BMC Palliative Care最新文献

{"title":"Study protocol of sustaining home palliative care for patients with Heart Failure (HF) and their family caregivers in rural Appalachia: a mixed methods randomized clinical trial.","authors":"Ubolrat Piamjariyakul, Stephanie Young, Angel Smothers, Sijin Wen, R Osvaldo Navia, George Sokos, Ann E Hendrickson, Peggy Fink, Diana Niland, Matthew Hottle, Angelo C Giolzetti, Carol E Smith","doi":"10.1186/s12904-025-01680-y","DOIUrl":"10.1186/s12904-025-01680-y","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is the leading cause of mortality, morbidity, and rehospitalization in Appalachia. Rural areas have the highest HF mortality rates. Rural Appalachians lack access to health services and end-of-life palliative care (EOLPC) and have extreme inequities in health.</p><p><strong>Methods: </strong>The aim of this mixed methods randomized controlled trial (RCT) is to test the integrated nurse-led intervention bundle of the HF home EOLPC (HF-FamPALhomeCARE) and to assess its ability to maintain sustainability with rural stakeholders, visiting volunteers, and the WV Faith Community Nurse Network. The participants are adult patients (50 to 80 years) with HF (NYHA III and IV and Stages C and D) and their caregivers (≥ 45 to 80 years). The primary aim is to test the outcomes of patients with HF and family caregivers (104 dyads) managing home supportive EOLPC in rural WV. The secondary aim is to assess the bundled intervention for helpfulness, cost and sustainability. All participants received standard care from their regular providers. The intervention group received 2 home visits, 3 biweekly telephone calls and telephone reinforcement across 12 months. Data collection for both groups was conducted at baseline and at 3, 6, 9, and 12 months.</p><p><strong>Discussion: </strong>This RCT supports research to improve health equity by improving access to health services and addressing social determinants of health in underrepresented rural Appalachia. It is designed to test practical, sustainable approaches using available local resources to address HF symptom management, support EOLPC preferences, support older adults' functional health and HF home caregiving skills, and provide social support.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06791850 Registered on date 19 January 2025.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"56"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587858","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":"Telehealth for the study of palliative care communication: opportunities, methodological challenges, and recommendations.","authors":"Elise C Tarbi, Susanna L Schuler, Natalie Ambrose, Rebecca N Hutchinson, Maija Reblin, Katharine L Cheung","doi":"10.1186/s12904-025-01700-x","DOIUrl":"10.1186/s12904-025-01700-x","url":null,"abstract":"<p><strong>Background: </strong>While telehealth may offer promise for accessible, efficient palliative care delivery, leveraging telehealth technologies as an opportunity to better understand and advance the science of palliative care communication has been less well explored. Without identifying solutions to overcome challenges to conducting research in the virtual environment, we are unable to conduct the foundational work to offer evidence-based recommendations for high-quality telehealth, particularly in the context of palliative care. Our objective is to highlight methodological challenges in the use of telehealth for the study of palliative care communication and share lessons learned from using these methods.</p><p><strong>Methods: </strong>This paper is the result of a reflective process and experience across three ongoing observational communication research studies focused on the use of telehealth during serious illness. These research datasets have been collected from multiple sites and represent rural and urban telehealth palliative care consultations for patients receiving dialysis (n = 34), patients with cancer (n = 13), and seriously ill, home-bound patients (n = 9). We illustrate challenges, insights, and recommendations with case studies from these studies.</p><p><strong>Results: </strong>We identify key challenges, and offer recommendations to address them, in telehealth palliative care communication research. Key insights fall within three themes: 1) addressing accessibility barriers to enrollment in telehealth research; 2) technical considerations regarding how software and hardware choices have implications for data collection and analysis; and 3) ethical considerations regarding the nuances of consent and privacy in telehealth encounters.</p><p><strong>Conclusions: </strong>Overall, our approach demonstrates possibilities for the use of telehealth to study palliative care communication and provides a \"how-to\" example for unique telehealth considerations from data collection through analysis. These strategies can facilitate success with large-scale health communication research studies in the telehealth context.