BMC Palliative Care最新文献

{"title":"Navigating the delicate balance of autonomy and harmony: a case study on the cultural adaptation of palliative care interventions in China.","authors":"Tong Zuo, Seng Yen Yeap, Guijun Lu","doi":"10.1186/s12904-025-01801-7","DOIUrl":"10.1186/s12904-025-01801-7","url":null,"abstract":"<p><strong>Background: </strong>The implementation of palliative care in China faces distinct challenges influenced by cultural and societal factors that significantly affect terminally ill patients and their families. This case study examines how palliative care interventions adapted to Chinese cultural factors such as death taboos, indirect communication styles, family-centered decision-making, and relational harmony helped empower a patient's autonomy, facilitate self-expression, and support personal transformation while aligning with Chinese cultural norms.</p><p><strong>Methods: </strong>This retrospective study utilized Interpretative Phenomenological Analysis (IPA) to conduct a thorough qualitative investigation of a single case, focusing on how a Chinese terminal cancer patient engaged with and responded to culturally adapted palliative care interventions. The data encompassed notes and audiovisual materials produced throughout the patient's palliative care process, supplemented by targeted retrospective data collection. The data, originally in Chinese, were translated into English for analysis, using back-translation and independent verification to maintain linguistic and cultural accuracy.</p><p><strong>Results: </strong>This study identified three critical mechanisms through which culturally adapted palliative care enhanced the patient's autonomy and facilitated personal transformation while maintaining relational harmony. The three mechanisms were: (1) a guided card game facilitating autonomous decision-making, (2) spiritual dialogues facilitating self-discovery and transformation, and (3) a communal concert balancing individual expression with relational harmony. Together, these mechanisms empowered the patient to assert personal autonomy and attain meaningful self-expression, all while maintaining significant involvement from family and community.</p><p><strong>Conclusions: </strong>This study underscores the critical role of cultural adaptation in implementing palliative care interventions for Chinese patients. The findings demonstrate that culturally adapted palliative care interventions, grounded in relational autonomy, effectively supported a Chinese patient's autonomy and personal transformation while maintaining relational harmony. These insights are instrumental in informing the provision of culturally adaptive end-of-life care practices in Chinese healthcare.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"168"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545733","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":"Moral courage of palliative care nurses and affecting factors.","authors":"Dilek Yildirim, Vildan Kocatepe, Ayşegül Türkmenoğlu","doi":"10.1186/s12904-025-01829-9","DOIUrl":"10.1186/s12904-025-01829-9","url":null,"abstract":"<p><strong>Background: </strong>Moral courage among palliative care nurses plays a critical role in ensuring high-quality care for patients in the final stages of life. This study aimed to assess the level of moral courage among palliative care nurses and identify the factors that influence it.</p><p><strong>Methods: </strong>This descriptive, cross-sectional study was conducted between September 2023 and September 2024, involving 181 palliative care nurses. Data were collected through an online survey distributed to nurses who voluntarily agreed to participate. The survey included a \"Personal Information Form\" and the \"Nurses' Moral Courage Scale (NMCS).\"</p><p><strong>Results: </strong>The mean age of participants was 31.82 ± 7.92 years, and their average professional experience was 9.33 ± 9.32 years. Of the nurses, 62.4% were female. The average NMCS score was 82.25 ± 12.21. Nurses with a master's degree scored significantly higher on the NMCS compared to those with lower educational levels (p < 0.001). Additionally, nurses who had chosen their current unit voluntarily (p = 0.046), and those who rated their knowledge of healthcare ethics as \"excellent\" (p < 0.001), demonstrated significantly higher moral courage scores. A positive correlation was found between moral courage and age (r = 0.153, p = 0.040), whereas a negative correlation was observed between moral courage and the average number of night shifts per month (r = -0.253, p = 0.001).</p><p><strong>Conclusion: </strong>The findings suggest that palliative care nurses generally exhibit high levels of moral courage. Educational attainment, voluntary selection of the work unit, and perceived competence in healthcare ethics were positively associated with moral courage. Conversely, challenging working conditions-such as high workloads, frequent night shifts, and insufficient institutional support-may hinder nurses' ethical decision-making by fostering caution and hesitation.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"179"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545732","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":"Using nudges with electronic health records systems to improve advance care planning: a systematic review.","authors":"Tong Zhu, Rongqing Wu, Jiangxue Wu, Rick Yiu Cho Kwan, Ming Liu, Aiting Zhou, Renli Deng","doi":"10.1186/s12904-025-01820-4","DOIUrl":"10.1186/s12904-025-01820-4","url":null,"abstract":"<p><strong>Background: </strong>Researchers are increasingly studying nudges as a theoretical approach to promote behavior change. With the advancement of technology, nudges with electronic health records (EHR) systems become a new way to encourage healthcare professionals to perform advance care planning (ACP). This review aims to summarize nudges with EHR interventions and assess their effects on ACP outcomes.