BMC Palliative Care最新文献

{"title":"Key challenges in communication across milestones of cancer care continuum: a systematic review.","authors":"Viet Cuong Nguyen, Khoa Tran, Do-Quyen Thi Phan, Nguyen-Tuong Pham, Yao-An Shen, Chi-Long Chen, Tsai-Wei Huang","doi":"10.1186/s12904-026-02181-2","DOIUrl":"10.1186/s12904-026-02181-2","url":null,"abstract":"<p><strong>Background: </strong>Effective communication is essential in cancer care, significantly influencing patients' emotional, psychological, and physical outcomes. As patients' needs and goals evolve across different stages of the cancer journey, communication barriers also change. This systematic review aimed to identify key communication barriers between healthcare providers and cancer patients across the cancer care continuum.</p><p><strong>Methods: </strong>Two reviewers systematically searched four databases (PubMed, Embase, Cochrane Library, and Web of Science) to identify studies examining communication barriers between healthcare providers and cancer patients at specific stages of care. This review is registered with PROSPERO (CRD420251074785).</p><p><strong>Results: </strong>A total of 139 articles were included and categorized into six distinct stages of the cancer journey. (1) During the screening phase, patients were reluctant to discuss or undergo cancer screening due to limited knowledge, the belief that cancer is unlikely in the absence of symptoms, and fear or anxiety about a potential diagnosis. (2) In the diagnosis phase, receiving cancer as 'bad news', combined with extensive information about treatment and prognosis, led to shock, emotional distress, and informational overload. (3) During treatment, patients found it difficult to discuss adverse effects, including fatigue, nausea, vomiting, and sexual health concerns. Many perceived these symptoms as normal indicators of treatment effectiveness and hesitated to burden their physicians. Female patients, in particular, reported difficulty discussing sexual health, especially with male physicians. (4) In the follow-up phase, limited consultation time contributed to insufficient discussions about long-term adverse effects, relapse risk, prognosis uncertainty, and individualized survivorship care planning. (5) In the recurrence phase, disclosing cancer recurrence was described by oncologists as particularly challenging, as patients often responded with anger, blame, or emotional withdrawal. (6) In end-of-life care, both patients and healthcare providers frequently delayed or avoided end-of-life conversations for various reasons.</p><p><strong>Conclusions: </strong>Communication barriers between healthcare providers and cancer patients are multifaceted and stage-specific, arising from emotional, cognitive, and relational factors on both sides.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382795","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 social implications of wearables to monitor physical activity in palliative care - a qualitative approach.","authors":"Natalie Öhl, Jordan Curry, Tobias Steigleder, Christoph Ostgathe, Maria Heckel, Cynthia C Forbes","doi":"10.1186/s12904-026-02213-x","DOIUrl":"10.1186/s12904-026-02213-x","url":null,"abstract":"<p><strong>Background: </strong>Reduced physical activity is common among patients receiving palliative care. Wearables and other measurement devices offer opportunities to objectively monitor activity and support clinical decision-making and patient motivation. However, integrating such technologies into palliative care may affect care delivery, including routines, interactions and underlying principles. Given the strong emphasis on interpersonal relationships and patient-centeredness in this setting, wearables may entail specific social implications. This study therefore aims to map the social implications of using wearables to monitor physical activity in palliative care.</p><p><strong>Methods: </strong>Based on the CARE-HOUSE Framework, developed to conceptualise the social implications associated with digital health technologies, we investigated the potential social implications of using wearables (smartwatches and accelerometers) to monitor physical activity. Focus groups were conducted with palliative care researchers with clinical experience. After presenting background information on wearable activity monitors, participants were prompted to discuss prospective benefits, risks and unknown effects on stakeholders, interactions, social roles, and tasks in the context of healthcare practice. Data was analysed using content structuring analysis.</p><p><strong>Results: </strong>We conducted two focus groups with palliative care researchers with clinical experience (each n = 4; ~50 min duration) to map social implications of wearable technologies used to monitor physical activity in palliative care. The findings showed that wearable technologies introduce new tasks and organizational requirements in clinical practice. They may increase patients' self-efficacy and motivation to remain active but can also provoke feelings of surveillance and influence interactions between patients, relatives, and healthcare professionals. Objective physical activity data may transform medical consultations by supporting assessment, and care planning. Furthermore, wearable technologies may support holistic palliative care by promoting physical activity, and therefore autonomy, and quality of life.</p><p><strong>Conclusions: </strong>Mapping the social implications of wearables to monitor activity can inform their implementation in palliative care. Addressing these implications is important to ensure that the devices support patient well-being. Future research should focus on translating these insights into practical guidance and incorporate the perspectives of both clinicians and patients.