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"55"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544181","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":"Prognostic models for survival predictions in advanced cancer patients: a systematic review and meta-analysis.","authors":"Mong Yung Fung, Yuen Lung Wong, Ka Man Cheung, King Hei Kelvin Bao, Winnie Wing Yan Sung","doi":"10.1186/s12904-025-01696-4","DOIUrl":"10.1186/s12904-025-01696-4","url":null,"abstract":"<p><strong>Background: </strong>Prognostication of survival among patients with advanced cancer is essential for palliative care (PC) planning. The implementation of a clinical point-of-care prognostic model may inform clinicians and facilitate decision-making. While early PC referral yields better clinical outcomes, actual referral time differs by clinical contexts and accessible. To summarize the various prognostic models that may cater to these needs, we conducted a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic literature search was conducted in Ovid Medline, Embase, CINAHL Ultimate, and Scopus to identify eligible studies focusing on incurable solid tumors, validation of prognostic models, and measurement of predictive performances. Model characteristics and performances were summarized in tables. Prediction model study Risk Of Bias Assessment Tool (PROBAST) was adopted for risk of bias assessment. Meta-analysis of individual models, where appropriate, was performed by pooling C-index.</p><p><strong>Results: </strong>35 studies covering 35 types of prognostic models were included. Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP), and Objective Prognostic Score (OPS) were most frequently identified models. The pooled C-statistic of PPI for 30-day survival prediction was 0.68 (95% CI: 0.62-0.73, n = 6). The pooled C-statistic of PaP for 30-day survival prediction was 0.76 (95% CI: 0.70-0.80, n = 11), while that for 21-day survival prediction was 0.80 (0.71-0.86, n = 4). The pooled C-statistic of OPS for 30-days survival prediction was 0.69 (95% CI: 0.65-0.72, n = 3). All included studies had high risk of bias.</p><p><strong>Conclusion: </strong>PaP appears to perform better but further validation and implementation studies were needed for confirmation.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"54"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537952","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":"Correction: \"The patient as teacher\" - thematic analysis of undergraduate medical students' experiences with an experiential learning project in palliative care.","authors":"Stephanie Stocklassa, Susan Block, Piret Paal, Frank Elsner","doi":"10.1186/s12904-025-01693-7","DOIUrl":"10.1186/s12904-025-01693-7","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"53"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524859","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":"Telehealth adoption in palliative care: a systematic review of patient barriers and facilitators.","authors":"Ann Kirby, Donal Griffin, Ciara Heavin, Frances J Drummond, Ciara McGrath, Fiona Kiely","doi":"10.1186/s12904-025-01698-2","DOIUrl":"10.1186/s12904-025-01698-2","url":null,"abstract":"<p><strong>Background: </strong>Telehealth is increasingly used in palliative care and its application is seen as one possible solution to improve access to palliative care services, thereby providing additional support for patients with advanced cancer. By completing a systematic review of the literature this research identifies the barriers and facilitators of telehealth adoption by patients with advanced cancer to determine the type of healthcare services needed to meet their needs.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted on CINAHL, MEDLINE, EMBASE, PsycINFO, PsycArticles, the Cochrane Library, Scopus, Web of Science, ScienceDirect, IEEE Xplore as well as grey literature to identify the barriers and facilitators of adopting telehealth by patients with advanced cancer in palliative care. The search was registered on PROSPERO (CRD42023446460) and focused on articles published between March 2021 and August 2023, after the first wave of COVID-19.</p><p><strong>Results: </strong>Overall, nine papers were identified and included in the review. Patients with advanced cancer were found to be willing to use telehealth reporting a high satisfaction. Patients with advanced cancer receiving palliative care experienced barriers such as software and hardware failures as well as technical issues. Complicating this even further was a language barrier, as well as aging and medical issues. Older patients found the use of telehealth difficult and reported needing additional support around its use, yet telehealth was broadly found to be accepted. Telehealth facilitated a sense of independence, control, comfort and security to patients. Operating in the background while remaining available it promoted a sense of empowerment for patients.