BMC Palliative Care最新文献

{"title":"Management challenges of invasive breast carcinoma in a male patient who refused treatment: a case report.","authors":"Alex Mremi, Glory Makupa, Munguatosha Ngowi, Subira Matiku, Gad Murenzi, Atiyya Hussein, Theresia Mwakyembe, Edwin A Liwa","doi":"10.1186/s12904-025-01685-7","DOIUrl":"10.1186/s12904-025-01685-7","url":null,"abstract":"<p><p>Male breast cancer is extremely uncommon, accounting for less than 1% of all male cancers and about 0.1% of male cancer deaths. It tends to occur in an older age group (60-70 s) when compared to women (50-60 s). Male breast cancer does not usually present with large tumor size; normally, it presents with advanced stage due to less breast tissue compared to women. However, when it is left untreated for a long time, it can attain a big size. Studies have reported that some patients with breast cancer may refuse cancer treatment. Our report describes a case of breast cancer in a male patient from Tanzania who refused oncological care. A 74-year-old male came to our facility because of a left breast mass after more than 12 months. On examination, his vital signs were within normal limits. He had an ulcerated left breast mass measuring 24 × 24 cm that was noted to occupy the entire breast. Biopsy results from the lesion confirmed it to be infiltrating ductal carcinoma, of no special type, grade II. Surprisingly, the patient refused to undergo all forms of oncological treatment and opted to go for traditional medicines. The patient was kept on palliative care for controlling symptoms and improving quality of life. To date, 12 months of follow-up, the patient is still alive, although his condition has remarkably deteriorated. Respecting patients' wishes is always a top priority, but physicians may provide more substantial reasoning to convince patients to undergo the indicated treatments by knowing the effect of dismissing operative treatment on their eventual survival. In addition, understanding why patients refuse treatment is important to effectively address their concerns.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"44"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450574","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":"Dementia as a predictor of palliative care: Uncovering patient patterns based on German claims data.","authors":"Elena Rakuša, Constantin Reinke, Gabriele Doblhammer, Lukas Radbruch, Matthias Schmid, Thomas Welchowski","doi":"10.1186/s12904-025-01672-y","DOIUrl":"10.1186/s12904-025-01672-y","url":null,"abstract":"<p><strong>Background: </strong>Palliative care aims to ensure a dignified and self-determined life for people facing the end of life. While palliative care is established for tumor diseases, it's notably absent from German medical guidelines for other progressive diseases with an unfavorable prognosis such as dementia. This study will identify predictors of palliative care use in older patients and explore how these predictors relate to the probability of palliative care.</p><p><strong>Methods: </strong>We used data from the largest German health insurance company of people over 50 years of age from the period 2014-2019. The analysis focused on the last year of life. Outcomes were outpatient and inpatient palliative care and predictors were demographics, comorbidities, therapeutic remedies and rehabilitation, care and medical interventions, medication and patient group. Combined logistic regression models and discrete conditional inference survival forests were used to predict the utilization of outpatient and inpatient palliative care. For evaluation we used concordance-index and calibration plots. We identified the most important predictors by using a permutation approach and the log-loss metric.</p><p><strong>Results: </strong>The study cohort for the analysis of inpatient palliative care comprised 43,896 patients, while the cohort for the analysis of outpatient palliative care included a total of 37,430 patients. The models had appropriate discriminatory power (inpatient palliative care: concordance-index = 0.737 (95%CI = 0.721-0.754); outpatient palliative care: concordance-index = 0.689; 95%CI = 0.675-0.704) and showed appropriate calibration. A diagnosis of dementia, like a diagnosis of cancer, is predictive of inpatient palliative care and outpatient palliative care. We observed a lower probability for inpatient and for outpatient palliative care for dementia patients compared to cancer patients.</p><p><strong>Conclusions: </strong>The findings highlight the need to focus palliative care on other patient groups besides cancer patients, such as dementia patients, and to facilitate access for all patients.