BMC Palliative Care最新文献

{"title":"Maintaining personhood within family life: a qualitative study of home-based palliative care for patients with advanced cancer in urban China.","authors":"Shan Zhang, Xiaotian Zhang, Yuan Qin, Minghui Wang, Zhaoyu Li, Lijie Xu, Xiaohong Ou, Zidan Wang, Yao Xiao, Lingling Wu, Peng Yue","doi":"10.1186/s12904-026-02204-y","DOIUrl":"10.1186/s12904-026-02204-y","url":null,"abstract":"<p><strong>Background: </strong>Globally, several patients prefer home as the place of death, making home-based palliative care (HBPC) an important component of holistic palliative care delivery. In China, where many patients receive palliative care at home, HBPC is constrained by limited resources, fragmented services and death-avoidant cultural norms. This study aimed to explore how urban patients with advanced cancer experience HBPC within family and cultural contexts in China.</p><p><strong>Methods: </strong>We conducted a focused ethnographic study in Beijing, China. Twelve urban patients with advanced cancer receiving HBPC were purposively recruited via two outpatient departments and four community health centers and all participated in the study. Data were generated through semi-structured interviews, participant observation, and field notes. Data were analyzed using content analysis with iterative coding and constant comparison to refine themes; team discussion and analytic memos were used to enhance rigor.</p><p><strong>Results: </strong>Content analysis generated four interrelated themes: (1) Being the focus of the family - patients sought to regain visibility in family life and embed care in daily routines; (2) Guarding my boundaries - patients defined personal limits, managed social exposure and articulated autonomy to preserve dignity; (3) The final safety net - patients sought external care and institutional support as illness progressed to enhance comfort and reduce family burden; (4) Preserving the value of life - patients affirmed meaning by reflecting on their life course, staying connected with family and aspiring to be remembered.</p><p><strong>Conclusions: </strong>For urban Chinese patients with advanced cancer, HBPC is experienced as a process of maintaining personhood within intersecting domains of care, identity and family ethics. Care should address not only symptom relief, but also dignity, meaning and culturally embedded family relationships.</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/PMC13587468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333886","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":"Factors associated with psychological distress among end-of-life care volunteers: a systematic review of quantitative and qualitative evidence.","authors":"Lina Mebus, David J Pedrosa, Anna J Pedrosa","doi":"10.1186/s12904-026-02201-1","DOIUrl":"10.1186/s12904-026-02201-1","url":null,"abstract":"<p><strong>Background: </strong>Volunteers are integral to end-of-life care, providing emotional, spiritual, and practical support. However, they often face emotionally demanding situations with limited training and supervision compared to professionals. Given the limited and fragmented literature on psychological distress experienced by end-of-life volunteers, this systematic review aimed to synthesise existing quantitative and qualitative evidence to identify factors associated with psychological distress.</p><p><strong>Methods: </strong>We conducted a systematic literature review including qualitative and quantitative evidence. Five databases (MEDLINE, EMBASE, PsycINFO, Cochrane Database and Web of Science) were searched for original studies, complemented by citation and reference searches. Study quality was assessed using the Qualsyst tool. Quantitative findings were synthesised using an algorithm to evaluate evidence strength, and qualitative data were integrated through thematic meta-synthesis.</p><p><strong>Results: </strong>Twenty-six studies (20 quantitative and 6 qualitative studies) met inclusion criteria. Quantitative research examined 49 volunteer-related, 18 service-related, and one volunteer-patient-interaction-related factor associated with anxiety, death anxiety, depression, burnout, and/or perceived stress. Moderate-strength evidence indicated that death anxiety was negatively associated with better health and well-being but unrelated to age, volunteer experience, or training. Furthermore, depression was negatively associated with volunteer training. Qualitative evidence was scarce, but highlighted additional patient-, interaction-, and service-level mechanisms.</p><p><strong>Conclusion: </strong>This review identifies a small, methodologically diverse evidence base on factors associated with psychological distress in end-of-life care volunteers. Quantitative evidence suggests a potential protective association between training and depression, though substantial heterogeneity limits firm conclusions. Limited qualitative evidence revealed patient-, interaction- and service-level factors that are rarely captured quantitatively. Robust theory-guided longitudinal studies are needed to better understand distress and resilience in this under-researched group.