</p><p><strong>Conclusions: </strong>Identification of the barriers and facilitators of telehealth use by patients with advanced cancer in palliative care, contributes to condition specific benchmarks for telehealth use and further informs national treatment guidelines around patients with advanced cancer needs to ensure sustainability and relevance now and in the future.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"52"},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517155","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":"Prescription of essential medication during the final hospitalization of patients with heart failure or cancer.","authors":"Valentina González-Jaramillo, Monika Hagemann, Lukas Hunziker, Maud Maessen, Steffen Eychmüller","doi":"10.1186/s12904-025-01682-w","DOIUrl":"10.1186/s12904-025-01682-w","url":null,"abstract":"<p><strong>Background: </strong>Four medication types-opioids, benzodiazepines, anticholinergics, and antipsychotics-have been proposed as essential for patients in their final days, regardless of their primary diagnosis. These drugs are typically prescribed for individuals with cancer who are under specialized palliative care (PC+). However, it is not known whether their usage is equally common for patients with other chronic and progressive conditions, such as heart failure (HF), or for those who are not under specialized palliative care (PC-).</p><p><strong>Aim: </strong>To assess the prescription frequency of each of the four medication types during the final hospitalization of patients with HF and compare it with the prescription frequency in patients with cancer (CA), considering both PC + and PC- patients in each disease group.</p><p><strong>Methods: </strong>A retrospective cohort study included all patients dying in a tertiary hospital between 2016 and 2022. We created three disease groups - \"HF,\" \"CA,\" and \"HF&CA\" - splitting each of them into two groups, depending on whether they received PC. So there were a total of six groups - \"HF PC+\", \"HF PC-\", \"CA PC+\", \"CA PC-\", \"HF&CA PC+\", and \"HF&CA PC-\".</p><p><strong>Results: </strong>Of the 3,874 patients, 1,921 (59%) had cancer exclusively, 371 (10%) had heart failure exclusively, and 691 (18%) had both. The median length of stay was 9 days (IQR 2-16). Within each diagnosis group, PC + patients had a higher prescription frequency for each medication type than PC- patients. For example, patients who received PC had 12 times the odds of being prescribed opioids than those who did not receive it (p < 0.05). Among the six groups, the highest prescription frequency of opioids, benzodiazepines, and anticholinergics was seen in the \"HF PC+\" group and the lowest in the \"HF PC-\" group. Antipsychotics were prescribed less frequently in the \"HF PC-\" and the \"CA PC-\" groups and were mainly prescribed in the \"CA PC+\" group.</p><p><strong>Conclusion: </strong>Across the diagnostic groups, a notable difference in the prescription of the four medication types was observed between PC + and PC- patients. This difference was more pronounced among patients with HF (without cancer).</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"51"},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517152","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":"Internal consistency and structural validity of the Swiss easy-read Integrated Palliative Care Outcome Scale for People with dementia: a secondary exploratory factor analysis.","authors":"Frank Spichiger, André Meichtry, Philip Larkin, Andrea Koppitz","doi":"10.1186/s12904-025-01691-9","DOIUrl":"10.1186/s12904-025-01691-9","url":null,"abstract":"<p><strong>Background: </strong>The Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) was developed as a promising person-centred proxy measure of symptoms and concerns. We used the Swiss-German easy-read version, a measure designed to be completed individually by family members and frontline staff caring for people with dementia. In this secondary data analysis of multicentre trial data, we investigate the IPOS-Dem's structural validity and internal consistency of the version.</p><p><strong>Methods: </strong>A total of 257 people with dementia were assessed by frontline staff, while family members assessed 118 people residing in one of 23 participating Swiss-German long-term care facilities. Each IPOS-Dem version, corresponding to the two rater populations (family members and frontline staff), underwent exploratory factor analysis separately, using data from one assessment per person with dementia. A minimum residual solution with varimax rotation was calculated to determine the factor structure. Item reduction decisions were based on factor loadings and indices for internal consistency.</p><p><strong>Results: </strong>The construct validity of the Swiss-German easy-read IPOS-Dem for frontline staff is demonstrated by two factors: Dementia Interaction and Physical Impact (Cronbach's α = 0.83) and Dementia Emotional and Behavioural Impact (Cronbach's α = 0.81). Four factors, with Cronbach's α ranging from 0.77 to 0.86, were computed for the family member version: Dementia Interaction Impact, Easy-to-Assess Dementia Physical Impact, Hard-to-Assess Dementia Physical Impact and Dementia Emotional and Behavioural Impact.