: </strong>This study emphasizes the important role of health-oriented leadership in addressing unique challenges in SAPV and fostering a supportive work culture. It highlights the diverse approaches of leaders and employees towards health management and underscored the increasing emphasis on self-care and mental well-being in high-stress healthcare environments.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"84"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744251","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":"The influence of an interactive educational approach on advance care planning counseling in individuals with psychiatric disorders.","authors":"Yi-Chien Chen, Fang-Ying Chu, Ling-Yu Chang, Ming-Yuan Hsieh, Chao-Hsien Lee","doi":"10.1186/s12904-025-01723-4","DOIUrl":"10.1186/s12904-025-01723-4","url":null,"abstract":"<p><strong>Background: </strong>In Taiwan, psychiatric patients often face premature judgments regarding cognitive impairment, emotional instability, communication barriers, or issues related to guardianship rights due to their psychiatric diagnosis. This leads to a reduction in their autonomy in healthcare decision-making. Advocacy for and experiential understanding of Advance Care Planning (ACP) among individuals with psychiatric disorders are significantly lacking. This research explores the influence of an interactive educational approach on the ACP process for psychiatric patients and whether this approach can enhance their comprehension, attitudes, and intentions regarding Advance Decisions (AD).</p><p><strong>Methods: </strong>To accommodate potential variances and ensure robustness in our findings, we ultimately elected to recruit 90 participants. Using a computer-generated random number generator, we conducted a randomized trial, assigning 45 individuals to the control group and an equal number to the intervention group. The control group continued with the routine self-care educational curriculum, while the intervention group, in addition to the standard curriculum, participated in bi-weekly intervention sessions for three months. This resulted in six group health education sessions, each lasting one hour. To evaluate participants' knowledge, attitudes, and intent to sign regarding ACP, the effects of group, time, and their interactions were assessed using Generalized Estimating Equations.</p><p><strong>Results: </strong>Both groups were homogeneous at baseline. Post-intervention, Knowledge improved by 3.31 points (p < 0.001) and Attitude by 4.91 points (p < 0.001). However, the increase in Intent to Sign (0.73 points, p = 0.222) was not statistically significant. The overarching findings indicate that the application of an interactive educational model significantly enhances psychiatric patients' knowledge and attitudes toward ACP, although it does not substantially impact their intention to sign.</p><p><strong>Conclusions: </strong>Interactive education effectively enhances psychiatric patients' knowledge and attitudes toward ACP but does not significantly influence their intent to sign AD. We advocate for their empowerment in ACP discussions. This study highlights the feasibility of integrating ACP promotion into routine psychiatric care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"82"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701937","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":"Experiences and needs of family caregivers for patients with End Stage Renal Disease (ESRD) in Palestine.","authors":"Zareefa Shaabna, Maysoon S Abdalrahim, Ruqayya Zeilani","doi":"10.1186/s12904-025-01722-5","DOIUrl":"10.1186/s12904-025-01722-5","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis play a crucial yet demanding role in patient care. Understanding their experiences and needs is essential for improving support systems and caregiving outcomes. This study investigates the caregiving experiences and needs of caregivers for ESRD patients on hemodialysis in Palestine.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological approach was employed, utilizing purposive sampling to recruit participants from the Palestine Medical Complex from March 2023 to June 2023. Data collection proceeded until saturation was reached, resulting in a total of 22 interviews. Data were collected through in-depth interviews and analyzed using Colaizzi's phenomenological method to capture the essence of caregivers' lived experiences.</p><p><strong>Results: </strong>The analysis revealed four central themes that illustrate the diverse challenges caregivers encounter: Overwhelming Demands of Caregiving, Altruistic Commitment to Care, Balancing Roles and Responsibilities, and A Journey Marked by Fears and Anxieties. Additionally, six key categories of support needs were identified: Access to Healthcare, Transportation Coverage, Shared Responsibilities, Physical and Psychological Well-being, Information Dissemination, and Scheduling Flexibility. These themes highlight the multifaceted nature of caregiving, encompassing both the emotional and practical burdens faced by caregivers.</p><p><strong>Conclusion: </strong>Palestinian caregivers of ESRD patients experience significant physical, emotional, and financial hardships, compounded by the complexities of caregiving and the burdens of inflexible hemodialysis schedules. These challenges are exacerbated by systemic issues, such as shortages of hemodialysis machines and restrictions imposed by the Israeli occupation, which frequently impede access to essential treatments. To effectively support these caregivers, a multi-faceted approach is required. This should include financial assistance to alleviate economic stress, provision of necessary caregiving resources, and the creation of accommodating environments during dialysis sessions. Additionally, psychological support is crucial to help caregivers manage the emotional toll of their responsibilities. Clear and comprehensive information regarding treatment options and prognosis is essential to empower caregivers in navigating the complexities of ESRD care. Future implications of this study suggest the need for policy interventions aimed at improving healthcare infrastructure, enhancing caregiver support systems, and developing targeted programs to bolster resilience among caregivers. Implementing these strategies will be vital in mitigating caregiver burden and ensuring the sustainability of caregiving within the context of chronic illness management in Palestine.