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"25 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333526","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":"Caregiver guilt as an underrecognised burden in family cancer caregiving: a scoping review and implications for palliative care support.","authors":"Han Xu, Xiaojuan Han, Wenxiang Fan, Yunhuan Sun, Kaixia Gao, Xiaoxia Liu, Xiaoyan Liu, Yawen Li, Yuqi Zhang, Wangting Du, Wenying Li, Zhe Zhou, Linping Shang","doi":"10.1186/s12904-026-02203-z","DOIUrl":"10.1186/s12904-026-02203-z","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers play a central role in cancer and palliative care but often experience substantial emotional burden. Caregiver guilt has increasingly been recognised as clinically relevant; however, existing research has largely examined guilt as a secondary component of broader psychosocial outcomes. Evidence regarding how caregiver guilt is conceptualised, measured, and addressed across cultural contexts remains fragmented. This scoping review aimed to synthesise current evidence on caregiver guilt among family caregivers of patients with cancer and to examine its conceptualisation, measurement, and implications for palliative care.</p><p><strong>Methods: </strong>A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. Thirteen English and Chinese databases were searched from database inception to 20 October 2025. Qualitative, quantitative, and mixed-methods studies examining guilt as a primary or secondary outcome among family caregivers of patients with cancer were included. Data were synthesised narratively to identify key themes across studies.</p><p><strong>Results: </strong>Twenty-seven studies were included. The studies used qualitative, quantitative, and mixed-methods designs and were conducted across diverse cultural and care contexts. Caregiver guilt was reported in relation to perceived inadequacy in caregiving, difficult care-related decisions, self-care, family and relational responsibilities, emotional suppression, and uncertainty around prognosis or end-of-life care. Measurement approaches were heterogeneous, including standardised scales, brief guilt items, study-specific questionnaires, and qualitative methods. Six studies were conducted in direct palliative, hospice, end-of-life, or bereavement contexts, and five addressed advanced, incurable, prognosis-related, or otherwise palliative-relevant cancer caregiving. Limited intervention-related evidence was identified, including one feasibility study that included caregiver guilt as an outcome and one single-case intervention component reported in a master's thesis.</p><p><strong>Conclusions: </strong>Caregiver guilt is a recurring but inconsistently conceptualised experience in cancer caregiving. Based on the reported patterns across included studies, this review proposes an interpretive framework comprising two interrelated dimensions of caregiver guilt: action-oriented guilt and identity-oriented guilt. Future research should develop and test conceptually clear measures of caregiver guilt and evaluate interventions that address guilt-related distress across palliative and broader cancer caregiving contexts.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310273","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 spiritual needs of patients receiving palliative care and their caregivers: a qualitative study.","authors":"Gülay Turgay, Banu Çevik, Sultan Kav, Ebru Akgün Çıtak","doi":"10.1186/s12904-026-02200-2","DOIUrl":"10.1186/s12904-026-02200-2","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing chronic or life-threatening illnesses can lead to spiritual struggles for patients and their caregivers. This study aims to explore the spiritual needs of patients receiving palliative care and their caregivers.</p><p><strong>Methods: </strong>The qualitative study was conducted with patients and their caregivers in the palliative care unit of a foundation hospital in Ankara. Semi-structured interviews were conducted with 22 patients and 22 caregivers. The interview questions for patients focused on health-related issues, challenges, coping strategies, significant aspects of their lives, and any changes in their beliefs during illness. Similarly, caregivers were asked four semi-structured questions regarding their challenges, coping strategies, the most meaningful aspects of their lives, and any changes in their beliefs as caregivers. Data analysis was performed using Colaizzi's phenomenological approach.</p><p><strong>Results: </strong>The most common diagnoses among patients were end-stage renal failure, chronic liver disease, lung cancer, and ovarian cancer, respectively. Data analysis revealed four main themes and eight sub-themes. The main themes identified were: \"Functional Disability,\" \"Transcendence and Family Support,\" \"Acceptance,\" and \"Psychological Pain.\" Four main themes and three sub-themes emerged from the caregiver data. The main themes were: \"Care Burden,\" \"Lack of Information,\" \"God/Higher Power,\" and \"Glory of Care.\" The \"Care Burden\" theme encompassed three sub-themes: \"Physical Problems,\" \"Stress,\" and \"Economic Problems.\"</p><p><strong>Conclusions: </strong>The results of this qualitative study indicate that spiritual values are indispensable for the patients and caregivers, and they perceive support from God, family, and friends even during the most difficult times.