BMC Palliative Care最新文献

{"title":"Evaluation of the HOPE spiritual assessment model: a scoping review of international interest, applications and studies over 20+ years.","authors":"Georgia Sleeth, Priya Gottlieb, Achutha Srinivasan, Ufuoma Thaddeus, Meera Mennillo, Gowri Anandarajah","doi":"10.1186/s12904-025-01809-z","DOIUrl":"10.1186/s12904-025-01809-z","url":null,"abstract":"<p><strong>Background: </strong>Evidence supports classifying spiritual health as a determinant of health and including spiritual care in comprehensive patient-centered care. Despite delineation of primary versus specialty palliative skills, including spiritual care, and availability of spiritual history/assessment communication tools designed for non-specialist (SH/SAs), medical teams continue to neglect patients' spiritual needs. A possible contributor is that consolidated evidence regarding uses and/or effectiveness of these SH/SA tools is lacking.</p><p><strong>Aim: </strong>To explore interest, applications and evaluations of one of the well-known SH/SA tools - the HOPE spiritual assessment.</p><p><strong>Methods: </strong>We conducted a scoping review following Arksey and O'Malley's protocol and PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched PubMed, Web-of-Science, Google Scholar, PsycInfo, Academic Search Premier, CINAHL, Atla Religion Database, with AtlaSerials and SocIndex, for all sources citing the original 2001 HOPE article (to July 2023); no restrictions on article type, location, language. We used tiered inclusion/exclusion criteria, corresponding to our specific research questions regarding interest, applications and evaluations of HOPE.</p><p><strong>Results: </strong>Of 1,047 unique sources, 909 underwent full-text review. 571 explicitly mentioned/cited HOPE, representing 51 countries, 21 languages, and multiple disciplines including: 55% medicine, 15% nursing, 7.5% psychology, 6% chaplaincy, 5% social work. 266 sources offered expert opinions about HOPE. 63 described specific experience using and/or evaluating HOPE; 17 from non-English speaking countries. 59 demonstrated acceptability, 34 feasibility, 30 content validity. Of the 31 formal studies/evaluations, 17 intervention studies of HOPE demonstrated validity as a clinical, educational, or qualitative research tool, and 14 studies analyzed the HOPE model itself, with 10 comparing SH/SA tools. In these comparisons, HOPE rated highly, as did some others. HOPE's comparative strengths include: acceptability for diverse (secular/religious/multicultural) populations; adaptability across clinical settings; flexibility for use by novice and expert clinicians.</p><p><strong>Conclusion: </strong>This first systematically constructed review of any of the well-known SH/SA tools revealed broad, international interest in HOPE and evidence for its acceptability, feasibility, and validity in diverse settings. Next steps for improving patient-centered spiritual care include: disseminating evidence; clarifying spiritual care competencies/boundaries for different disciplines/settings; increasing required primary spiritual care training; increasing availability of spiritual care specialists; and improving clinical systems to support whole-person care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"191"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585380","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 success in sub-acute hospital-to-home transitions for palliative patients: a descriptive qualitative study.","authors":"Krystal Kehoe MacLeod, Taylor Shorting, Madeline McCoy, Shirley H Bush, Genevieve Lalumière, Jill Rice, Sarina R Isenberg","doi":"10.1186/s12904-025-01830-2","DOIUrl":"10.1186/s12904-025-01830-2","url":null,"abstract":"<p><strong>Background: </strong>Transitioning from a sub-acute hospital to home is highly desirable to some palliative and end-of-life individuals and their family caregivers, but the transition process itself is complex and can be logistically challenging. This formative assessment sought to better understand what constitutes a successful sub-acute hospital-to-home transition from the perspectives of health care providers connected to a sub-acute care facility in Ottawa, Canada, with reflections from a patient and a family caregiver.</p><p><strong>Methods: </strong>Our descriptive qualitative study involved 13 virtual interviews and one virtual focus group between February and May 2023. Our sample included health care providers involved in the sub-acute hospital-to-home transition for palliative patients from a sub-acute facility, as well as one patient and one family caregiver who had experienced a palliative transition in this context. We used reflexive thematic analysis to code the data, and we inductively developed themes based on participants' experiences.</p><p><strong>Results: </strong>We collected data from 14 health care providers, one patient, and one family caregiver who were involved in, or had experienced, a sub-acute hospital-to-home transition. We found three themes delineating participants' shared perceptions of the key foundations of a successful sub-acute hospital-to-home transition in the palliative context: meeting patient goals; sharing information to ensure informed decision-making; and having someone to coordinate the transition.</p><p><strong>Conclusions: </strong>Our study highlighted that a successful sub-acute hospital-to-home transition should be person-centred and requires effective communication and coordination, both within and across, hospital and home environments. These insights will help inform intervention co-design to improve palliative care transitions in the next phase of this project.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"190"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585381","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":"Mapping end-of-life care in India: a scoping review to identify gaps in policy, practice, and psychosocial support.","authors":"Babita P A Varkey, Arun Ghoshal, Naveen Salins, Catriona R Mayland","doi":"10.1186/s12904-025-01825-z","DOIUrl":"10.1186/s12904-025-01825-z","url":null,"abstract":"<p><strong>Background: </strong>Little about access to palliative and end-of-life care in India is known.