BMC Palliative Care最新文献

{"title":"Understanding the benefits and limitations of mixing virtual and face-to-face consultations to outpatient palliative care services; a mixed-methods study.","authors":"Caradoc Morris, David Waterman, Lesley Anne Henson","doi":"10.1186/s12904-024-01578-1","DOIUrl":"10.1186/s12904-024-01578-1","url":null,"abstract":"<p><strong>Background: </strong>The Covid-19 pandemic led to a rapid increase in the use of virtual consultations across healthcare. Post-pandemic, this use is expected to continue alongside the resumption of traditional face-to-face clinics. At present, research exploring when to use different consultation formats for palliative care patients is limited.</p><p><strong>Aim: </strong>To understand the benefits and limitations of a blended approach to outpatient palliative care services, to provide recommendations for future care.</p><p><strong>Methods: </strong>A mixed-methods study. Component 1: an online survey of UK palliative care physicians. Component 2: a qualitative interview study exploring patients' and caregivers' experiences of different consultation formats. Findings from both components were integrated, and recommendations for clinical practice identified.</p><p><strong>Results: </strong>We received 48 survey responses and conducted 8 qualitative interviews. Survey respondents reported that face-to-face consultations were appropriate/necessary for physical examinations (n = 48) and first consultations (n = 39). Video consultations were considered appropriate for monitoring stable symptoms (n = 37), and at the patient's request (n = 42). Patients and caregivers felt face-to-face consultations aided communication. A blended approach increased flexibility and reduced travel burden.</p><p><strong>Conclusions: </strong>A blended outpatient palliative care service was viewed positively by physicians, patients and caregivers. We identified 13 clinical practice recommendations for the use of different consultation formats.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"260"},"PeriodicalIF":2.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631054","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 death education needs of patients with advanced cancer: a qualitative research.","authors":"Shenghuan Yang, Chao Yan, Jing Li, Yinglu Feng, Huizini Hu, Yonghong Li","doi":"10.1186/s12904-024-01540-1","DOIUrl":"10.1186/s12904-024-01540-1","url":null,"abstract":"<p><strong>Background: </strong>Cancer remains a global health concern, with nearly 20 million new cancer cases and approximately 10 million cancer-related deaths reported in 2020.An increasing number of individuals with advanced-stage cancer are likely to confront the reality of mortality.In China, cancer-related deaths hold the top position among factors contributing to resident mortality, accounting for nearly a quarter of all deaths. Patients with advanced-stage cancer contend with both physical challenges such as pain, physical decline, and functional impairments, as well as psychological issues including death anxiety, fear of death, and feelings of meaninglessness and hopelessness during disease treatment. Death education serves as a method to educate patients on coping with death, alleviating death-related anxieties and fears, and approaching death calmly, thereby facilitating a peaceful end-of-life experience. Currently, there is a dearth of death education content tailored to patients'specific circumstances in China. Consequently, this study aims to explore the content of death education needs among patients with advanced-stage cancer in China.</p><p><strong>Methods: </strong>A qualitative research based on phenomenology was used to select 19 patients with advanced cancer from November 2022 to June 2023. Semi-structured interviews were used to interview, and Colaizzi 7-step analysis method was used to organize and analyze the data.</p><p><strong>Results: </strong>Six themes were extracted: 1. Death cognition and education; 2. Life review; 3. Ethics of death; 4. End-of-life decision-making; 5. Social support; 6. Disease treatment.</p><p><strong>Conclusions: </strong>Patients with advanced-stage cancer face significant distress caused by their illness and the prospect of death. This distress can impact their quality of life and even influence treatment decisions. It's essential to comprehensively assess the current state and needs of patients, engaging in ongoing interventions tailored to individual patient circumstances. This approach involves implementing targeted death education content and methods. When executing death education, it's imperative to consider the patient's knowledge framework and their level of acceptance. Integrating the patient's disease progression and treatment, as well as addressing their negative emotional states, becomes crucial for enhancing the patient's overall well-being and quality of life.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"259"},"PeriodicalIF":2.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631052","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 a structured, family-supported, and patient-centred advance care planning on end-of-life decision making among palliative care patients and their family members: protocol of a randomised controlled trial.","authors":"Doris Y P Leung, Joyce O K Chung, Helen Y L Chan, Raymond S K Lo, Kevin Li, Po Tin Lam, Nancy H Y Ng","doi":"10.1186/s12904-024-01588-z","DOIUrl":"10.1186/s12904-024-01588-z","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is a well-recognized quality indicator for palliative care. Despite two decades of effort, previous studies showed that ACP-related documentation and end-of-life discussion rates remain low for palliative care patients. Although ACP is about self-determination and autonomy, studies consistently show the importance of family involvement in adult patient's medical decision-making. Yet, research on ACP interventions with structured components targeting family member remained limited. The current study aims to evaluate the effectiveness of a structured, family-supported, patient-centred ACP programme for adult palliative care patients and their families.</p><p><strong>Methods: </strong>This is a 2-arm parallel group randomized controlled trial with follow-ups at 6 and 12 months. One hundred and seventy eligible palliative care patients and their families are planned to be recruited from three hospitals, and randomized to either a structured, family-supported, patient-centred ACP programme (ACP-Family) or usual ACP care (ACP-UC) arm. The ACP-Family intervention consists of 2 sessions. The primary outcome is family's prediction accuracy of patient's treatment preferences at 6 months. Secondary outcomes include proportions of new ACP documentations and family-reported perception of whether the patient's end-of-life (EOL) care preference was respected; patient's decisional conflict; quality of communication; family's decision-making confidence; family's anxiety and depression; and patients' and family members' satisfaction of the intervention. Outcomes of the two groups will be compared using regressions and linear mixed-effects models.