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"46"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450571","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":"Spiritual well-being and attitudes toward caring for dying patients: a cross-sectional study in Iranian nursing students.","authors":"Asra Nassehi, Javad Jafari, Azizollah Arbabisarjou, Hajar Sadeghi, Mojtaba Jafari, Najmeh Saberi","doi":"10.1186/s12904-025-01688-4","DOIUrl":"10.1186/s12904-025-01688-4","url":null,"abstract":"<p><strong>Background: </strong>The concept of death is one of the most significant issues in the nursing profession. To provide effective and comprehensive end-of-life care, nursing students, as future nurses, should have spiritual well-being (SWB) and a proper attitude toward the care of dying patients (ATCODP). The present study was conducted to investigate the relationship between the level of SWB and ATCODP of Iranian nursing students in 2019.</p><p><strong>Methods: </strong>This descriptive-correlational study was conducted on 139 nursing students at Bam University of Medical Sciences who were selected by the census method. To collect data, a three-part questionnaire consisting of personal information, the Paloutzian & Ellison SWB scale, and the Frommelt Attitude Toward Care of the Dying (FATCOD) scale were used. The data were analyzed by IBM SPSS version 20.</p><p><strong>Results: </strong>The mean age of the participants was 21.63 ± 3.23 years. The mean score of SWB in 98 (70.5%) nursing students was moderate, and 41 of them (29.5%) had a high score. The correlation coefficient between religious and existential health with a total score of SWB was 88% and 86%, respectively. According to Pearson's test, a significant relationship was observed between ATCODP, SWB, and its dimensions (P < 0.05).</p><p><strong>Conclusion: </strong>A significant relationship was observed between ATCODP, SWB, and its dimensions. Considering that most nursing students have a moderate level of spiritual well-being, measures should be taken to improve it during their studies. Because improving SWB in students will prepare future nurses for better quality care of dying patients and enhance their positive attitude toward death.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"45"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450622","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":"Improving Palliative Care Knowledge of nurses caring for heart failure patients : Author and corresponding author.","authors":"Sana Ali, Kim McMillan, Freya Kelly","doi":"10.1186/s12904-025-01669-7","DOIUrl":"10.1186/s12904-025-01669-7","url":null,"abstract":"<p><strong>Background: </strong>Approximately 80% of patients with advanced heart failure (HF) die within five years of diagnosis and may benefit from palliative care (PC). PC is underutilized in HF patients. One barrier is nurses' insufficient knowledge of PC. This quality improvement project aimed to enhance the PC knowledge of nurses caring for patients with HF in a Canadian tertiary care setting.</p><p><strong>Method: </strong>This project was guided by the Knowledge-to-Action framework. Semi-structured interviews were conducted to identify nurses' learning needs, which informed the development of the educational sessions. These sessions were delivered using hybrid, virtual, and asynchronous modalities. PC knowledge tests were used pre- and post-intervention to evaluate the nurses' PC knowledge. The data were presented using descriptive statistics.</p><p><strong>Results: </strong>Thirteen nurses attended the educational sessions. Ten responses were received for both the pre- and post-knowledge tests. Most participants had more than 10 years of experience, were 41 years or older, and had received prior PC training. The post-test showed improved knowledge (90-100%) of opioid use for symptomatic relief of dyspnea, advanced care planning (ACP) discussions, and communication processes. Knowledge of NSAID use in patients with HF increased by 60%. All nurses demonstrated an understanding of ACP concepts before and after the education. PC concept understanding increased from 80 to 90%.</p><p><strong>Conclusions: </strong>Educational sessions improved nurses' PC knowledge, and future education should emphasize improving PC perceptions and symptom management. However, evaluating the effectiveness of PC education is challenging because of low participation. Further research with a larger sample, longer implementation time, ongoing evaluation of PC knowledge, and nurses with diverse ages and experiences is required to understand the impact of PC education.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"43"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426187","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":"Prediction model for delirium in advanced cancer patients receiving palliative care: development and validation.","authors":"Duan Guo, Chuan Zhang, Chaohui Leng, Yu Fan, Yaoli Wang, Ling Chen, Han Zhang, Ning Ge, Jirong Yue","doi":"10.1186/s12904-025-01683-9","DOIUrl":"10.1186/s12904-025-01683-9","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common and distressing mental disorder in palliative care. To date, no delirium prediction model is available for thepalliative care population. The research aimed to develop and validate a nomogram model for predicting the occurrence of delirium in advanced cancer patients admitted to palliative care units.