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310234","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":"Grief experiences among LGBTQ+ populations: a scoping review.","authors":"Tamara Rodríguez Pérez, Cristo Manuel Marrero González, Héctor Vera Ortega, Alfonso Miguel García Hernández","doi":"10.1186/s12904-026-02202-0","DOIUrl":"10.1186/s12904-026-02202-0","url":null,"abstract":"<p><strong>Context: </strong>LGBTQ+ individuals face grieving processes complicated by minority stress, structural discrimination, and fears related to disclosure of their sexual orientation or gender identity, which leads to disenfranchised grief within healthcare systems that remain heteronormative. Recent literature on palliative care highlights inequities in access, a lack of recognition of chosen families, and gaps in professionals' LGBTQ+ cultural competence.</p><p><strong>Objective: </strong>To explore research published between 2021 and 2026 on grief and bereavement-related experiences among LGBTQ+ adults in healthcare and palliative care settings, identifying the main topics addressed and knowledge gaps relevant to clinical practice.</p><p><strong>Methods: </strong>A scoping review was conducted following the framework of Arksey and O'Malley and the recommendations of the Joanna Briggs Institute and reported according to PRISMA-ScR. Original articles were searched for in 6 databases (February 2026). Independent double screening (k = 0.87) with removal of duplicates. Primary empirical studies on grief and bereavement-related experiences in LGBTQ+ adults in healthcare or palliative care settings were included, including studies on end-of-life communication, advance care planning, disclosure processes, and bereavement-related support when they provided identifiable primary data. Data were extracted using structured templates and analyzed through inductive thematic analysis.</p><p><strong>Results: </strong>Seven primary empirical studies were included, with qualitative designs predominating. The evidence was mainly produced in English-speaking countries. Four main themes were identified: minority stress, complexities of disclosure, disenfranchised grief, and gaps in professional training. Critical gaps included underrepresentation of transgender people, a scarcity of quantitative data, an absence of intersectional perspectives, and concentration in Western contexts.</p><p><strong>Conclusions: </strong>Grief and bereavement-related experiences of LGBTQ+ adults in healthcare and palliative care settings appear to be profoundly shaped by structural dynamics of stigma, the invisibility of the chosen family, and training deficits in LGBTQ+ cultural competence. These findings suggest the need to develop institutional protocols sensitive to disclosure preferences, formally recognize the chosen family in end-of-life decisions, and incorporate mandatory training in LGBTQ+ competencies into curricula and continuing education programs. Future research should prioritize longitudinal and interventionist designs, intersectional approaches, and studies in non-Western contexts.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303703","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":"Effect of nurse-led individualized noise nursing intervention on sleep comfort and pain relief in terminally ill patients undergoing palliative care.","authors":"Songchao Wang, Yi Zhang, Leiting Tang, Xia Yang","doi":"10.1186/s12904-026-02196-9","DOIUrl":"10.1186/s12904-026-02196-9","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbance and pain are common sources of distress in terminally ill patients receiving palliative care, and nighttime ward noise is a modifiable environmental factor that may aggravate both symptoms. This study evaluated the effect of a nurse-led, individualized noise nursing intervention on sleep comfort and pain relief in terminally ill patients receiving palliative care, with the aim of providing practical evidence for comfort-oriented nursing care.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using existing clinical and nursing records of 163 terminally ill patients admitted to the palliative care ward of our hospital from March 2024 to August 2025. Patients were divided into an observation group (n = 89) and a control group (n = 74) according to the nursing methods received. The control group received routine palliative care combined with standardized noise nursing, while the observation group received nurse-led individualized noise nursing in addition to the routine care. The average intervention period was 4 weeks for both groups. Indicators related to sleep comfort, pain status, and noise interference were compared between the two groups.</p><p><strong>Results: </strong>After the intervention, the observation group showed greater improvements in sleep comfort, pain-related indicators, and noise interference indices compared to the control group. The observation group also had higher scores for nursing compliance and family satisfaction, along with better quality of life and a lower incidence of adverse events. All between-group differences were statistically significant (P < 0.05).</p><p><strong>Conclusion: </strong>Among terminally ill patients receiving palliative care, a nurse-led, individualized noise nursing program is associated with improved sleep comfort and better pain-related outcomes. During the intervention period, patients show better adherence to nursing measures, and family satisfaction increases.