</p><p><strong>Methods: </strong>A comprehensive search was conducted in Scopus, CINAHL, Web of Science, PubMed, and Embase for randomized controlled trials (RCTs) published up to December 2024. Studies were included if they employed nudges developed within the EHR environment in healthcare setting and reported at least one objective measure of ACP. Two reviewers screened the titles, abstracts, and full texts and extracted data. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0. A narrative synthesis was conducted for the data.</p><p><strong>Results: </strong>Ten reports (nine studies), including 27,556 participants, met all of the inclusion criteria. Nudge interventions included both EHR-delivered nudges and non-EHR nudges. Using the MINDSPACE framework, the EHR-delivered nudges were categorized as priming (n = 10), salience/affect (n = 1), and default (n = 1). The non-EHR nudges were classified as priming (n = 5), salience/affect (n = 2), and norms and messenger (n = 1). Narrative synthesis showed consistently positive effects on ACP documentation, serious illness conversations documentation, prognosis communication, advance directive completion, and goals-of-care documentation. Most studies reported statistically significant improvements. In contrast, the effects of interventions on end-of-life outcomes were inconsistent and largely non-significant.</p><p><strong>Conclusion: </strong>Overall, findings suggest that EHR-integrated nudge strategies may improve documentation and communication practices related to ACP in patients with serious illness. However, their impact on downstream clinical outcomes remains uncertain. Due to the limited number of studies and high heterogeneity, further research is needed to validate these findings.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"180"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545738","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":"Effects of environmental temperature on mortality in cancer patients in palliative care.","authors":"Encinas Paloma, Garcia Naomi, Emilio Gutierrez","doi":"10.1186/s12904-025-01808-0","DOIUrl":"10.1186/s12904-025-01808-0","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in cancer treatment, the incurability of the disease is the basis for palliative care.</p><p><strong>Methods: </strong>A sample of 334 oncological patients in palliative care underwent a two-year assessment to determine the effects of environmental temperature on mortality.</p><p><strong>Results: </strong>The results revealed a positive relationship between environmental temperature and the mortality rates of patients under palliative care, with a higher number of deaths occurring in the warmer months. Thus, a 1ºC increase in temperature correlated with an 8.1% increase in mortality for patients dying in the first week of care, 4.8% for those dying within 15 days, and 3.8% for those dying within 30 days. However, for patients surviving more than 30 days, the effect of temperature decreased, with no significant effects of temperature being observed.</p><p><strong>Conclusions: </strong>Thus, environmental temperature could be a relevant factor in the mortality and survival rates of the palliative care program.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"175"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545728","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":"\"You're just in such crisis mode…frantic to get through the next day\": an interpretative phenomenological analysis of adjustment experiences among carers of patients with advanced oesophago-gastric cancer.","authors":"Cara Ghiglieri, Martin Dempster, Lisa Graham-Wisener","doi":"10.1186/s12904-025-01810-6","DOIUrl":"10.1186/s12904-025-01810-6","url":null,"abstract":"<p><strong>Background: </strong>In advanced oesophago-gastric cancer, rapid disease progression and complex symptoms contribute to a distinct caring context. Yet little is known about how those providing informal care interpret and adjust to these experiences, despite increasing recognition that this plays a key role in shaping psychological well-being. This study aimed to comprehensively explore these carers' adjustment experiences, identifying opportunities for improved care and support.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with ten purposefully recruited individuals who had cared for someone with advanced oesophago-gastric cancer in the UK. The interviews were audio-recorded, transcribed verbatim, and analysed using interpretative phenomenological analysis.</p><p><strong>Results: </strong>Carers experienced a demanding adjustment process as they took on complex nutritional and emotional responsibilities, often with limited guidance or support. The rapid trajectory and disruption to roles and routines left many feeling overwhelmed and unable to meet their own needs. Ongoing efforts to seek understanding, preserve connection, and focus on the present supported their attempts to manage uncertainty and sustain meaning.</p><p><strong>Conclusions: </strong>The findings reflect the unique complexities of advanced oesophago-gastric cancer care, pointing to the need for support models that acknowledge the complex, relational, and often hidden aspects of adjustment to caring in this context.