BMC Palliative Care最新文献

{"title":"Palliative care: a foreign language? Nurses' perspectives on palliative care in a French comprehensive cancer centre.","authors":"Gail Taillefer, David Verger, Marie Bourgouin, Valérie Mauriès-Saffon, Nathalie Caunes-Hilary","doi":"10.1186/s12904-025-01678-6","DOIUrl":"10.1186/s12904-025-01678-6","url":null,"abstract":"<p><strong>Background: </strong>Integrated patient-centred palliative care for cancer patients is widely advocated internationally, but promoting it often proves difficult. The literature suggests that one key factor is physicians' perspectives of palliative care (PC). Nurses' views, however, from their pivotal stance within the healthcare team between patients and physicians, have been less well researched. This study explores French nurses' perspectives on PC, how their view frames their role, and how they experience PC implementation. Nurses' discourse is then explored as a reflection of their experience.</p><p><strong>Methods: </strong>Semi-structured interviews were audio-recorded of 21 registered nurses, purposively sampled, in a French comprehensive cancer centre. Reflexive thematic analysis was applied by a team including a patients' rights representative (a PC carer and applied linguist), the quality manager, and three PC physicians. Considerations of speech emphasis and style completed the analysis.</p><p><strong>Results: </strong>Analysis generated three themes. Nurses perceive PC as a complex and continuous journey, passing through phases to the end of life. It revolves around patients' physical and psychological well-being, timeliness, patient communication and empowerment. This perception frames their caring role as members of the healthcare team, based on necessary knowledge, training, and working conditions allowing them to fulfil their mission. Consequently, they experience PC implementation as either a virtuous or a vicious circle and suggest ways to improve the latter. Analysis of nurses' discourse enhances the meaningfulness of the thematic analysis, reflecting that the more difficult the care context, the more in-depth the description and the more evaluative and emphatic the words chosen.</p><p><strong>Conclusions: </strong>These French nurses see their holistic view of PC as diverging from that of physicians, keeping them (painfully) from fulfilling their caregiving role. While the nurses are able to \"speak PC\" with patients, they see it as a foreign concept/language for physicians (and management), resulting in a sometimes vicious circle of care. Physicians' and management's openness to hearing nurses' views would be a first step towards patient and professional well-being. As the nurses suggest, a palliative approach and communication skills can be learned, and institutions can commit to rethinking priorities, policies, and resources. PC can become a shared language.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"65"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626498","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":"Latent class analysis of death coping ability among palliative care nurses and its association with their emotional labor.","authors":"Jie Li, Anne Arber, Xiaoyan Chen, Yanzi Chen, Cuihua Sun, Jinfeng Wu, Xian Chen","doi":"10.1186/s12904-025-01708-3","DOIUrl":"10.1186/s12904-025-01708-3","url":null,"abstract":"<p><strong>Objective: </strong>Death coping ability is a critical professional skill for palliative care nurses. This study aimed to identify subgroups of death coping ability among Chinese palliative care nurses based on their assessments using the Death Coping Ability Scale, and to analyze the relationship between these subgroups and their emotional labor.</p><p><strong>Method: </strong>Convenient sampling was employed to survey 868 palliative care nurses from medical institutions in Beijing, Jiangsu Province, Anhui Province, and Hunan Province. Data was collected using a general information questionnaire, the Chinese version of the Death Coping Ability Scale, and the Emotional Labor Scale. Latent profile analysis was conducted to categorize the nurses' death coping abilities, and differences in emotional labor among these categories were compared.</p><p><strong>Results: </strong>The death coping ability of palliative care nurses was categorized into three groups: \"low death coping ability group\" (11.5%), \"medium death coping ability group\" (52.0%), and \"high death coping ability group\" (36.5%). Factors influencing these categories included specialization in palliative care, opportunities for interaction with the bereaved, participation in grief counseling training, and personal bereavement experiences, all statistically significant (p < 0.05). Notably, there were significant differences in emotional labor scores among the three groups (F = 33.006, p < 0.001).</p><p><strong>Conclusions: </strong>The death coping ability of palliative care nurses can be classified into three distinct categories, each associated with different levels of emotional labor. Nursing managers should recognize these differences and implement targeted, personalized interventions to enhance the death coping abilities of palliative care nurses.