</p><p><strong>Methods: </strong>This was a prospective, multicenter, observational study. Logistic regression was used to identify the independent risk factors for incident delirium among advanced cancer patients in palliative care units. Advanced cancer patients admitted to palliative care units between February 2021 and January 2023 were recruited from four hospitals in Chengdu, Sichuan Province, China. Model performance was evaluated via the area under the receiver operating characteristic curve, calibration plots and decision curve analysis.</p><p><strong>Results: </strong>There were 592 advanced cancer patients receiving palliative care in the development cohort, 196 in the temporal validation cohort and 65 in the external validation cohort. The final nomogram model included 8 variables (age, the Charlson comorbidity index, cognitive function, the Barthel index, bilirubin, sodium, the opioid morphine equivalent dose and the use of anticholinergic drugs). The model revealed good performance in terms of discrimination, calibration, and clinical practicability, with an area under the receiver operating characteristic curve of 0.846 in the training set, 0.838 after bootstrapping, 0.829 in the temporal validation and 0.803 in the external validation set.</p><p><strong>Conclusions: </strong>The model serves as a reliable tool to predict delirium onset for advanced cancer patients in palliative care units, which will facilitate early targeted preventive measures to reduce the burden of delirium.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"41"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411321","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 palliative care needs of advanced AIDS patients in China: insights from a descriptive phenomenological study.","authors":"Yan Zeng, Chunrong Lv, Chuntao Wu, Xia Zhao, Lu Zhang, Chunmei Liu, Dan Su, Tongtong Yang, Xi Yan, Bin Wan","doi":"10.1186/s12904-025-01675-9","DOIUrl":"10.1186/s12904-025-01675-9","url":null,"abstract":"<p><strong>Background: </strong>HIV is still an incurable disease, causing many problems in the daily lives of patients and affecting their overall quality of life. Previous studies have shown that advanced AIDS patients have more serious physical, psychological, social, and economic problems than HIV patients and that advanced AIDS patients have more unmet needs at this time. The main objective of this study is to better understand the needs of late-stage AIDS patients and to develop targeted palliative care services for them.</p><p><strong>Method: </strong>Descriptive phenomenological methods were used. Advanced AIDS patients were selected using purposive sampling in a tertiary infectious disease hospital. Participants (n = 15) were interviewed in one-to-one semi-structured interviews between March and May 2024. Data saturation was reached after the 15th interview, as no new themes emerged. A phenomenological thematic analysis method was used to analyze the interviews.</p><p><strong>Results: </strong>The following four themes emerged and are reported in this study: (1) Physiological needs: Participants often reported that chronic pain and fatigue were the main concerns and needed help from daily activities. (2) Information needs: Patients emphasized the gap in understanding treatment plans and drugs, hoping to get clear guidance from medical service providers. (3) Psycho-spiritual needs: Participants expressed their desire for respect, friendship, and dignity, as well as their fear of future uncertainty and humiliating experiences. (4) Social support needs: economic burden, limited nursing continuity, and social discrimination are the outstanding challenges faced by participants.</p><p><strong>Conclusion: </strong>This is the first study to comprehensively examine the palliative care needs of advanced AIDS patients in China. The findings underscore the urgent need for culturally sensitive, policy-driven interventions to address these multifaceted needs. Tailored strategies can significantly enhance the quality of life for this vulnerable population and provide actionable insights for healthcare policymakers to bridge existing care gaps.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"42"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415721","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 the hidden curriculum on the risk of burnout in junior doctors in a palliative medicine rotation - a qualitative exploratory study.","authors":"Eng Koon Ong, Ranitha Govindasamy, Wen Shan Sim, Lalit Kumar Radha Krishna","doi":"10.1186/s12904-025-01665-x","DOIUrl":"10.1186/s12904-025-01665-x","url":null,"abstract":"<p><strong>Background: </strong>Palliative Care (PC) provides person-centred care for patients with life-limiting diseases and their families. Studies have shown that healthcare professionals delivering PC are predisposed to moral distress and burnout due to constant exposure to death and dying and aspects of the hidden curriculum (HC) through which culture and values are transmitted implicitly. However, there are limited studies focusing on the latter through the lens of junior doctors. Using the Ring Theory of Personhood (RToP) and the Krishna-Pisupati Model (KPM), which categorize and map conflicts between personal and professional values, beliefs, and principles within the four domains of personhood, this study investigates the impact of palliative care experiences on the risk of burnout in junior doctors.