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"171"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545725","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":"Use of brief, simple anxiety assessment tools in palliative care - yes, we can: a cross-sectional observational study of anxiety visual analog scale and numeric rating scale.","authors":"Adrien Evin, Jean-François Huon, Aurelie Le Thuaut, Patricia Jego, Pierre Nizet, Caroline Victorri-Vigneau, Marianne Bourdon","doi":"10.1186/s12904-025-01814-2","DOIUrl":"10.1186/s12904-025-01814-2","url":null,"abstract":"<p><strong>Background: </strong>Given the high prevalence of anxiety in palliative care and its frequent underestimation by healthcare professionals, it is important to use simplified tools to facilitate the evaluation of anxiety. The State-Trait Anxiety Inventory-State scale is a reference 20-item questionnaire that has been validated in this population, but is too long for some patients. The visual analog scale (VAS) and the numeric rating scale (NRS) are two short instruments that have been validated to assess pain, but not anxiety in palliative care.</p><p><strong>Aim: </strong>This study sought to investigate the correlation between anxiety VAS and NRS and State-Trait Anxiety Inventory-State scale for assessing anxiety in palliative care patients.</p><p><strong>Methods: </strong>A single-center cross-sectional observational study was conducted over 2 years. All palliative care patients followed by the palliative care team of a French university hospital were eligible. Each patient completed the State-Trait Anxiety Inventory-State scale and rated their perceived anxiety using the NRS and VAS. Pearson's correlation test between the scales and receiver operating characteristic (ROC) curve analysis were performed to determine diagnostic cut-offs.</p><p><strong>Results: </strong>A total of 186 patients were included (89.8% with cancer), 20.4% of whom had severe or very severe anxiety. The NRS/ State-Trait Anxiety Inventory-State scale and VAS/ State-Trait Anxiety Inventory-State scale correlations were 0.62 and 0.70, respectively. The NRS and VAS showed good discrimination, with an area under the ROC curve of 0.81 and 0.88, respectively. Cut-offs of 5 (NRS) and 49 millimeters (VAS) yielded sensitivities of 89.5% and 89.2%, respectively, for the detection of severe or very severe anxiety, with specificities of 60.1% and 70.3%, respectively.</p><p><strong>Conclusion: </strong>Cut-offs of 5 for the NRS and 49 millimeters for the VAS showed excellent sensitivity for detecting anxiety in palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"173"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545736","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":"Functional goals and outcomes of rehabilitation within palliative care: a multicentre prospective cohort study.","authors":"Matthew Maddocks, Lucy Fettes, Naomi Takemura, Joanne Bayly, Helena Talbot-Rice, Karen Turner, Rebecca Tiberini, Richard Harding, Fliss E M Murtagh, Richard J Siegert, Irene J Higginson, Stephen A Ashford, Lynne Turner-Stokes","doi":"10.1186/s12904-025-01816-0","DOIUrl":"10.1186/s12904-025-01816-0","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation is an integral component of palliative care. An understanding of functional goals can help tailor interventions and support the evaluation of services. This study examined the nature and timescale of functional goals in palliative care, attainment of goals following personalised rehabilitation, responsiveness relative to health-related quality of life across, and factors associated with goal achievement.</p><p><strong>Methods: </strong>Prospective, observational cohort study of adults with advanced progressive illness from 10 UK hospices referred for rehabilitation assessment. Urgency of care needs and functional status were assessed using the palliative Phase of Illness (stable, unstable, deteriorating) and Australia-modified Karnofsky Performance Status (AKPS, ≥ 60,60 - 50, ≤ 40) respectively. Health-related quality of life was assessed using EuroQoL 5-Dimension 5-Level (EQ-5D-5 L) utility score. Functional goals were set collaboratively with patients using SMART goal statements, mapped onto the WHO International Classification of Functioning, Disability and Health (ICF). Goal Attainment Scaling (GAS) was used to evaluate achievement against an anticipated outcome using a T-score. Ordinal logistic regression was sued to identify factors associated with goal achievement.</p><p><strong>Results: </strong>364 patients (54% female, mean (SD) age 68 (14) years, 71% cancer, 71% stable Phase, median AKPS 60) took part. They set a median (range) of 2 (1-4) goals; 645 in total. Goals had a median (range) timeframe of 28 (1-196) days and spanned 13/30 ICF domains; most frequently mobility, general tasks and demands, mental functions, community, social and civic life, and self-care. The majority focused on activity (51%) and participation (20%). Following personalised rehabilitation, GAS T-scores improved overall (mean (SD) change 8.9 (13.4)) and for each subgroup by Phase and AKPS (all p < 0.01). EQ-5D scores improved overall, but not for those with a deteriorating Phase or AKPS ≤ 40. Living alone or receiving multiple interventions increased the likelihood of goal achievement, whereas being wheelchair or bedbound, receiving a generic exercise intervention, or having goals rated as very difficult reduced it.</p><p><strong>Conclusions: </strong>Functional goals in palliative care typically focus on optimising activity and participation in the short term. Progress towards personalised goals can be achieved through personalised rehabilitation, including among people with deteriorating health or largely confined to bed. Goal Attainment Scaling can help direct and evaluate rehabilitation interventions in this setting.