</p><p><strong>Conclusions: </strong>Like other reduced patient-related outcome measures, palliative care measures and their parent instrument IPOS we identified subscales in the easy-read IPOS-Dem that describe a psychosocial impact and a physical impact. Differences in the internal structure of the family and staff versions of the IPOS-Dem likely stem from variations in observation intervals, roles and perspectives, with family members often focusing on loss and past experiences whereas staff may equate quality of life with quality of care leading to differing ratings. However, the identified internal consistency indices between 0.77 and 0.86 indicate acceptable internal consistency for the subscales and the IPOS-Dem should be taken forward for further psychometric evaluation.</p><p><strong>Trial registration: </strong>The overarching trial has been approved by the Swiss Regional Ethics Committee of the Canton of Zürich as the leading ethics committee for the involved regions, with clearance certification number BASEC2019-01847 (12/11/2019). The main study and secondary analysis are registered with the German Clinical Trials Register (DRKS00022339, 05/10/2020). Full registration is available online at http://www.drks.de/DRKS00022339 .</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"49"},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477223","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":"Actual needs of patients with amyotrophic lateral sclerosis: a qualitative study from Wuhan, China.","authors":"Lijuan Zeng, Fen Yang, Dandan Xu, Jing Zhou, Guiyuan Qiao, Man Wu, Chaoyang Li, Yiqing Yu, Yufei Qiu, Jiali Liu","doi":"10.1186/s12904-025-01684-8","DOIUrl":"10.1186/s12904-025-01684-8","url":null,"abstract":"<p><strong>Background: </strong>Amyotrophic Lateral Sclerosis (ALS) is a progressive and fatal neurodegenerative disorder that significantly impacts individuals and families. Previous research on ALS has predominantly focused on its pathophysiology, genetic factors, and potential therapeutic interventions. While these aspects are essential for understanding and treating the disease, there has been a growing recognition of the importance of studying patients' actual needs. Understanding these needs is vital for developing patient-centered care models that can enhance the well-being of ALS patients. However, existing studies on patients' needs are often limited in scope. Many are conducted in Western countries, and the results may not be directly applicable to patients in other cultural and socioeconomic contexts. China, with its large population and diverse cultural, economic, and healthcare landscapes, presents a unique setting for studying ALS patients' needs. At the same time, traditional Chinese medicine (TCM) practices are deeply ingrained in their healthcare system and may affect the way people with ALS seek treatment and manage their condition. Therefore, these differences may lead to differences in the actual needs of ALS patients in China. In conclusion, this qualitative study on the actual needs of ALS patients in China aims to bridge the gap in the existing research. By exploring these needs, it can provide valuable insights for healthcare providers, policymakers, and researchers, ultimately contributing to the improvement of care and quality of life for ALS patients in China.</p><p><strong>Method: </strong>We carried out a qualitative study using an empirical phenomenological approach. Individual in-depth interviews were performed among 22 people with ALS from the motor neuron disease rehabilitation center of a tertiary Chinese medicine hospital in China, and the interview content was analyzed qualitatively. Interview recordings were converted to text content by NVivo 11.0 software and analyzed using Colaizzi's phenomenological method.</p><p><strong>Result: </strong>Three main themes were identified in this study: (1) Demand for healthcare services, (2) Emotional requirements, (3) Functional requirements. In addition, 8 sub-themes were extracted as the actual needs of ALS patients.</p><p><strong>Conclusion: </strong>This study is based on the real experience of ALS patients after diagnosis, and a deep understanding of these experiences can explore the actual needs of patients from many aspects and give reasonable advice and help. Given the particularity of the disease and the uncertainty of treatment, patients will have practical needs for relevant medical support, emotional requirements, physical functions, and other aspects during the period of illness, and the corresponding support is an effective measure to reduce the burden on patients.