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"81"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701933","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":"Factors influencing accessibility of palliative care: a systematic review and meta-analysis.","authors":"Zhiyi Shi, Mai Du, Shuqin Zhu, Yang Lei, Qin Xu, Weiying Li, Wenwen Gu, Ning Zhao, Yi Chen, Wanting Liu, Haonan Wang, Yucheng Jiang","doi":"10.1186/s12904-025-01704-7","DOIUrl":"10.1186/s12904-025-01704-7","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is essential for enhancing quality of life in patients with life-threatening illnesses. However, its accessibility remains inconsistent across populations and regions. This review systematically examines and quantifies factors influencing accessibility of palliative care.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search in PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, Wanfang, and VIP databases, covering the period from January 2014 to July 2024. The search aimed to identify observational studies on factors influencing accessibility of palliative care. Keywords related to accessibility were derived from the five dimensions defined by Penchansky and Thomas: availability, accessibility, accommodation, affordability, and acceptability. Study quality was assessed using the Joanna Briggs Institute (JBI) tools, and a meta-analysis was conducted using Review Manager 5.3.</p><p><strong>Results: </strong>A total of 20 studies were included in the analysis, with 15 using a retrospective design with secondary data analysis, two employing a cross-sectional design, and three using a cohort design. There were no studies on availability, one study on accessibility, two studies on affordability, one study on accommodation, and sixteen studies on acceptability. The influencing factor for accessibility is geographic location. The influencing factors for affordability and accommodation are mainly demographic characteristics, including race, religion, and employment status. The most influential factors for acceptability are categorized as sociodemographic, healthcare service, disease-related factors. Meta-analysis results indicated that female gender (OR = 1.18, 95% CI: 1.14-1.23), higher income level (OR = 1.11, 95% CI: 1.08-1.14), and larger hospital bed capacity (OR = 1.22, 95% CI: 1.14-1.32) facilitated accessibility to palliative care (P < 0.05). Conversely, residing in rural areas (OR = 0.80, 95% CI: 0.67-0.95) and being of African descent (OR = 0.78, 95% CI: 0.68-0.90) were barriers to accessibility (P < 0.05).</p><p><strong>Conclusions: </strong>This review highlights a relationship between key sociodemographic characteristics, healthcare service, disease-related factors and the accessibility of palliative care. However, the limited number of studies focusing on specific dimensions, such as availability, affordability, accessibility, and accommodation, creates gaps in understanding. Further research is needed to clarify the underlying mechanisms and potential causality of these associations. Recognizing the significant implications of limited accessibility of palliative care can help identify underserved populations and develop targeted interventions to improve the access to the service for these groups.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"80"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701934","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":"Still safe; still respectful: a mixed methods study exploring the early experiences of a rural community hospice in providing voluntary assisted dying.","authors":"Kirsten Auret, Terri J Pikora, Beatriz Cuesta Briand","doi":"10.1186/s12904-025-01713-6","DOIUrl":"10.1186/s12904-025-01713-6","url":null,"abstract":"<p><strong>Background: </strong>Voluntary assisted dying has become available as an end-of-life choice in many countries, including Australia. There is evidence on the mixed impact of voluntary assisted dying legislation on palliative care healthcare professionals, however, less is known about the interface between palliative care and voluntary assisted dying in smaller rural settings. This study explored the experiences of staff at a hospice in rural Western Australia in the two years following the implementation of voluntary assisted dying legislation.</p><p><strong>Methods: </strong>A mixed-methods research methodology was used, with data collected via a brief anonymous survey and semi-structured interviews conducted with hospice staff in one rural location in Western Australia. Survey data was exported into SPSS and descriptive statistics were performed. Interviews were audio recorded and after deidentification, the transcripts were analysed thematically.</p><p><strong>Results: </strong>A total of 30 participants took part in the survey and 10 were interviewed. The majority (n = 19) of survey respondents had been involved in voluntary assisted dying, yet only seven reported that their day-to-day role had changed. Supporting patient choice and autonomy were the most cited benefits of the introduction of voluntary assisted dying. Analysis of the qualitative data yielded three main themes: everyone is involved with patients accessing VAD; nothing changes but everything changes; and perceived support, education and training needs.