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303640","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":"A knowledge graph-driven paradigm for holistic symptom management: development and evaluation of a nurse-led KG-QA system in community palliative care.","authors":"Xu Yan, Ran An, Guozhen Liu, Youqing Wang, Yan Jiang, Qiaoqin Wan","doi":"10.1186/s12904-026-02198-7","DOIUrl":"10.1186/s12904-026-02198-7","url":null,"abstract":"<p><strong>Background: </strong>Community nurses play a pivotal role in palliative care but face barriers in managing complex symptoms, such as fragmented knowledge and a lack of community-tailored evidence-based guidance, impairing clinical efficiency. The aim of this study was to develop and evaluate a knowledge graph-based question-answering system for symptom management in community palliative care.</p><p><strong>Methods: </strong>A three-phase codesign study guided by the Knowledge-to-Action framework was conducted. Phase 1 (Knowledge Creation): A Symptom Management Knowledge Base (Knowledge Product I) was developed through a codesign process involving a multidisciplinary expert panel. This panel adapted a knowledge base created by researchers through systematic evidence synthesis, employing FAME criteria for contextual adaptation. Phase 2 (Action Cycle: Implementation): A semantically structured knowledge graph (Knowledge Product II) was constructed via automated extraction by software developers, followed by manual verification by researchers. Based on this graph, a question-answering system was created and implemented as a WeChat mini-program, resulting in a practical KG-QA system (Knowledge Product III). Phase 3 (Action Cycle: Evaluation): The system's acceptability, usability, and perceived usefulness and ease of use were assessed among experts and community nurses during a two-week evaluation period using the Clinical Nursing Information System Effectiveness Evaluation Scale and the Post-Study System Usability Questionnaire, which is grounded in the Technology Acceptance Model.</p><p><strong>Results: </strong>The knowledge base comprises 225 evidence items for nine symptoms; the knowledge graph integrates ten entity types, 11 relationship categories, 442 entities and 668 relationships, with the system supporting four query interfaces and three search methods. The evaluations demonstrated high perceived usefulness and ease of use, with strong scores for acceptability (102.25 ± 16.21; 110.56 ± 9.90) and usability (2.47 ± 1.98; 2.23 ± 1.93).</p><p><strong>Conclusion: </strong>The question-answering system bridges the evidence-practice gap via a nursing-process paradigm, offering a potentially scalable model that aligns with national policies pending further validation. However, these findings are based on a small‑scale, single‑region, short‑term evaluation relying largely on subjective measures. Future research should explore its long-term clinical outcomes and cross-setting scalability.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284590","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":"Palliative care preparedness among undergraduate nursing students in Northern Saudi Arabia: a cross-sectional study of Knowledge, Attitudes, and Spiritual Care.","authors":"Manal Hassan Baqeas, Fathia Ahmed Mersal, Ibrahim Naif Alenezi, Faisal Khalaf Alanazi, Amal Ahmed Elbilgahy","doi":"10.1186/s12904-026-02193-y","DOIUrl":"10.1186/s12904-026-02193-y","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is a core component of holistic nursing practice, yet international and regional evidence indicates persistent gaps in nursing students' preparedness, particularly in knowledge, attitudes, and spiritual care competence. In Saudi Arabia, these gaps are influenced by cultural expectations and variable curricular integration.</p><p><strong>Objective: </strong>To assess palliative care preparedness among undergraduate nursing students in Northern Saudi Arabia across three domains knowledge, attitudes toward caring for the dying, and spiritual care preparedness and to examine their associations with palliative care training and clinical experience.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 232 third- and fourth-year nursing students using stratified random sampling. Data were collected using the Palliative Care Knowledge Test (PCKT), the Frommelt Attitude Toward Care of the Dying Scale-B (FATCOD-B), and the Student Survey of Spiritual Care (SSSC). Descriptive statistics, Mann-Whitney U tests, Pearson correlations, and multiple linear regression were performed.</p><p><strong>Results: </strong>Students demonstrated moderate knowledge (M = 13.78/20), with higher scores in psychiatric and dyspnea management domains. Clinical experience with dying patients was associated with significantly higher knowledge (p = 0.0189). Attitude scores were generally positive (M = 3.13/5), though slightly lower among students with training or clinical experience. Spiritual care preparedness was moderate (M = 3.86/6) and did not differ by training or experience. A weak negative correlation was observed between knowledge and attitudes (r = - 0.143, p = 0.0296).</p><p><strong>Conclusion: </strong>Nursing students in Northern Saudi Arabia exhibit moderate preparedness for palliative care. Clinical exposure enhances knowledge, while spiritual care readiness appears culturally grounded rather than training dependent. Findings highlight the need for integrated, culturally responsive palliative and spiritual care education within undergraduate nursing curricula.