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377622","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 digital legacy in end-of-life care: unspectacular and meaningless, or not enough recognized? An online survey on the attitudes and personal experiences of professionals and volunteers.","authors":"Anne Meißner, Dafina Mahaj","doi":"10.1186/s12904-026-02212-y","DOIUrl":"10.1186/s12904-026-02212-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Title: &lt;/strong&gt;The digital legacy in end-of-life care: Unspectacular and meaningless, or not enough recognized? An online survey on the attitudes and personal experiences of professionals and volunteers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The digital era has transformed the way individuals construct and perpetuate their identities, leaving an indelible mark not only in the analogue but also in the digital realm. The digital legacy, comprising online artefacts and virtual traces, plays a pivotal role in shaping one's personality and life narrative. Recognizing its impact on the bereaved and the dying and understanding the nuances of digital legacy are crucial for providing meaningful end-of-life care. Despite the increasing importance of this phenomenon, there is a substantial research gap, and a comprehensive discussion regarding the relevance of digital legacy for dignified and value-oriented end-of-life support is lacking in Germany.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the recommendations of the German Federal Ministry of Justice regarding the handling of digital legacy, a 34-item questionnaire was developed. A nationwide online survey was conducted using a random sample. Participants were recruited through palliative and hospice organizations with the aim of capturing attitudes, perceived needs, competency requirements, personal experiences and assessments of various professional and occupational groups, including nursing, medicine, social work, and volunteering. The collected data were analysed using descriptive statistics, and four free-text options integrated into the survey were evaluated through content analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 396 people participated in the survey, mainly professionals (42.3%) and volunteers (30.8%). For approximately one-quarter of the respondents (26.9%), clear identification was not possible, and they made use of the option 'other'. The majority of respondents were female (82.3%), over 50 years old (74.5%) and had &gt; 5 years of professional or work experience (75.7%), predominantly in outpatient care (66.0%). The study showed that the majority of respondents considered the relevance of the digital legacy as high. Moreover, according to 85.8% of the respondents, it does not receive enough attention in end-of-life care. The way in which digital legacies are dealt with varied considerably and were ambivalent in some cases. There is uncertainty with regard to professional responsibilities and the need for guidance, although most respondents perceived their own skills as inadequate and sought to broaden or deepen their knowledge (90.1%). Additionally, there was little engagement with one's own digital legacy. The free-text responses illustrated a lack of awareness, uncertainty and the desire for further training and supporting materials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The discrepancy between the recognized importance and the lack of direct engagement with one's own digital l","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370309","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":"Hospice care knowledge and death attitude profiles among hospital-based healthcare workers: a latent profile analysis.","authors":"Xiuping Li, Hanxiao Luo, Hangfei Mao, Shina Qiao, Mengjiao Sun, Xiaojie Zhang, Fanglei Gu, Weilan Xiang","doi":"10.1186/s12904-026-02216-8","DOIUrl":"10.1186/s12904-026-02216-8","url":null,"abstract":"<p><strong>Background: </strong>Healthcare workers' attitudes toward death may influence end-of-life care delivery. However, heterogeneity in these attitudes and their relationship with hospice care knowledge remain insufficiently understood.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 1,421 hospital-based healthcare workers from secondary and tertiary hospitals in Zhejiang Province, China. Death attitudes were assessed using the Death Attitude Profile-Revised (DAP-R), and hospice care knowledge was measured using a structured self-developed questionnaire. Latent profile analysis was applied to identify distinct death attitude profiles. Multinomial logistic regression was used to examine associations between hospice care knowledge, demographic and occupational characteristics, and profile membership.</p><p><strong>Results: </strong>The sample was predominantly composed of nurses (93.8%). Three distinct death attitude profiles were identified: a less adaptive profile characterized by lower acceptance and higher fear or avoidance, a moderate profile with intermediate levels across dimensions, and a high adaptive profile marked by higher acceptance and lower fear-related responses. Hospice care knowledge demonstrated a consistent graded association with profile membership, with higher knowledge scores associated with increased likelihood of belonging to more adaptive profiles. In contrast, demographic and occupational characteristics were not independently associated with profile membership after adjustment. Overall hospice care knowledge levels were relatively low across the sample.