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"63"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626420","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":"Emergency palliative cancer care: anxiety and midazolam.","authors":"Morten Tranung, Tora S Solheim, Erik Torbjørn Løhre, Morten Thronaes, Michael Due Larsen","doi":"10.1186/s12904-025-01687-5","DOIUrl":"10.1186/s12904-025-01687-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Cancer patients treated with palliative intent often report anxiety. Anxiety is associated with dyspnoea, cancer pain, and reduced quality of life. Limited knowledge on variability and treatment effects warranted exploring factors associated with improvement in anxiety for hospitalised palliative cancer patients.</p><p><strong>Methods: </strong>This study is a cross-sectional secondary analysis. All patients admitted to an acute palliative care unit for one year were assessed and 164 patients satisfied the study inclusion criteria. The patients reported self-registered symptom intensities using the 11-point numeric rating scale. Demographic variables, patient reports, and medical management were analysed for associations with anxiety.</p><p><strong>Results: </strong>At admission, 37.8% of the patients reported moderate or severe anxiety, and of these 43.6% used benzodiazepines. The corresponding numbers for benzodiazepine use were 35.1% and 24.4% for patients with mild and no anxiety, respectively. Of all patients, 26.8% reported improved anxiety during their hospital stay. More patients with moderate or severe anxiety at admission reported improved anxiety during hospitalisation (50.0%) compared to the corresponding patients with mild anxiety (22.8%). Patients with moderate or severe anxiety reported less improvement in pain compared to patients with mild anxiety. Improved dyspnoea was the only factor statistically associated with improvement in anxiety, both for patients reporting mild anxiety and moderate and severe anxiety. Thirty-seven-point-1% of patients with moderate or severe anxiety at admission received no benzodiazepine treatment during the hospital stay. Patients receiving midazolam had more anxiety at admission, were younger, and had poorer performance status. Median dose and interquartile range [IQR] of midazolam in these patients were 2 mg/24 h [IQR: 2.0-6.0].</p><p><strong>Conclusion: </strong>Improved dyspnoea was associated with reduced anxiety; however, the use of benzodiazepines was not.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"64"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626413","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":"Evaluation of palliative care needs rounds in residential aged care homes in South Australia: a qualitative study.","authors":"Sara Javanparast, Jennifer Tieman","doi":"10.1186/s12904-025-01695-5","DOIUrl":"10.1186/s12904-025-01695-5","url":null,"abstract":"<p><strong>Background: </strong>Palliative care needs rounds have been introduced to improve palliative and end-of-life care in residential aged care homes. As part of the Australian Government initiative 'Comprehensive Palliative Care in Aged Care Measure', needs rounds have been trialled in seven metropolitan and fifteen regional/rural aged care homes in South Australia. This qualitative study examined stakeholders' perspectives about potential values and factors that facilitate or hinder the implementation and sustainability of needs rounds.</p><p><strong>Methods: </strong>A qualitative approach was employed by using individual interviews and focus groups. Semi-structured interviews (n = 13) were conducted with executives, project team members and staff from both sites. Additionally, four focus groups were facilitated in regional/rural sites (n = 10) to further unpack specific elements of needs rounds' model that were tailored based on their needs. The interview and focus group data were recorded and transcribed verbatim. The transcripts were transferred into the qualitative data management software NVivo (version 14) for coding and analysis. Guided by a coding framework, thematic analysis was undertaken.</p><p><strong>Results: </strong>Participants found palliative care needs rounds valuable in providing a structured approach to improving palliative care planning and enhancing workforce knowledge and confidence in identifying and managing care towards the end of life. Access to telehealth facilitated needs rounds participation, especially in regional/rural areas. Comparing the nurse practitioner with the medical consultant led needs rounds revealed that there is no 'one size fits all' approach with advantages and disadvantages for each model. Successful implementation of such a model depends on the context within which needs rounds are implemented such as organisational needs, capacity and infrastructure, geography, and resources. Organisational commitment to palliative care, preparedness for change, strong leadership and financial support, and access to online platforms were noted as key factors enabling successful implementation of needs rounds.</p><p><strong>Conclusions: </strong>Palliative care needs rounds can contribute to improving organisational culture and workforce knowledge in palliative and end-of-life care. Policy commitment and financial support to adopt and tailor palliative care needs rounds that meet local needs are highly recommended.