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"172"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545731","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: Comparing EQ-5D-5L and IPOS among residents with malignant tumors in a community home hospice: a longitudinal study.","authors":"Takeshi Miura, Masato Kaneko, Kei Kawano, Yuka Kanoya, Makoto Kuroki","doi":"10.1186/s12904-025-01822-2","DOIUrl":"10.1186/s12904-025-01822-2","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"181"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545726","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":"Decision-Making preferences in advanced cancer patients: associations with sociodemographic and psychological factors.","authors":"Caterina Calderon, Ana Fernández-Montes, Marina Gustems, Lucia Roncero, Jesús Peña-López, Elena Asensio-Martínez, Mar Muñoz-Sánchez, Paula Jimenez-Fonseca","doi":"10.1186/s12904-025-01806-2","DOIUrl":"10.1186/s12904-025-01806-2","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced cancer often wish to be involved in medical decisions but may vary according to sociodemographic and clinical factors. This study examined how these variables relate to patients' preferred roles in decision-making.</p><p><strong>Methods: </strong>Data from 1198 advanced cancer patients were collected via self-administered questionnaires and clinical records. The Control Preferences Scale was used to classify patients into three profiles: Patient Control (decisions mainly made by the patient), Shared Control (decisions made jointly with the physician), and Physician Control (decisions primarily led by the physician). Associations with sociodemographic and psychological variables were analyzed.</p><p><strong>Results: </strong>Among participants, 53% were in the Patient Control group, 10% in the Shared Control group, and 37% in the Physician Control group. Sociodemographic variables were significantly associated with decision-making profiles: men and participants with higher education (secondary or above) were more represented in the Physician Control group (41% and 43%), while women and unemployed participants predominated in the Patient Control group (both 57%). In contrast, clinical variables such as tumor site, treatment type, and disease stage showed no significant associations. Regarding psychological characteristics, the Physician Control group reported lower levels of distress and higher levels of positive adjustment (p <.05) compared to the other groups.</p><p><strong>Conclusion: </strong>Decision-making preferences among advanced cancer patients depend predominantly on sociodemographic and psychological factors, rather than clinical variables. Patients deferring decisions to physicians experience lower distress and better psychological adjustment. Personalized communication informed by patient background and coping styles may improve patient-centered care and outcomes.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"174"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545727","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":"Spread, participant experience, and implementation of Pallium Canada's Palliative Care ECHO project: a mixed methods study.","authors":"José Pereira, Lynn M Meadows, Ashwak Rhayel, Ashlinder Gill, Dragan Kljujic, Michael Panza, Jonathan Faulkner, Jeffrey Moat Cm","doi":"10.1186/s12904-025-01804-4","DOIUrl":"10.1186/s12904-025-01804-4","url":null,"abstract":"<p><strong>Background: </strong>Pallium Canada's Palliative Care Extension for Community (ECHO) Project (PC ECHO) is a five-year national initiative (launched April 2021) to support continuous professional development and to facilitate the integration of palliative care across different care settings. PC ECHO includes a superhub (Pallium Canada) and several partner hubs. The goal of this formative evaluation study is to explore the project's early spread and the experiences of hub partners and participants from April 2021 to September 2023.</p><p><strong>Methods: </strong>A mixed-methods approach was used. Webinar and participant demographic information was collected by Pallium Canada's online learning management system and by partner hubs. Participants' experience feedback was collected through a standardized online evaluation form. Project leads at the superhub and three inaugural partners were interviewed and transcriptions subjected to a thematic analysis.</p><p><strong>Results: </strong>A total of 301 sessions were delivered during the study period; 155 (51%) by Pallium Canada and 146 (49%) by nine partner hubs. Of these, 125 (42%) were standalone-type sessions and 176 (58%) were community of practice (COP)- or series-type sessions. A total of 7648 individuals - representing over 17 professions - participated across the 301 sessions; the nursing professions were the largest group (36.8%). There was a total of 17,467 participations across the 301 sessions, with participants from across Canada and 31% from rural or small population centres. 5105 evaluations of sessions were received (response rate 29%). Of these, 90% stated they \"Agreed\" or \"Strongly Agreed\" that the sessions were good learning experiences, and 93% indicated that they would recommend the session to colleagues. Project strengths and facilitators included accelerating partners' palliative care mandates, increased connections to other partners and resources, flexibility with the ECHO model, and funding received.</p><p><strong>Conclusion: </strong>The intended outcomes of the PC ECHO Project are materializing, including utility for participants and helping partner hubs accelerate their palliative care mandates. There is evidence of significant spread, over a relatively short period of time. Future studies should include further exploration of the respective roles and impact of different session types (standalone versus communities of practice and series) and impact at higher patient and health system levels.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"176"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545734","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}