</p><p><strong>Conclusions: </strong>Hospital-based healthcare workers exhibited substantial heterogeneity in death attitudes. Higher hospice care knowledge was consistently associated with more adaptive death attitude profiles. Although causal inferences cannot be drawn due to the cross-sectional design, these findings highlight the potential relevance of hospice and palliative care education in supporting workforce preparedness for end-of-life care. Future longitudinal and interventional studies are needed to clarify the directionality of these associations.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370259","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":"Writing about the disrupted self: a randomized controlled trial of a structured online expressive writing intervention for bereaved Chinese adults.","authors":"Junlong Zheng, Dongpeng Yao, Jie Li","doi":"10.1186/s12904-026-02210-0","DOIUrl":"10.1186/s12904-026-02210-0","url":null,"abstract":"<p><strong>Background: </strong>Disruption and restoration of the self are theorized to be central to bereavement adjustment, yet previous interventions rarely address self-disruption directly. This study examined whether an online expressive writing intervention targeting self-disruption could alleviate grief symptoms in bereaved adults.</p><p><strong>Methods: </strong>In a two-arm randomized controlled trial, 66 bereaved participants were randomly assigned to an intervention group (n = 35) or a waitlist control group (n = 31). The intervention consisted of six sessions (one psychoeducational session and five structured expressive writing sessions) over three weeks, focusing on four aspects of self-disruption, namely: Loss of Self-Direction, Self-Derailment, Self-Devaluation, and Disconnection of Relational-Self. Grief severity was assessed using the PG-13-R at baseline and post-intervention, with a six-month follow-up for the intervention group.</p><p><strong>Results: </strong>Compared with the waitlist control group, the intervention group showed a significantly greater reduction in grief severity (Cohen's d = - 0.93). Within the intervention group, the improvement remained stable at the six-month follow-up.</p><p><strong>Conclusion: </strong>Online expressive writing targeting self-disruption in bereaved adults may provide an effective, low-cost, and scalable intervention for grief. However, in the absence of a validated measure of self-disruption, whether the intervention exerts its effects through changes in the self remains untested.</p><p><strong>Trial registration: </strong>This trial was retrospectively registered with the Chinese Clinical Trial Registry (Registration Number ChiCTR2600120661, Date 18.03.2026).</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363298","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":"Quality domains in home-based pediatric hospice and palliative care: adolescent and young adult perspectives.","authors":"Daniel H Grossoehme, Claire A Crawford, Jhansi Chandra Ellakula, Toluwalase Ajayi, Justin N Baker, Sarah Friebert, Lisa Humphrey, JillAnn Jarrell, Rachel Thienprayoon, Pamela S Hinds","doi":"10.1186/s12904-026-02208-8","DOIUrl":"10.1186/s12904-026-02208-8","url":null,"abstract":"<p><strong>Background: </strong>Current United States palliative care practice guidelines are intended to cover care across all age groups. Previous research with pediatric providers and caregivers concluded that pediatric hospice and palliative care have unique attributes. Not known is how adolescent hospice and palliative care patients understand quality palliative care. The purpose of this study was to characterize and define quality of care domains as described by adolescent and young adult patients receiving home-based hospice and palliative care.</p><p><strong>Methods: </strong>Semi-structured interviews with 10-26 year-olds who received home-based hospice and/or palliative care visits in the prior three years at six diverse sites in the United States. Data were analyzed using Krippendorff's semantic content analysis methodology.</p><p><strong>Results: </strong>There were 32 participants (63% female) who had a median(range) age of 17.5 (10-26) years old, and 69% (n = 22) were White. The domains with the highest number of themes were Structure and Processes of Care and Compassionate Care.</p><p><strong>Conclusions: </strong>The results address an important gap by including adolescent/young adult patients' voices regarding delivery of home-based hospice and palliative care. Clinical implications include prioritizing and making time to build trusting relationships directly with the AYA, empowering them to participate in their care to the extent appropriate and prepare for transition to adult care when needed, providing support for family members, and training for all providers in generalist spiritual care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363275","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":"Association between family-perceived quality of death and dying, prognostic awareness, and end-of-life discussions in five common diseases: a nationwide mortality follow-back study.","authors":"Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Masanori Mori, Yoshiyuki Kizawa, Yasuyuki Okumura, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa","doi":"10.1186/s12904-026-02205-x","DOIUrl":"10.1186/s12904-026-02205-x","url":null,"abstract":"<p><strong>Introduction: </strong>Discussing prognosis and end-of-life (EOL) care with patients and physicians is a sensitive and critical aspect of EOL care. However, the association between prognostic awareness and EOL discussions and the quality of death and dying (QOD) remains uncertain. This study aimed to describe prognostic awareness and participation in EOL discussions among patients with common causes of death and to clarify their association with QOD.