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"50"},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477222","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":"Increasing challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study.","authors":"Matthias Villalobos, Anastasia Korezelidou, Laura Unsöld, Nicole Deis, Michael Thomas, Anja Siegle","doi":"10.1186/s12904-025-01690-w","DOIUrl":"10.1186/s12904-025-01690-w","url":null,"abstract":"<p><strong>Background: </strong>The timely initiation of end-of-life (EOL) conversations is considerered best practice for patients with advanced cancer and therefore recommended in oncological guidelines. General practitioners (GPs) play a key role in the coordination of EOL-care and often claim that they have also the responsibility to initiate the necessary conversations. Nonetheless, the content of these conversations is rarely a subject of communication between GPs and oncology specialists but crucial for timely integration of palliative care. The aim of this study is to explore the GPs' perspectives on initiation and conduction of EOL-conversations in patients with metastatic lung cancer and how they perceive the interaction with the oncologists of a cancer center.</p><p><strong>Methods: </strong>Qualitative design with in-depth interviews with GPs that refer patients with metastatic lung cancer to a cancer center; thematic analysis following Braun and Clarke.</p><p><strong>Results: </strong>We identified three main themes: timing and conduction of EOL-conversations, factors influencing EOL-conversations, and modes of GP-oncologist interaction. All themes showed important and increasing challenges in regard to communication strategies or procedures within the cancer center and between general practitioners and oncologists. Aside from the elucidated challenges of EOL-communication, new problems arise from the difficulties in keeping pace with advances in oncology and the increasing prognostic uncertainty. Additionally, the lack of standardized communication in EOL-topics between GPs and oncologists is underlined. Options in the mode of interaction include written information in reports or digital platforms and direct phone calls.</p><p><strong>Conclusions: </strong>Because of the growing complexity in modern oncology, strategies for improvement in GP-oncologist interaction have to consider information about therapeutic advances and prognosis of patients. The increasing prognostic uncertainty hazards the adequate provision and conduction of EOL-conversations and thus, the timely integration of palliative care. As a consequence, a trustful personal interaction that includes direct contact via phone calls between GPs and oncologists should be encouraged.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"48"},"PeriodicalIF":2.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469742","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":"Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study.","authors":"Annica Lagerin, Christina Melin-Johansson, Bodil Holmberg, Tove Godskesen, Elin Hjorth, Lena Junehag, Carina Lundh Hagelin, Anneli Ozanne, Johan Sundelöf, Camilla Udo","doi":"10.1186/s12904-025-01681-x","DOIUrl":"10.1186/s12904-025-01681-x","url":null,"abstract":"<p><strong>Background: </strong>Communication is central to implementing palliative care (PC) and effective interdisciplinary team functioning. Communication about existential issues is often urgent in PC, yet interdisciplinary teams frequently lack the time and education to meet these communication needs. Thus, more knowledge of existential conversations in different PC contexts is required.</p><p><strong>Aim: </strong>This study aimed to gain an in-depth understanding of healthcare professionals' (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model.</p><p><strong>Method: </strong>Seven focus-group interviews that included 26 HCPs who worked with PC patients in different care settings were carried out in 2020 and 2022. The grounded theory method was used to analyse and compare data from the interview transcripts.</p><p><strong>Results: </strong>The HCPs' primary concern in daily work was establishing a trusting relationship, a prerequisite for enabling existential conversations with a person with PC needs and/or their next-of-kin. The main concern was characterised by the core category maintaining presence and four categories describing interdisciplinary strategies that the HCPs used to achieve a trusting relationship and enable existential conversations in the late phase of life. Several potential barriers also hindered existential conversations. The theoretical model 'meaningful existential conversations in PC' was constructed.</p><p><strong>Conclusions: </strong>The interdisciplinary strategies used to establish existential conversations, the potential barriers to these conversations and the model we present can be used as a basis for reflection in professional collaborative learning in PC, as a tool for teachers in educational PC programmes and as a guide for HCPs in PC.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"47"},"PeriodicalIF":2.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460207","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}