</p><p><strong>Conclusions: </strong>This study has described day-to-day work and experiences of those working in a small rural hospice which has integrated VAD into the care offered within the facility, observing there are subtle changes in the organisational atmosphere when VAD occurs. The education and support activities in place and the noted gaps may be a useful checklist for other hospices in the early phases of integrating VAD into their facility. Recommendations for future research are made.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"78"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693709","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 consultation teams in long-term care: a descriptive retrospective cohort study.","authors":"Helen Tam-Tham, Nadine Persaud, Amit Arya","doi":"10.1186/s12904-025-01716-3","DOIUrl":"10.1186/s12904-025-01716-3","url":null,"abstract":"<p><strong>Purpose: </strong>Given the wide prevalence of advanced illness and frailty among residents in long-term care (LTC), a palliative approach to care can support comfort and quality of life. Yet, significant gaps exist with the provision of palliative care in LTC settings. We aim to describe a palliative care consultation team designed to address this need.</p><p><strong>Methods: </strong>A single-centre retrospective cohort study was conducted at a LTC home in Toronto, Ontario, Canada. We included residents referred to the palliative care consultation team between February 1, 2021, to February 1, 2023, with at least six-months of follow-up time. We used a descriptive quantitative approach to examine access to the palliative care consultation team, changes to advance care plans, and hospital transfers.</p><p><strong>Results: </strong>Eighty-seven residents were referred and seen by the palliative care consultation team. The mean age was 85 years, 71.3% were female, and 48.3% had three to four comorbidities. Most residents were seen once (55.2%). Among residents that died (n = 53), 41.5% were referred with greater than three months of survival time. Among residents that had advance care plans documenting \"Transfer to Hospital\" (n = 41) and \"Full Code\" status (n = 17), 53.7% adjusted to \"Do Not Transfer\" and 76.5% to \"Do Not Resuscitate\" orders, respectively. The hospitalisation rate was one per 1000 resident-year.</p><p><strong>Conclusions: </strong>At this LTC home, palliative care consultation teams represented an important service to improve the provision of palliative care particularly around facilitating advance care planning discussions. The findings of this study may inform further research on palliative care interventions for LTC residents.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"79"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694249","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":"Need and challenges of palliative care in tribal people: a qualitative analysis.","authors":"S B Keerthana, A Kubendran","doi":"10.1186/s12904-025-01711-8","DOIUrl":"10.1186/s12904-025-01711-8","url":null,"abstract":"<p><strong>Background: </strong>Indigenous people are the most vulnerable and marginalised parts of society. Health services available to the tribal people are in developing face when compared to non-indigenous people. The situation with palliative care services exhibits a similar discrepancy. This study aims to explore the challenges and needs of palliative care within the tribal communities of Kerala.</p><p><strong>Methods: </strong>The study followed a case study method conducted among the Paniya tribal community in Kambhatti, Maani, and Ozhakodi settlements of the Wayanad district, Kerala. The researchers used semi-structured interviews and observation as data collection methods. The data were collected from tribal people, ASHA workers, and promoters. Tribal people older than 18 years are considered for this study. A six-step model of reflexive thematic analysis was used for analysis. Open coding, followed by axial coding, was used to analyse the data collected from the participants. The codes were combined to form themes.</p><p><strong>Results: </strong>A total of 12 participants were interviewed for the study, among them 8 participants were tribal people, 2 participants were promoters and 2 participants were ASHA workers. The majority of the tribal individuals live in joint families inside their settlement. Most of the participants were women, compared to men. Most of the women are employed through the Mahatma Gandhi National Rural Employment Guarantee Act. Nine major themes related to the challenges of palliative care were derived after the analysis are, lack of awareness, accessibility, financial issues, cultural beliefs and practice, fear and communication barriers, insufficient health care workforce, palliative care services, and health-related issues.</p><p><strong>Conclusions: </strong>This study highlights the significance of palliative care for tribal populations. There is an increased need for palliative care, accompanied by challenges with receiving it in a culturally acceptable and sensitive manner. Developing a hybrid healthcare approach that integrates both traditional and modern medications exclusively for tribes is essential. The tribal population requires support in accessing comprehensive palliative care services from various professionals. It is crucial to establish healthcare programs aimed at addressing the entire healthcare needs of the tribal populations.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"76"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671631","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}