</p><p><strong>Methods: </strong>Retrospective nationwide mortality follow-back survey in Japan (Feb 2019; Feb 2020). Bereaved families of patients who died in hospitals or at home from cancer, heart disease, cerebrovascular disease, pneumonia, or renal failure. The primary outcome was family-reported QOD. Exposures of interest included family-reported prognostic awareness and EOL discussions, including care settings and code statuses. Analyses were conducted separately by disease category and place of death. Logistic regression and generalized linear models were used for analysis.</p><p><strong>Results: </strong>Of the 115,861 family members who were sent the questionnaires, we finally analyzed 50,641 responses. Accurate patient prognostic awareness ranged from 56.8% to 70.2% for patients with cancer and from 30.5% to 53.3% for patients with non-cancer diseases. Patient-physician discussions about care settings occurred in 36.4%-54.8% of hospital deaths and 67.8%-81.5% of home deaths across diseases. There were small differences in the QOD scores between patients with accurate and inaccurate prognostic awareness across most subgroups. However, participation in EOL discussions was associated with higher QOD scores than non-participation. The largest QOD score difference was observed in patients who died from pneumonia in hospitals, with discussions about care settings (64.0 versus without 42.6) showing a difference of 21.4 (95% confidence interval: 16.3, 26.5).</p><p><strong>Conclusions: </strong>Participation in EOL discussions was associated with higher family-reported QOD across diseases and places of death in this observational study. Similar patterns were observed among patients who died in hospital settings. These findings suggest that EOL discussions may be related to QOD beyond the final place of death.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363306","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":"'Stay Curious': guest experiences of philosophical counselling in palliative care - a qualitative study.","authors":"Patrick Schuchter, Sandra Radinger, Stefanie Veronika Rieger, Klaus Wegleitner","doi":"10.1186/s12904-026-02178-x","DOIUrl":"10.1186/s12904-026-02178-x","url":null,"abstract":"<p><strong>Background: </strong>Philosophical counselling creates a dialogical space for exploring existential questions arising from serious illness, confrontation with mortality, bereavement, and caregiving. Although philosophy has long engaged with mortality and existential concerns, philosophy in form of philosophical counselling is not established in palliative care and has seldom been empirically studied. This study examines the views and experiences of individuals who engaged in philosophical counselling in palliative care-related contexts.</p><p><strong>Methods: </strong>Nine counselling processes were completed; post-counselling interviews were obtained from eight guests and analysed. Purposive sampling identified practitioners via professional associations in Austria, Germany, and Switzerland; guests were recruited by these practitioners in naturalistic practice settings. A qualitative content analysis was used to identify categories and subthemes.</p><p><strong>Results: </strong>Through iterative, interpretive analysis, we generated four main categories: distinctive features of philosophical counselling; how guests perceived the philosophical practitioner; perceived effects; and strengths and limits. Participants valued freedom to explore open-ended questions without pressure to act or solve problems. Conversations were described as inspiring and created space for a \"stepping out\"-being seen as a person rather than only as affected. We interpreted philosophical curiosity as a grounding stance toward mortality. At the same time, critical questioning could become destabilizing, underscoring the need for calibrated movement between personal involvement and abstract reflection within an empathetic dialogical relationship.</p><p><strong>Conclusions: </strong>Philosophical counselling seems to offer a space for reflective depth and existential inquiry in palliative care, fostering curiosity, wonder, and connectedness. It is described as offering intellectual freedom and an open, goal-free space. Practice implications include preserving this space, resisting help-driven agendas and didactic, overly abstract lecturing, and calibrating critical inquiry within empathetic dialogue. Philosophical counselling may contribute to facets of death literacy. Our findings indicate that end-of-life themes are already being addressed within philosophical counselling and offer guidance for introducing practice in palliative care contexts.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354516","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 the application of Artificial Intelligence in palliative care and its practical, technical and ethical considerations: a scoping review.","authors":"Thanarpan Peerawong, Tharin Phenwan, Sitthichok Chaichulee, Kamonrat Tangudomkit","doi":"10.1186/s12904-026-02191-0","DOIUrl":"10.1186/s12904-026-02191-0","url":null,"abstract":"<p><strong>Background: </strong>Palliative care improves the quality of life of people living with life-limiting conditions and their families; however, global access remains constrained by workforce shortages and late referrals. Artificial Intelligence (AI) has been proposed as a scalable solution for optimising the identification of needs, supporting clinical decision-making, and enhancing care delivery. However, real-world evidence of the application of AI in palliative care remains sparse, particularly regarding its impact on quality of life, quality of care, and associated practical, technical and ethical challenges.