BMC Palliative Care最新文献

{"title":"Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals.","authors":"Huijing Lin, Yanhua Huang, Yunling Wang","doi":"10.1186/s12904-025-01848-6","DOIUrl":"10.1186/s12904-025-01848-6","url":null,"abstract":"<p><strong>Background: </strong>Palliative care improves the quality of life and quality of death, yet in China, existing resources remain largely concentrated in urban areas. Limited access to palliative care exacerbates the sufferings of patients with life-threatening diseases such as cancer in rural regions.</p><p><strong>Objectives: </strong>This study aimed to explore the facilitators and barriers to palliative care delivery in rural China, based on the perceptions and experiences of rural healthcare professionals.</p><p><strong>Methods: </strong>Between July and August 2024, semi-structured interviews were conducted with 25 participants from rural areas, including 18 village doctors and 7 staff from township health centers (5 doctors and 2 nurses). A thematic analysis approach was used to identify key themes and subthemes.</p><p><strong>Results: </strong>Three themes were identified, including (1) the necessity of rural palliative care: highlighting the growing population of left-behind older individuals, and poor quality of death in rural areas; (2) facilitators of rural palliative care: including door-to-door service provided by village doctors, close doctor-patient relationships, support from families and neighbors, and care in familiar environment; and (3) barriers of rural palliative care: such as heavy workloads for village doctors, limited professional authority and high perceived legal risk, unbalanced healthcare resources allocation, poor economic conditions, lack of service standards, death-related taboo and stigma, performative filial piety, and limited understanding of palliative care.</p><p><strong>Conclusion: </strong>Palliative care in rural China remains underdeveloped. There is an urgent need to establish home-based palliative care services in low-resource regions. Implementing hospital-community-home care model can support more equitable allocation of healthcare resources. Expanding insurance reimbursement and promoting culturally adapted death education may further facilitate the delivery and acceptance of rural palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"211"},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709598","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 for people with substance use disorders: a qualitative study of the experiences of rural primary care providers.","authors":"Layale Tayba, Beatriz Cuesta-Briand, Kirsten Auret, Mathew Coleman","doi":"10.1186/s12904-025-01828-w","DOIUrl":"10.1186/s12904-025-01828-w","url":null,"abstract":"<p><strong>Background: </strong>In Australia, substance use disorders disproportionately affect people living in rural and remote areas. Patients with substance use disorders who receive palliative care have complex, often unmet, end-of-life needs. There is scarce evidence on the management of patients with substance use disorders in palliative care, and there is no consensus on the model of care to assist general practitioners manage their patients. This is particularly salient for general practitioners in rural areas, who provide most of the palliative care to their patients.</p><p><strong>Methods: </strong>This qualitative study explored the experiences of providing palliative care to patients with a substance use disorder among general practitioners in regional Western Australia. Data were collected through semi-structured interviews and subjected to thematic analysis.</p><p><strong>Results: </strong>A total of 12 interviews were conducted. Three main themes were identified: (1) a value-laden space; (2) substance-specific attitudes and practice; and (3) barriers to managing substance use disorders in palliative care. It was found that General practitioners' personal values shape attitudes towards substance use, and impact on the management of substance use disorders for patients receiving palliative care. Attitudes and palliative care practice vary depending on the type of substance of concern. Perceived barriers to recognition and management of substance use in palliative care included patient, health professional, health system and societal factors.</p><p><strong>Conclusions: </strong>Early recognition and intervention for people presenting with substance use disorders in palliative care settings may improve patient quality of living and make managing life-limiting illness safer and more effective. In rural settings in Australia, care is often provided by general practitioners yet despite their whole of person approach to medicine and capacity to manage complexity and multimorbidity, challenges persist in optimising the care of substance use disorders in palliative care. This study provides insight into areas for further research, the potential for the development of clinical practice standards and guidelines in this complex area of palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"210"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700116","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":"Delivering home-based palliative care during COVID-19 in Taiwan: a qualitative study with interdisciplinary team members.","authors":"Yu-Hsuan Wang, Mireille Jacobson, Pei-Yu Tsai, Susan Enguidanos","doi":"10.1186/s12904-025-01846-8","DOIUrl":"10.1186/s12904-025-01846-8","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted palliative care globally, but its impact on home-based palliative care (HBPC) within universal healthcare systems, particularly in Asian contexts, remains understudied. Taiwan's National Health Insurance system supports a well-established HBPC program. This background offers a unique lens to examine how interdisciplinary teams adapted HBPC delivery during different pandemic phases.</p><p><strong>Methods: </strong>This qualitative study used telephone-based semi-structured interviews with 14 HBPC providers from two medical centers: one in a rural area and one in an urban area. Transcripts were analyzed using inductive thematic analysis. The study design and reporting were guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).</p><p><strong>Results: </strong>Four themes related to the impact of the COVID-19 pandemic on the delivery of HBPC were identified: (1) variation in impacts across time, (2) divergent views of the impact on the uptake of HBPC, (3) difficulties in providing adequate care under restrictions, and (4) disrupted care coordination.