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279556","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":"Healthcare professionals' conceptualizations of palliative care and readiness for early integration: a cross‑sectional mixed‑methods survey in Finland.","authors":"Ebba Åström, Ella Saaranen, Heidi Andersén, Mikael Johansson, Nelli-Sofia Nåhls","doi":"10.1186/s12904-026-02194-x","DOIUrl":"10.1186/s12904-026-02194-x","url":null,"abstract":"<p><strong>Background: </strong>Early integration of palliative care for patients with advanced cancer is recommended by major organizations and guidelines, yet palliative care is often still perceived as end-of-life care or as incompatible with active oncological treatment. Such misconceptions may delay timely integration.</p><p><strong>Methods: </strong>We conducted a cross-sectional mixed-methods survey among healthcare professionals in oncology services in Ostrobothnia, Finland. The survey included 15 Likert-scale statements (1-5) addressing perceived knowledge, values and role beliefs, and perceived capacity and support, plus one free-text question: \"What is palliative care?\". Likert responses were summarized descriptively and compared across demographic groups using non-parametric tests. Free-text responses were coded using a predefined framework of 25 themes derived from the WHO definition of palliative care and Finnish national quality recommendations, generating a binary concept-coverage score (0-25). Responses were also classified for an end-of-life/non-concurrent conceptualization (\"non-concurrent framing\"). Group differences in concept-coverage scores were tested using Mann-Whitney U.</p><p><strong>Results: </strong>Ninety-six professionals completed the survey (response rate 88.1%); 95 responded to the free-text item. While participants strongly endorsed statements about palliative care benefits and values, endorsement was lower for perceived competence and lowest for resources and support. Nearly one-third of participants expressed a non-concurrent/end-of-life framing of palliative care in their free-text definition. Concept-coverage scores were significantly lower among participants with non-concurrent framing compared with those without, particularly framework categories related to practical factors and system-level drivers.</p><p><strong>Conclusion: </strong>The open-ended responses indicated variability in the conceptualization of palliative care, including descriptions consistent with an end-of-life or non-concurrent view. This pattern identifies a potential target for education and implementation aligned with national guidance and quality recommendations.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266763","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 impact of opioid stigma on patient-provider interaction and decision-making in cancer pain management: a qualitative meta-synthesis.","authors":"Ying-Xiang Chen, Rui Yu, Min Xu, You Zhou, Wen-Yan He, Xiao-Lan Zhang","doi":"10.1186/s12904-026-02197-8","DOIUrl":"10.1186/s12904-026-02197-8","url":null,"abstract":"<p><strong>Context: </strong>Clinical guidelines recommend opioids for moderate-to-severe cancer pain, yet undertreatment remains common. In the context of the opioid crisis and increasingly restrictive regulatory policies, communication and decision-making around cancer pain management have become more challenging. Opioid stigma may be an overlooked influence on how patients and healthcare providers communicate and make treatment decisions.</p><p><strong>Objectives: </strong>To explore how opioid stigma influences patient-provider interaction and decision-making through a qualitative meta-synthesis.</p><p><strong>Methods: </strong>This qualitative meta-synthesis followed PRISMA and ENTREQ and was registered in PROSPERO (CRD420261329320). We searched PubMed, CINAHL, Embase, PsycINFO, Web of Science, the Cochrane Library, WanFang, and CNKI from database inception to 1 March 2026. We included qualitative studies examining stigma, interaction, and decision-making in cancer pain management. Findings were synthesized using thematic synthesis, and confidence was assessed using CERQual.</p><p><strong>Results: </strong>Twenty studies were included. Most had moderate methodological limitations, particularly in reflexivity and positionality. A total of 145 findings were extracted and grouped into 10 descriptive categories and 4 analytical themes. Opioid stigma was shaped by sociocultural narratives and institutional processes. Patients internalized this stigma as shame and fear, which could reduce pain expression and help-seeking. Clinicians faced tension between adequate analgesia and risk management, contributing to conservative prescribing. In clinical encounters, patients often felt compelled to justify the legitimacy of their pain, whereas clinicians responded defensively to perceived risks.</p><p><strong>Conclusions: </strong>Opioid stigma shapes patient-provider interaction and decision-making in cancer pain management and may reinforce undertreatment. Multilevel efforts to reduce stigma may improve communication, support shared decision-making, and promote more appropriate opioid-related decision-making in cancer pain management.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266814","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}