</p><p><strong>Methods: </strong>A scoping review was conducted following the Joanna Briggs Institute methodology and the PRISMA-ScR checklist. Five databases (the ACM Digital Library, CINAHL, Cochrane Central, PubMed and Web of Science) were searched between September and October 2025. Studies reporting the use of AI to facilitate or enhance palliative care delivery in adults were eligible. Four reviewers independently screened the records, and two reviewers extracted the data using Covidence software. A narrative synthesis was then performed.</p><p><strong>Results: </strong>Fifteen studies, published between 2021 and 2025, were included. Fourteen originated from Global North settings (USA 5, Germany 2, Japan 2, Taiwan 2, UK 1, Spain 1 and Cyprus 1) and one from Iran. Conceptually, AI applications fall into three domains: (1) early identification of palliative care needs, (2) symptom assessment and management and (3) clinical decision support for care conversations. Fifteen studies (100%) reported or discussed quality of care outcomes, most commonly prognostic performance, usability and referral/conversation rates, and only two (13.3%) directly addressed quality of life. Effectiveness was consistently positive, with four randomised controlled trials demonstrating superiority over usual care in referrals, advance care planning, pain control and quality of life domains. Practical barriers were centred on workflow integration and resource demands, while technical limitations include data quality, generalisability, and interpretability. Ethical discourse is underdeveloped, with major gaps in the principles of AI governance.</p><p><strong>Conclusions: </strong>AI shows potential to improve prognostic accuracy, trigger earlier involvement of palliative care specialists and support symptom management. However, this evidence is geographically skewed, methodologically immature and ethically underdeveloped. Future research must prioritise diverse global settings, patient-reported quality of life outcomes, participatory co-design and systematic ethical governance to ensure equitable implementation.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346948","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":"Advance care planning with patients of Islamic migration background: a qualitative study identifying the need for relational autonomy and hope-sustaining communication.","authors":"Anouk Putker, Amine Haddane, Yvonne Engels, Evelien Kuip, Marieke Perry","doi":"10.1186/s12904-026-02207-9","DOIUrl":"10.1186/s12904-026-02207-9","url":null,"abstract":"<p><strong>Background: </strong>Advance Care Planning (ACP) is largely based on ideas of individual autonomy and direct communication, which may conflict with the relational, cultural and religious perspectives of patients with an Islamic migration background. We explored the perspectives of patients with an Islamic background on ACP conversations within a Dutch healthcare system and which communication strategies may support more culturally appropriate ACP.</p><p><strong>Methods: </strong>A qualitative study was conducted consisting of two focus groups with cultural experts and healthcare professionals (N = 14) and interviews with patients with an Islamic migration background receiving palliative cancer treatment (N = 6) in the Netherlands. Semi-structured interview guides and an ACP introduction video were used to initiate discussion and reflection in both settings. Inductive thematic analysis was applied to all interview transcripts.</p><p><strong>Results: </strong>Three main themes emerged: (1) ACP decision-making is predominantly family-driven: patients rely on relational autonomy through their family network, although individual preferences vary across generations. This highlights the importance of exploring patients' preferred role of the family in decision-making, facilitating family involvement in ACP conversations, and avoiding assumptions of individual decision-making as the default. (2) Cultural and religious meaning of illness and suffering strongly shapes how patients interpret the end of life. Rather than using concepts such as \"quality of life\", clinicians should explore what gives patients (spiritual) meaning and hope. Palliative care was sometimes misunderstood as hastening death, highlighting the importance of explaining the difference between symptom management and ending life. (3) Hope is a crucial determinant for maintaining engagement in ACP discussions. Direct communication, especially statements removing all hope, was experienced as distressing and damaging to trust. Patients valued communication that preserved hope, matched their emotional readiness, and showed genuine personal and cultural interest.</p><p><strong>Conclusion: </strong>ACP with patients with an Islamic migration background requires a relational, hope-sustaining and culturally sensitive approach. Decision-making is often family-driven, and individualistic perspectives on autonomy may not align with patient preferences. Religious meanings of illness and suffering influence perceptions of palliative care, while maintaining hope is essential for engagement. Adapting communication including preserving hope may enhance trust and offers concrete strategies to support appropriate ACP conservations.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333863","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}