</p><p><strong>Aim: </strong>To map various facets of end-of-life care in India, from perceptions of stakeholders to capacity and quality of care, training, and education, and to identify the current gaps in end-of-life care delivery.</p><p><strong>Design: </strong>A scoping literature review was conducted, with the protocol registered on the Open Science Framework, on November 29, 2023 ( https://osf.io/twc9j ).</p><p><strong>Data sources: </strong>Between January 1, 1990, and May 31, 2024, an electronic literature search was conducted using the MEDLINE, SCOPUS, CINAHL, EMBASE, and PSYCHINFO databases, as well as citations and grey literature.</p><p><strong>Results: </strong>The availability and accessibility of end-of-life care are limited to a few geographical regions, primarily urban areas. While some states have community-based programs, most end-of-life care practices are concentrated in hospitals, especially intensive care units. Patients frequently lack access to essential medications, such as morphine, as well as appropriately trained medical professionals and adequate infrastructure. Financial difficulties, limited knowledge, social stigma toward the terminally ill and dying, and the psychological and physical burdens of care add to the challenges faced by stakeholders.</p><p><strong>Conclusion: </strong>The availability and accessibility of end-of-life care in India are fragmented. A comprehensive strategy that includes policy and legislative reforms, education, and expanded palliative services is crucial for improving the quality of end-of-life care across the country.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"189"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585382","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 variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach.","authors":"Nathan Shuftan, Mark Dayan, Sarah Scobie, Bee Wee, Antoniya Dimova, Elka Atanasova, Liubove Murauskiene, Coralie Gandré, Zeynep Or, Gonçalo Figueiredo Augusto, Triin Habicht, Kristina Köhler, Kristiina Kahur, Bertil Axelsson, Madelon Kroneman, Judith de Jong, Anke de Veer, Wanda Bemelmans, Chantal Pereira, Ajay Aggarwal, Joanna Davies, Ewout van Ginneken, Dimitra Panteli","doi":"10.1186/s12904-025-01831-1","DOIUrl":"10.1186/s12904-025-01831-1","url":null,"abstract":"<p><strong>Background: </strong>Palliative care aims to maintain quality of life and offer treatment and person-centred care options for people with serious end-stage illnesses and their families. The purpose of this exploratory study was to compare the statutory coverage and access to palliative care for adult services for people with cancer in 8 European countries using a vignette approach.</p><p><strong>Methods: </strong>We used a patient vignette to examine coverage and access to palliative care services across Europe. The palliative care vignette describes a pathway based on guidance for best practices of palliative care patients with incurable cancer. The surveys accompanying the vignette were completed by health services researchers knowledgeable on palliative care, practitioners, government officials, or teams consisting of a health systems expert working together with practitioners.</p><p><strong>Results: </strong>Completed vignettes were received from 8 countries: Bulgaria, Estonia, France, Lithuania, the Netherlands, Portugal, Sweden and England. Services provided for palliative care envisioned in the vignette's pathway are, generally, covered by the statutory health systems. However, in some countries cost sharing exists for hospital stays, certain medicines and medical aids. Furthermore, coverage of social and financial assessments, home equipment and financial advice varied in nearly every country. Travel times to and availability of palliative care specialists were identified as challenges across nearly all countries. Organizational barriers, societal stigmas and knowledge gaps about what palliative care entails were also found to be areas in need of improvement.</p><p><strong>Conclusions: </strong>The comparative research presented provides further insight how countries organise palliative care, how services are offered and what levels of access exist around Europe. Our study showed differences in the scope of coverage of and access to the care options in the vignette. While responses showed countries have basic levels of coverage and access to services provided, there were variations, such as availability of specialists or the extent travel and waiting times influence care delivery. Settings where patients receive services also varied. As the need for palliative care grows in the future, health ministries and insurers should be increasingly concerned with how to guarantee coverage of and access to this care, as well as aware of best practices among countries facing similar challenges.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"188"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585383","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":"Urban residence, income source, and place of death among Chinese older adults.","authors":"Rui Zhou, Shuangshuang Wang, Aaron Yao","doi":"10.1186/s12904-025-01824-0","DOIUrl":"10.1186/s12904-025-01824-0","url":null,"abstract":"<p><strong>Background: </strong>Place of death has received extensive interest among scholars, but research focusing on place of death among Chinese older adults is scarce. This study aimed to explore the associations between rural/urban residence, primary income source, and place of death among Chinese older adults.