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"66"},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626416","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":"Gender disparities in end-of-life care: A scoping review of patient, caregiver and care provider perspectives in low-and middle-income countries.","authors":"Divya Narayanan, Akshaya Sudha Chandrasekaran, Elstin Anbu Raj S, Navya Vyas","doi":"10.1186/s12904-025-01702-9","DOIUrl":"10.1186/s12904-025-01702-9","url":null,"abstract":"<p><strong>Background: </strong>The term \"end-of-life\" care refers to the physical, social, spiritual, and emotional assistance provided to people near the end of their lives. Throughout history, gender has profoundly impacted many of the decisions people make. Studies have shown an increased demand for palliative care worldwide, which varies significantly among low-and middle-income countries. Achieving universal health coverage requires everyone to have access to health care where and when they need it, irrespective of gender. This scoping review aims to map the evidence available on the gender disparities in end-of-life care in low-and middle-income countries, considering the perspectives of patients, caregivers, and care providers.</p><p><strong>Methodology: </strong>A comprehensive search was done for the review in the following databases: PubMed, Embase, Scopus, Web of Science, ProQuest, and Cumulative Index to Nursing and Allied Health Literature. The World Health Organization's definition of gender was the inclusion standard. Studies conducted in low-and middle-income countries were included. Only articles published between 2005 and 2024 were retained. Articles on sexual minorities were excluded.</p><p><strong>Results: </strong>Eight articles were selected for the review and the descriptive analysis was done, followed by a thematic analysis to synthesize the available data into themes. The themes identified based on the patient's perspectives were end-of-life preferences, challenges, and perceptions towards caregiving. Care provider perspectives included attitude toward euthanasia and perception towards care provision, while caregiver perspectives involved perceptions of caregiving and challenges. Gender disparities were evident across all perspectives, with women being disproportionately affected.</p><p><strong>Conclusion: </strong>The review identified significant gender disparities in different aspects of end-of-life care. Women often experience a greater caregiving burden and higher risks of emotional, physical, and sexual violence, while men encounter societal stigma in caregiving roles. Addressing these disparities is required to ensure equitable and inclusive EOL care. Further research should be done in this direction to identify the influence of gender on end-of-life care and how it interacts with other factors like culture, religion, socio-economic status, and education to inform policies that promote gender-sensitive end-of-life care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"62"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587853","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 multidimensional orientation toward dying and death inventory: cross-cultural translation and validated in Mainland China participants.","authors":"Yazhou Wang, Yuanheng Li, Yuzhuo Xie, Yuwei Zhang, Jingzhi Wang, Jiaqi Guo, Jiajun Shi, Mingxue Ma, Lu Zhao, Mingli Jiao","doi":"10.1186/s12904-025-01697-3","DOIUrl":"10.1186/s12904-025-01697-3","url":null,"abstract":"<p><strong>Background: </strong>The negative impact of over-treatment in end-of-life individuals has led to attention to the value of death. Reassessing the attitude of death and dying can improve care and improve the quality of life. Therefore, the use of multidimensional tools to comprehensively assess the attitudes of individuals on dying and death, identify attitude tendencies and causes meaningful, and evaluate the effectiveness of the tools is an important prerequisite.</p><p><strong>Objectives: </strong>We aimed to obtain MODDI-F-C through cross-cultural translation and to evaluate its psychometric characteristics among mainland China participants.</p><p><strong>Methods: </strong>In order to obtain MODDI-F-C, a cross-cultural translation of MODDI- F/eng was performed using the Brislin model. The items quality, factor structure, reliability and validity were assessed among 2105 participants from mainland China. The concurrent validity was assessed using the Chinese version of DAP-R for the first time.</p><p><strong>Results: </strong>MODDI-F-C consists of 27 items, and five common factors were identified through factor analysis, accounting for 56.79% of the overall variance.The total consistency coefficient was 0.949.The correlation coefficient between DAP-R-C-Z and the overall scale was 0.55 (p < 0.001), between DAP - R-C - Z and the subscale 0.37-0.56 (p < 0.001).Most of the methods used for psychometric evaluation meet acceptable criteria.</p><p><strong>Conclusions: </strong>Our research has initially confirmed that MODDI-F-C is an effective tool to evaluate the fear dimension of death and dying attitude, which can identify individuals' tendencies and causes related to dying and death. However, the acceptance dimension needs further assessment.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"59"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586838","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":"What are the experiences and support needs of district nurses caring for terminally ill people with delirium at home? A qualitative study.","authors":"Elizabeth Arnold, Jean Lugton, Juliet Spiller, Anne Finucane","doi":"10.1186/s12904-024-01627-9","DOIUrl":"10.1186/s12904-024-01627-9","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a serious neuropsychiatric syndrome, which is common amongst terminally ill people in the community. District nurses have a key role in supporting terminally ill people to remain at home.