</p><p><strong>Methods: </strong>This qualitative exploratory study was conducted at the Division of Supportive and Palliative Care in the National Cancer Centre Singapore, involving medical residents who had completed at least one month with the division between 2020 and 2022. 13 participants were recruited for individual semi-structured interviews carried out by an independent research assistant. Acknowledging HC and burnout as sociocultural constructs, we adopted a constructivist ontological position and a relativist epistemological lens to guide thematic analysis of the data.</p><p><strong>Results: </strong>The themes identified were: (1) The Nature of PC (2), Moral Distress, and (3) Impact of Environment on Wellbeing. Junior doctors saw the value of the philosophy of care in PC and felt compelled to adopt values espoused by the discipline. However, compounded by consistent exposure to death and dying and limitations to manpower and time, elements of the HC, such as staff support measures, proved to be significant stressors-contributing to burnout and moral distress.</p><p><strong>Conclusion: </strong>This is the first study on the effects of the HC on burnout for junior doctors in a PC rotation. It provides unique insights into the impact of complex clinical, personal, social, ethical and organizational factors on burnout and suggests that all factors need to be addressed in tandem for any attempts at staff support to be successful. This study can guide current and future research and programs that support wellbeing for junior doctors.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"40"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411323","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":"Outcomes of delivery in patients with diagnosed life-limiting fetal condition and evaluation of perinatal palliative care program: a retrospective review of palliative care service over 7 years.","authors":"Aleksandra Korzeniewska-Eksterowicz, Hanna Moczulska, Mariusz Grzesiak, Piotr Kaczmarek","doi":"10.1186/s12904-025-01671-z","DOIUrl":"10.1186/s12904-025-01671-z","url":null,"abstract":"<p><strong>Background: </strong>The parents with a diagnosis of life-limiting fetal condition should receive medical information about the nature of defect, prognosis, possibilities of care and obstetric complications and receive psychological, spiritual, legal support. In our model of care, the perinatal hospice - functioning outside the hospital structure - offers a multidisciplinary support and coordinates care in close cooperation with hospitals. The aims of study are: analysis of the birth outcome in patients with life-limiting fetal conditions, perinatal palliative care model evaluation and analysis of factors affecting earlier contact of patients with perinatal hospice.</p><p><strong>Methods: </strong>We conducted retrospective reviews of medical records of perinatal hospice patients in 2014-2020. The study population was divided into two groups. Group 1 comprised deliveries which ended with the birth of a living newborn; Group 2: pregnancies with intrauterine fetal death and death during delivery. Separately, we analysed patients who underwent cesarean birth.</p><p><strong>Results: </strong>Out of 72 families, 68 decided to continue pregnancy. The most common diagnoses were trisomies 18 and 13. In 47 cases, deliveries resulted in a live-born newborn; in 21 pregnancies, fetal death occurred. Nineteen pregnancies were delivered via cesarean on obstetric indications. The time interval from diagnosis to first palliative consultation was, on average, 48 days in group 1 vs. 33 in group 2. Women with stillbirths contacted the hospice at an earlier stage of pregnancy (p = 0.0469), and multidisciplinary team consultation in the hospital took place earlier (p = 0.0045) and in a shorter time interval from the first consultation in hospice (p = 0.0298). Patients who were older and lived in large cities contacted hospice earlier.</p><p><strong>Conclusion: </strong>System solutions should be considered, obliging the physician to refer the pregnant woman to a perinatal palliative care program. Shortening the interval between diagnosis and palliative care consultation would allow for more effective professional support and more time to prepare the parents for losing a child.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"38"},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400597","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":"\" I can't do it anymore\": a qualitative study on the emergence of crisis in outpatient palliative care-the perspective of family caregivers.","authors":"Sofia Azhar, Anne Herrmann-Johns, Daniel Wolff, Michael Rechenmacher, Ulrich Kaiser, Maria Wasner","doi":"10.1186/s12904-025-01664-y","DOIUrl":"10.1186/s12904-025-01664-y","url":null,"abstract":"<p><strong>Background: </strong>The outpatient palliative care system is a central component of the palliative care structure in Germany, with family caregivers playing a vital role in ensuring and maintaining its success. However, crisis situations can destabilise and harm outpatient care. Previous studies have analysed hospitalisations and emergency admissions during palliative care. However, little is known about the factors that contribute to the emergence of crises in palliative outpatient care. The aim of this study was to identify factors contributing to the emergence of crisis in palliative outpatient care including the identification of protective strategies.