</p><p><strong>Methods: </strong>The sample consists of 24,794 decedents (female = 60%, died at home = 88%, mean age at death = 95) from the 2002-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Chi-squared tests and binary logistic regression models were used to analyze relationships between residential area (urban vs. town or rural), income source (financial support from family vs. personal income), and place of death (home vs. hospitals or other healthcare settings).</p><p><strong>Results: </strong>Decedents living in cities were 3.5 times more likely to die in hospitals or other healthcare settings than at home, and those who had personal income were 1.5 times more likely to die in healthcare settings than at home. Notably, the interaction between city and personal income were significant (P < 0.001). Older adults who both lived in cities and had personal income had the highest probability (83%) to die in healthcare settings.</p><p><strong>Conclusions: </strong>Urban residence and having personal income were highly associated with dying in hospitals or other healthcare settings. As China urbanizes and expands its pension system, an increasingly higher percentage of deaths may happen in healthcare settings. This study alerts policymakers of the enormous pressures that the hospital-centered care system may face in the future. A home-based palliative care and hospice system may be needed to improve the incidence and experiences of patients dying at home.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"183"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555495","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: Managing cultural diversity in end-of-life care: a qualitative study.","authors":"María José Cáceres-Titos, Juan Miguel Porras-Santana, María R Cabillas-Romero, E Begoña García-Navarro","doi":"10.1186/s12904-025-01823-1","DOIUrl":"10.1186/s12904-025-01823-1","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"186"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555491","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":"Understanding the acute care context to inform palliative care improvements: a qualitative study of hospital-based multidisciplinary clinicians.","authors":"Claudia Virdun, Gursharan K Singh, Patsy Yates, Jane L Phillips, Alison Mudge","doi":"10.1186/s12904-025-01815-1","DOIUrl":"10.1186/s12904-025-01815-1","url":null,"abstract":"<p><strong>Background: </strong>Population ageing and rising levels of non-communicable diseases are increasing the number of people living with and dying from advanced serious illnesses globally. Many of these people are hospitalised more than once in their last year of life. While there is sound evidence on what patients and their families require for safe and high-quality hospital palliative care, enabling this remains a challenge. This study aimed to understand the clinician, team, and organisational-level barriers and enablers to integrating good palliative care into acute care.</p><p><strong>Methods: </strong>An exploratory-descriptive, qualitative study involving semi-structured interviews and practical thematic analysis was conducted. Medical, nursing and allied health disciplines were recruited from three wards (cancer care, mixed general medicine/renal and mixed general medicine/respiratory) within a large Australian metropolitan hospital.</p><p><strong>Results: </strong>Eighty-eight interviews (nursing (n = 39); medicine (n = 24); allied health (n = 25)) were undertaken, with a median duration of 25.5 min (range 5 to 55 min). Most participants were female (n = 73, 83%), holding a Bachelor's degree (n = 86, 98%) and ranged from new graduates to participants with over 40 years of post-registration experience. The analysis generated six themes, reflecting the challenges of providing optimal palliative care within acute hospital wards: 1. Understanding when and how to provide palliative care 2. Negotiating shared or changing medical governance in a siloed system 3. Supporting clinicians with the knowledge, skills and confidence to meet palliative care needs 4. Prioritising palliative care amidst the acute care demands of the hospital 5. Optimising the clinical environment to enable private, restful and family-friendly spaces 6. Harnessing organisational support and multidisciplinary clinical leadership CONCLUSIONS: This study reveals complex, multi-level organisational barriers to integrating palliative care within the acute hospital which will need to be addressed for effective and sustained improvement. Harnessing organisational support and multidisciplinary clinical leadership is key to successful change. Improvements with a focus on developing clinician knowledge, skills, and confidence in palliative care need to pay attention to organisational siloes that constrain shared care, cultures of care that prioritise cure and efficiency, clinical uncertainty in the context of advanced serious illness and optimising the environment for quality palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"185"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555494","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":"Immunosuppressant management in palliative care: a systematic review.","authors":"Kassandra Maja Birchler, Caroline Hertler, Tara Pfrunder, David Blum, Markus Schettle","doi":"10.1186/s12904-025-01836-w","DOIUrl":"10.1186/s12904-025-01836-w","url":null,"abstract":"<p><strong>Background: </strong>To summarize the available literature on the management of immunosuppressive therapy in palliative care patients at the end-of-life stage, highlighting challenges associated with decision-making in this context and the current lack of clear clinical guidelines.</p><p><strong>Methods: </strong>A systematic search was conducted in the PubMed, EMBASE, and Medline databases for studies evaluating the application of immunosuppressive therapy in patients nearing the end of life or patients who have allograft failure without plans for retransplantation and thus are candidates for palliative care. The search strategy followed PRISMA guidelines.