</p><p><strong>Objectives: </strong>To explore the experience and support needs of district nurses caring for people with delirium in home settings.</p><p><strong>Methods: </strong>Semi-structured individual and small group interviews were conducted via Microsoft Teams with 12 district nurses in Scotland, UK. Data was analyzed using framework analysis. Data was coded both deductively and inductively.</p><p><strong>Results: </strong>Overarching themes were (i) challenges of delirium detection in the community, (ii) challenges managing delirium in the community, (iii) family carers as providers and recipients of care and (iv) education, training and support needs. Participants valued clinical judgement alone in detecting delirium, over use of formal assessment tools. Patients were referred to district nursing services at an advanced stage of their illness, with nurses needing to make rapid decisions about their care, sometimes with limited information. Participants were familiar with non-pharmacological strategies and the importance of family carer support, but uncertainty remained regarding pharmacological management of distressing symptoms. The term 'delirium' was rarely used. Challenges accessing timely advice and practical support from other health and social care professionals were reported. Participants identified delirium detection and the pharmacological management of persistent delirium as priorities for training.</p><p><strong>Conclusion: </strong>Caring for terminally ill people with delirium in the community is challenging. Educational interventions may be beneficial in developing district nurses' confidence in supporting terminally ill patients and their families. Responsive advice and support are required from specialist palliative care services.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"60"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587499","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 impacting loneliness in patients with serious life-limiting illness in the Emergency Medicine Palliative Care Access (EMPallA) study.","authors":"Brendan Maloney, Mara Flannery, Jason J Bischof, Kaitlyn Van Allen, Oluwaseun Adeyemi, Keith S Goldfeld, Allison M Cuthel, Alex Chang, Corita R Grudzen","doi":"10.1186/s12904-025-01699-1","DOIUrl":"10.1186/s12904-025-01699-1","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a quality-of-life (QoL) concern for patients facing serious, life-limiting illnesses. Discerning risk factors of loneliness in palliative care patients allows providers to take preventative action and develop holistic treatment plans.</p><p><strong>Methods: </strong>A planned sub-study of patients who completed the previously developed Three-Item Loneliness Scale upon enrollment into the multicenter, randomized clinical trial Emergency Medicine Palliative Care Access (EMPallA) with the objective of investigating the association of multimorbidity with loneliness in patients with late-stage illnesses. The EMPallA study included patients who were at least 50 years old and diagnosed with at least one end-stage illness (advanced cancer, advanced congestive heart failure (CHF), end-stage renal disease (ESRD), or advanced chronic obstructive pulmonary disease (COPD)).</p><p><strong>Results: </strong>We analyzed 1,212 surveys using a mixed-effects logistic regression model. Our findings suggest those with a single illness are less likely to be lonely than those with multimorbidity (odds ratio [OR] = 0.5, 95% CI 0.3 to 0.8). Additionally, older age was associated with less loneliness (OR comparing age by 10-year increments is 0.7 [95% CI: 0.6 to 0.9]), after adjusting for disease type, education level, race, sex, immigrant status, having a caregiver, COVID-19 period, language, and site geographic location.</p><p><strong>Conclusions: </strong>Patients suffering from multimorbidity self-report being \"very lonely\" more often than patients with a single advanced illness; furthermore, advanced illness patients who were middle-aged (versus elderly) were 25% more likely to report being \"very lonely.\"</p><p><strong>Trial registration: </strong>Clinicaltrials.gov identifier: NCT03325985. Registered October 30, 2017.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"58"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587834","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 effectiveness of web-based grief intervention for adults who lost a loved one: A systematic review and meta-analysis.","authors":"Danyang Yao, Fang Qian, Tao-Hsin Tung, Huanhuan Shi, Dongjun Bi","doi":"10.1186/s12904-025-01679-5","DOIUrl":"10.1186/s12904-025-01679-5","url":null,"abstract":"<p><strong>Background: </strong>Many bereaved individuals suffer from intense grief, anxiety, depression and post-traumatic stress disorder. To prevent these conditions from worsening, web-based grief interventions have emerged as a promising solution for providing accessible, flexible, and anonymous support to bereaved individuals. However, two previous meta-analyses focused only on the post-intervention effects of web-based grief interventions on grief, post-traumatic stress disorder, and depression in bereavement individuals, relying on a small number of studies published before 2021. Therefore, after including new research, the present study evaluated the effects of web-based grief interventions on grief, anxiety, depression, and posttraumatic stress disorder in bereaved adults, both post-intervention and after three months of follow-up.