</p><p><strong>Conclusion: </strong>Despite Taiwan's well-established palliative care programs, HBPC delivery faced ethical, clinical, and coordination challenges during the pandemic. This experience reveals an urgent need to strengthen virtual care infrastructure, establish clearer interdisciplinary coordination protocols, and provide sustained support for caregivers. These lessons should inform future public health preparedness strategies to ensure that infection control measures do not come at the expense of holistic, patient- and family-centered palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"209"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700115","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":"Cultural adaptation and validation of Turkish version of The Spiritual Needs Assessment for Patients (T-SNAP) scale in patients with cancer.","authors":"Nuriye Efe Erturk, Hatice Polat, Sinan Aslan, Afitap Ozdelikara","doi":"10.1186/s12904-025-01765-8","DOIUrl":"10.1186/s12904-025-01765-8","url":null,"abstract":"<p><strong>Background: </strong>The patients may attribute different meanings to diseases and develop various coping mechanisms to cope with them depending on the geography and cultures. In this respect, spirituality is an important dimension that patients frequently refer to in chronic and life-threatening diseases such as cancer. In the Turkiye, the availability of measurement tools designed to assess patients' spiritual needs remains limited. This study aimed to adapt the The Spiritual Needs Assessment for Patients scale into Turkish and examine its psychometric properties.</p><p><strong>Methods: </strong>The scale adaptation process involved the following steps: (1) translation and cross-cultural adaptation and (2) psychometric evaluation, including factor analysis, reliability analysis, and inter-item correlation assessment. 453 patients with cancer were included in the study. The data were collected in 2023. The participants were patients with cancer who were receiving outpatient and inpatient treatment in the medical oncology and hematology clinics of three university hospitals in Turkiye. Data collection tools included the Patient Information Form and the Spiritual Needs Assessment for Patients scale. Validity was examined through content and structural validity assessments, while reliability was measured using Cronbach's alpha coefficient and test-retest reliability.</p><p><strong>Results: </strong>The content validity index of the T-SNAP was calculated as 80.54%. The exploratory factor analysis indicated 3 factors (psychosocial needs, spiritual needs, religious needs) with 23 items. The combined three factors accounted for 66.92% of the total variance. The factor loadings ranged from 0.43 to 0.96. The Cronbach's alpha coefficient was found to be 0.95, and the test-retest reliability score was 0.96.</p><p><strong>Conclusions: </strong>The findings suggest that the T-SNAP scale is a reliable and valid tool for assessing the spiritual needs of patients in Turkiye.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"208"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family relationships and caregiver burden among family caregivers of patients with terminal cancer.","authors":"Boram Kim, In Cheol Hwang, Hong Yup Ahn, Jae-Woo Lee","doi":"10.1186/s12904-025-01855-7","DOIUrl":"10.1186/s12904-025-01855-7","url":null,"abstract":"<p><strong>Background: </strong>Family relationships play a crucial role in the care and support of patients with terminal cancer, impacting their physical and emotional well-being. This study investigates whether family relationships are associated with caregiver responses in end-of-life (EOL) care for patients with terminal cancer.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 172 family caregivers of patients with terminal cancer, collected from nine hospice and palliative care centers in South Korea between June 2021 and May 2023. Standardized tools, including the Caregiver Reaction Assessment (CRA) and the Korean Family Relationship Assessment Scale (FRAS), assessed caregiver burden and family relationships. Analyses were adjusted for variables such as age, gender, marital status, employment status, presence of a spouse, religion, caregiving environment, social support, psychological resilience, and emotional distress. Multivariate regression and subgroup analyses were performed to examine these associations.</p><p><strong>Results: </strong>The overall FRAS score was significantly correlated with all five domains of caregiver burden, adjusting for various factors (p < 0.01). The financial problems domain of the CRA was positively correlated with family conflict (p < 0.01); however, no correlation was observed with family support and togetherness. In the self-esteem domain of the CRA, positive correlations were observed among caregivers who were older adults, females, spouses, those with lower education levels, married, and those experiencing high emotional distress (p < 0.01). Subgroup analyses revealed variations based on age, gender, caregiver relationship, social support level, resilience, and emotional distress.</p><p><strong>Conclusions: </strong>These findings emphasize the integral role of family relationships in shaping caregiver experiences for patients with terminal cancer during EOL care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"207"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692089","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":"Ethical challenges in sensitive research: a reflective narrative on managing the clinician-researcher dual role.","authors":"Yakubu Salifu","doi":"10.1186/s12904-025-01850-y","DOIUrl":"10.1186/s12904-025-01850-y","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"205"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668796","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 associated with ADL-defined disability-free survival among patients with advanced cancer in a palliative care setting: a retrospective cohort study.","authors":"Ryo Soeda, Michiyuki Kawakami, Kengo Nagashima, Tsuyoshi Harada, Takuya Yamaguchi, Yu Furukawa, Tetsuya Tsuji","doi":"10.1186/s12904-025-01847-7","DOIUrl":"10.1186/s12904-025-01847-7","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"206"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668797","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":"Social support and depressive symptoms in older adults receiving hospice care: the mediating role of developmental task attainment.","authors":"Magdalena Zadworna","doi":"10.1186/s12904-025-01841-z","DOIUrl":"10.1186/s12904-025-01841-z","url":null,"abstract":"<p><strong>Background: </strong>Recognizing and addressing depressive symptoms among palliative care patients is essential, given their impact on quality of life, connections to increased physical symptoms, and links with heightened mortality risk. The current study aimed to identify the relationships between social support, developmental task attainment, and depressive symptoms in older hospice patients.