</p><p><strong>Results: </strong>We screened 2892 studies, assessed 23 records for eligibility, and included 9 publications in the systematic review. These studies cover different immunosuppressive strategies in palliative care for patients with solid organ or stem cell transplants. The evidence suggests that it is common practice to discontinue immunosuppression for patients with allograft failure who do not have any plans for retransplantation. Corticosteroids can be used to ameliorate the negative effects that arise from immunosuppressant discontinuation.</p><p><strong>Conclusions: </strong>The management of immunosuppression after allograft failure requires a careful balance between minimizing drug-related risks and preserving future transplant eligibility. Discontinuing immunosuppression may be appropriate for many patients nearing the end of life, provided that symptom management and ethical considerations are prioritized. Standardized guidelines and multidisciplinary approaches are needed to optimize immunosuppression withdrawal, reduce complications, and ensure patient-centered care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"187"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555492","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":"Socioeconomic profile and vulnerabilities of people receiving home-based palliative care in Kerala, India.","authors":"Jashanjot Singh Mangat, Shreyas Patil, Deepak Sudhakaran, Smriti Rana, M M Sunil Kumar, Parth Sharma","doi":"10.1186/s12904-025-01834-y","DOIUrl":"10.1186/s12904-025-01834-y","url":null,"abstract":"<p><strong>Introduction: </strong>Home-based palliative care (HBPC) enhances access to palliative care, reduces health-related costs, and improves health outcomes. However, studies centered on the socioeconomic profile of HBPC are limited. This study aimed to describe the socio-economic profile of HBPC recipients in Kerala, India, and to assess the impact of the disease on the financial, educational, and employment status of their family members.</p><p><strong>Methods: </strong>The socio-economic details of HBPC beneficiaries of a non-profit palliative care organization were collected. Individuals enrolled under HBPC who first received it between March 2020 and April 2024 were included in this study. Data on the socioeconomic details of the beneficiaries were extracted and digitized from registries maintained by Pallium India. Of the 1296 entries received, 964 with complete data were included in the final analysis, which was performed using Jamovi v2.3.28.</p><p><strong>Results: </strong>The mean (SD) age of the beneficiaries was 61.0 (16.6) years. Among the total, 52.9% of the beneficiaries were female, and the median (IQR) family size was 9 (6-13). A total of 83.25% lived in their own homes, and 62.97% resided in rural areas. Cancer (21.1%), followed by Cerebrovascular diseases (20.3%), were the two most common conditions requiring HBPC. Debt was reported by 31.3% of families, with a median (IQR) debt of 2389.5 (597.4-4779.0) USD. The primary reason for debt was health-related expenses. 62.5% of families had beneficiaries receiving pensions, and 7.21% received support from another organization. In 4.2% of families, there was no breadwinner, and 9.5% and 66.8% of patients could not afford food and medicines, respectively. A family member lost their job in 8.0% of families, while in 2.8% of families, a child had to discontinue their education due to the patient's illness.</p><p><strong>Conclusion: </strong>Healthcare costs were the major cause of debt, with many HBPC recipients unable to afford medicines. Moreover, the employment and education of other family members were also threatened. Further strengthening of social and economic security measures is essential to safeguard these individuals and their families.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"182"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555493","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 greatest opportunities for innovation to improve access to and quality of palliative care services to children? A qualitative interview study.","authors":"K Grailey, J Roland, M Lambert, G Fontana, L Dale-Harris, I Williams, A Shaw, A L Neves, J Downing","doi":"10.1186/s12904-025-01837-9","DOIUrl":"10.1186/s12904-025-01837-9","url":null,"abstract":"<p><strong>Background: </strong>Innovation is required within children's palliative care (CPC) to improve access to and quality of care. Existing research demonstrates a lack of access to CPC worldwide. This study aimed to explore the current opportunities for innovation within CPC from the provider's perspective.</p><p><strong>Methods: </strong>Global leaders in CPC were purposively sampled and invited to partake in a qualitative semi-structured interview. Data were thematically analysed using an inductive approach.</p><p><strong>Results: </strong>Fifty-one CPC leaders from 27 countries were interviewed, encompassing clinical, managerial and patient advocacy roles. A thematic framework housing nine key themes was created, reflecting what innovation means in the context of CPC and the future of innovation. Key findings included opportunities to leverage new technologies within the sector. The importance of a clear vision and user-centred design were seen as crucial when innovating in CPC.</p><p><strong>Conclusions: </strong>This study provides novel insights into opportunities for innovation in CPC, creating a thematic framework that brings together key themes and may help guide future innovation. We also highlight essential areas for innovation such as the use of technology. In the context of existing guidance for the delivery of CPC, leaders and policy makers can use the insights from this work to innovate and improve quality and access to CPC worldwide.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"184"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555496","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}