</p><p><strong>Methods: </strong>A qualitative study using semi-structured interviews with family caregivers recently involved in outpatient palliative care was performed. The analysis was conducted using thematic coding.</p><p><strong>Results: </strong>A total of 15 family caregivers (13 female and 2 male) were recruited for the study. Crisis situations emerged through a cumulation of factors. Four categories of factors were identified: (1) structural factors, including limited access to health care professionals and a lack of necessary information, (2) illness related factors such as sudden progression in the illness trajectory and symptoms, (3) the intensity of care involvement and (4) emotional and psychological burden of family caregivers. A diverse range of protective strategies were employed by family caregivers, encompassing the involvement of the social network, the pursuit of information and the identification of a sense of purpose.</p><p><strong>Conclusion: </strong>The findings of this study confirm the importance of providing continuous, competent, and empathetic care to both family caregivers and patients in palliative outpatient care. The study highlights the importance of expanding the palliative care infrastructure, as well as ensuring unrestricted access to palliative care professionals, developing tailored information tools for family caregivers, and reducing bureaucracy. Further studies are needed to identify additional influencing factors and evaluate effective measures.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"39"},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400596","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":"Self-reported knowledge and difficulties towards palliative care among healthcare professionals in rural China: a cross-sectional study.","authors":"Junwei Niu, Min Feng, Changhui Song, Hui Xie","doi":"10.1186/s12904-025-01674-w","DOIUrl":"10.1186/s12904-025-01674-w","url":null,"abstract":"<p><strong>Background: </strong>Palliative care (PC) in rural China remains underdeveloped, with limited specialized services and significant challenges for healthcare professionals. This study aimed to examine the difficulties in providing PC and their factors from the perspective of healthcare professionals in rural Henan province, China, where specific PC services are currently unavailable.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between June and July 2024, using a convenience sample of 255 healthcare professionals from four secondary/tertiary hospitals participated. Data were collected on participants' demographic characteristics, information on recently deceased cancer patients they had cared for, and PC-related information. PC knowledge and PC difficulties were assessed using the Palliative Care Knowledge Questionnaire-Chinese version (PCKQ-PCN) and the Palliative Care Difficulties Scale (PCDS). Linear regression analysis identified factors associated with PC difficulties.</p><p><strong>Results: </strong>Among the 255 participants (Mean[age]: 34.82 ± 7.04), 71.8% were females, 57.3% were physicians, and the average work experience was 10.20 years. Regarding PC experience, 48.2% had participated in 1-2 training sessions annually over the past two years, and 32.2% reported a poor understanding of PC. The total PCKQ-PCN mean score was 13.28 ± 2.62, with 25.2% of participants classified as having poor knowledge. The PCDS mean score was 42.58 ± 13.59. Linear regression analysis showed that participating in at least one PC training session every six months (β = -10.66; p = 0.032), having experience caring for seriously ill people at home (β =  -6.31; p = 0.024), greater knowledge of symptom management (β = -3.72; p = 0.012), and higher levels of basic knowledge (β = -5.12; p = 0.007) were negatively associated with PC difficulties. Conversely, limited understanding of PC (β = 12.95; p = 0.021), greater knowledge of spiritual care and death education (β = 4.95; p = 0.034), and having new rural cooperative medical insurance (β = 6.36; p = 0.023; β = 3.21; p = 0.042) were positively associated with PC difficulties.</p><p><strong>Conclusions: </strong>This study highlights critical gaps in rural China's PC services, including inadequate training, limited focus on spiritual needs and death education, and disparities in insurance coverage. Targeted training programs in healthcare professionals and policy reforms are urgently needed to improve PC quality and accessibility in rural areas.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"37"},"PeriodicalIF":2.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374769","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}