</p><p><strong>Methods: </strong>The study included 120 Polish older patients aged 60-87 years receiving home palliative care. Respondents completed the Geriatric Depression Scale, the Developmental Tasks Questionnaire for Seniors, the Multidimensional Perceived Social Support Scale, and a sociodemographic survey.</p><p><strong>Results: </strong>The overall level of perceived social support and all its dimensions were negatively associated with depressive symptoms in older hospice patients. Effective handling of developmental tasks typical of old age emerged as a stronger protective factor against depressive symptoms. Moreover, developmental task attainment partially mediated the relationships between perceived social support and depressive symptoms.</p><p><strong>Discussion: </strong>A high level of social support combined with the effective accomplishment of developmental challenges typical of late life may prevent depressive symptoms in older hospice patients. The findings have valuable implications for psychological interventions in palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"204"},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668799","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 access and use among homeless individuals: a scoping review.","authors":"Ashley Rodericks-Schulwach, Ravi Gokani, Lynn Martin","doi":"10.1186/s12904-025-01835-x","DOIUrl":"10.1186/s12904-025-01835-x","url":null,"abstract":"<p><strong>Background: </strong>Homeless individuals experience severe health inequalities, increased rates of disease, and premature mortality. Yet the provision of palliative care for homeless individuals faces distinct challenges. The purpose of this scoping review was to understand previous research on the provision of palliative and end-of-life care for homeless populations and to clarify current knowledge about the unique needs and recommendations for care provision to this group.</p><p><strong>Methods: </strong>A scoping review was conducted using PubMed, CINAHL, Embase (via Elsevier), and Web of Science databases. Peer-reviewed articles were included if they focused on palliative care in homeless populations and were published in English on or after January 1, 2010.</p><p><strong>Results: </strong>Forty-five publications met the inclusion criteria. We first present the characteristics of these 45 studies, including country of origin, study design, the setting in which data were collected, sample size and characteristics, and terminology used. We then present a synthesis of study findings in three related themes: (1) the importance of the relationship between homeless individuals and healthcare staff; (2) provider-side barriers to palliative care access; and (3) the promise and perils of integrated models for palliative care provision for homeless individuals.</p><p><strong>Conclusions: </strong>Homeless individuals experience unique needs and challenges when accessing palliative care. Recommendations include future research into the experience of specific sub-populations within homelessness, inter-disciplinary initiatives and models of PC provision, and specialized staff training to work with this population.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"203"},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668798","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":"Priorities for research in perinatal palliative care: an international Delphi study.","authors":"Martin Loučka, Markéta Zindulková, Hana M Dvořáková, Zuzana Staníčková","doi":"10.1186/s12904-025-01845-9","DOIUrl":"10.1186/s12904-025-01845-9","url":null,"abstract":"<p><strong>Background: </strong>Perinatal palliative care (PPC) addresses the complex needs of families facing life-limiting fetal or neonatal conditions through an interdisciplinary, family-centered approach. Despite growing recognition of its importance, there is a lack of systematically defined research priorities to guide the development of evidence-based PPC practices.</p><p><strong>Objective: </strong>To identify and establish research priorities for perinatal palliative care (PPC) using a Delphi method with international experts and parents who experienced perinatal loss.</p><p><strong>Methods: </strong>This Delphi study involved three Delphi survey rounds with experts and bereaved parents. Participants provided and refined research priorities across rounds. In the first round, participants provided suggestions for research topics spontaneously. Topics were analyzed using principles of thematic analysis and further rated and ranked based on their importance in two additional rounds of consensual scoring. Consensus was defined as a score above the mean from at least 75% of respondents.</p><p><strong>Results: </strong>A total of 125 experts and 10 parents who experienced a perinatal loss were invited to participate in the study. Response rate in the three rounds was 24, 31, and 34%. A total of 187 research priorities were initially suggested, resulting in 34 topics reaching consensus. Final rankings and priority topics were categorized into seven thematic areas: organization of care, decision-making and communication, staff support and education, ethics, symptom management, bereavement, and family experience.</p><p><strong>Conclusions: </strong>This study identified critical research areas in PPC, providing a roadmap for future research to enhance support for families and healthcare providers in PPC.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"202"},"PeriodicalIF":2.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650992","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}