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) were retrieved from The Cochrane Library, PubMed, Web of Science, PsycARTICLES, Embase, CINAHL, Medline, and Clinical Trials, with a search time range from database establishment to February 1, 2024, without language limitations. The quality of the included RCTs was evaluated using the Cochrane Risk Assessment Tool, and evaluation was conducted using Review Manager 5.3. PROSPERO Registration: CRD42024506293.</p><p><strong>Results: </strong>A total of 726 and 771 participants were in the intervention and control groups, respectively. After the implementation of the web-based grief intervention, significant improvements were observed in anxiety (standard mean difference [SMD] = -0.37, 95% CI [-0.54, -0.20] p < 0.0001), posttraumatic stress disorder (SMD = -0.64, 95% CI [-0.78, -0.50], p < 0.00001), depression (SMD = -0.37, 95% CI [-0.47, -0.27], p < 0.00001), and grief (SMD = -0.30, 95% CI [-0.40, -0.19], p < 0.00001) among the bereaved individuals. In the intervention group, after three months of follow-up, significant improvements continued in grief (SMD = -0.19, 95% CI [-0.31, -0.08], p = 0.001), depression (SMD = -0.15, 95% CI [-0.26, -0.04], p = 0.009) and posttraumatic stress disorder (SMD = -0.23, 95% CI [-0.45, -0.01], p = 0.04), whereas no significant improvement was observed in anxiety (SMD = -0.02, 95% CI [-0.22, 0.19], p = 0.86).</p><p><strong>Conclusion: </strong>Web-based grief interventions have a positive and promising effect on anxiety, depression, grief, and post-traumatic stress disorder in bereaved individuals following the intervention. However, after three months of follow-up, the web-based grief intervention had a lasting positive effect on grief, post-traumatic stress disorder, and depression, but not on anxiety.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"61"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586895","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":"Patient-centeredness and determinant factors of palliative care service for adult cancer patients in public hospitals of addis Ababa, Ethiopia, 2024: cross-sectional mixed method study.","authors":"Muday Beneberu, Getachew Teshale, Kaleb Assegid Demissie, Endalkachew Dellie, Melak Jejaw, Asmamaw Atnafu","doi":"10.1186/s12904-025-01694-6","DOIUrl":"10.1186/s12904-025-01694-6","url":null,"abstract":"<p><strong>Introduction: </strong>Providing patient centered palliative care is essential to enhance the wellbeing of patients with life-limiting illnesses and their families. As the demand for palliative care services increases and the cancer burden grows in Ethiopia, it is crucial to know how much these services are patient centered and what factors may determine it. Therefore, this study assess the level and determinant factors of patient-centeredness for adult cancer patients' palliative care services in public hospitals found in Addis Ababa.</p><p><strong>Method and materials: </strong>A cross-sectional mixed method was employed from May 16 to August 19, 2024. A total of 407 adult cancer patients, 7 key informant interviews and five in-depth interviews were included. The quantitative data was collected using Kobo collect tool version 2.023.21 and exported to STATA version 14 for analysis. Binary and multi-variable logistic regression with 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR) were fitted to identify factors associated with the patient-centeredness of care. Qualitative data was recorded, transcribed and thematically analyzed by using Open Code software version 4.0.1.</p><p><strong>Results: </strong>Patient-centeredness care for adult cancer patients was 77.9%. age group 30-39 (AOR: 3.52, 95% CI: 1.21, 10.21), being divorced (AOR: 0.14 95%, CI: 0.06, 0.37), monthly income > 12,000 Birr (AOR: 0.36, 95 CI: 0.156, 0.836), health literacy (AOR: 0.08, 95% CI: 0.02, 0.25), intimacy with the provider (AOR: 0.14 95% CI: 0.02, 0.75), service easiness (AOR: 0.34, 95% CI: 0.17, 0.67), and appointment waiting time (AOR: 0.4 95% CI: 0.19, 0.83) were found to be significant factors for patient-centeredness of palliative care service.</p><p><strong>Conclusion and recommendations: </strong>The magnitude of patient-centered care for adult cancer patients in palliative care was 77.9%. Most patients felt respected and involved in decision-making, and their physical and emotional comfort was maintained. However, only one-third of them reported ease of access to services. Age, marital status, income, participation in decision-making, intimacy with providers, ease of access, and appointment length was the significant factors. Recommendations include improving service coordination, reducing waiting time, fostering emotional connections between patients and providers, and offering tailored support to single or widowed patients to enhance patient-centered care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"57"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587856","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}