</p><p><strong>Discussion: </strong>This study will provide rigorous scientific evidence on the effectiveness of a structured and well-design family-supported, patient-centred ACP programme for adult palliative care patients and their family members in the hospital setting. If the ACP-Family proves to be effective, it will provide a structured and systematic approach to facilitate ACP discussions involving family members. This will respond to local needs and inform international ACP practice.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05935540.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"257"},"PeriodicalIF":4.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607165","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: Community-based palliative care needs and barriers to access among cancer patients in rural north India: a Participatory action research.","authors":"Mayank Gupta, Ankita Kankaria, Liya E Joshy, Sandeep Singh, Bhajan Lal, Subhash Choudhary, Sapna Marcus, Anju Grewal, Lajya Devi Goyal, Rakesh Kakkar","doi":"10.1186/s12904-024-01591-4","DOIUrl":"10.1186/s12904-024-01591-4","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"258"},"PeriodicalIF":4.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual needs of family caregivers in palliative care.","authors":"Uğur Uzun, Serpil Başar, Aykut Saritaş","doi":"10.1186/s12904-024-01589-y","DOIUrl":"10.1186/s12904-024-01589-y","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study is to elucidate the spiritual needs encountered by family members who intricately engage in the progression of illness within the palliative care framework, thus assuming the paramount responsibility of caregiving.</p><p><strong>Methods: </strong>This study was approved by the Institutional Review Board and Ethics Committee of the University of Health Sciences İzmir Tepecik Training and Research Hospital (17/01/2022-2022/01-16). The research was designed as a prospective study. It was conducted through face-to-face, interactive interviews with family caregivers of patients admitted to the palliative care unit at Tepecik Training and Research Hospital between April 2022 and December 2022. The interviews were performed using a phenomenological approach and structured in a question-and-answer format. Data from twenty family caregivers were analyzed using thematic analysis. The questions were specifically designed to explore the psychological processes, spirituality, conceptions of God, meaning-making, and coping strategies of the family caregivers.</p><p><strong>Results: </strong>Caregivers experienced various psychological and emotional states progressing through stages of denial, anger, and acceptance. Spirituality emerged as a critical coping mechanism providing strength and meaning amidst caregiving challenges. Caregivers' perceptions of God varied from loving to punitive, influencing their interpretations of suffering and caregiving roles.</p><p><strong>Conclusion: </strong>This study underscores the importance of integrating spiritual support into palliative care practices. Recognizing and addressing caregivers' spiritual needs is crucial for enhancing their well-being and improving the quality of palliative care delivery. Training healthcare professionals in spiritual care and implementing targeted interventions can effectively support family caregivers in their caregiving journey.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"256"},"PeriodicalIF":4.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607168","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 readiness among community-dwelling older adults and the influencing factors: a scoping review.","authors":"Fang Gao, Ping Lei Chui, Chong Chin Che, Li Xiao, Qin Zhang","doi":"10.1186/s12904-024-01583-4","DOIUrl":"10.1186/s12904-024-01583-4","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is pivotal in mitigating end-of-life suffering and ensuring healthcare congruence with the values of older adults and dignity in death. Despite its paramount importance, the current readiness for ACP among community-dwelling older adults and the intricate influencing factors have yet to be explored.</p><p><strong>Objective: </strong>To review the literature focusing on ACP readiness among community-dwelling older adults and the influencing factors.</p><p><strong>Methods: </strong>A scoping review conducted using the Arksey and O'Malley (2005) framework. Electronic databases (PubMed, CINAHL, Cochrane, Web of Science, PsycINFO), as well as grey literature databases (OpenGrey and GreyLit.org) were searched to identify studies published in English between January 2012 and March 2023.</p><p><strong>Results: </strong>19 studies were selected, comprising 3 qualitative, 13 quantitative, 2 mixed-methods, and 1 review article. The study evaluated the readiness of older adults for ACP by examining their knowledge and attitudes. It categorizes influencing factors into intrinsic and extrinsic levels. This review revealed that the knowledge about ACP among older adults across all settings was limited. However, they had positive attitudes toward it. In addition, intrinsic factors including sociodemographic characteristics, psychological factors, and family relationships, along with extrinsic factors including health care professionals' attitudes and experience, as well as policies and laws, influenced the ACP readiness among older adults.</p><p><strong>Conclusions: </strong>This study established the groundwork for future ACP intervention trials, providing a theoretical framework to guide their design and implementation. operationalization.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"255"},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570076","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":"Expected benefits and concerns regarding virtual reality in caring for terminally ill cancer patients - a qualitative interview study.","authors":"Anja Greinacher, Bernd Alt-Epping, Christina Gerlach, Cornelia Wrzus","doi":"10.1186/s12904-024-01557-6","DOIUrl":"10.1186/s12904-024-01557-6","url":null,"abstract":"<p><strong>Background: </strong>Many palliative cancer patients require inpatient hospital treatment for medical reasons, which contrasts their frequent desire to be at home. Virtual reality (VR) could be a way of bringing the home environment closer to them. First observations have shown benefits from VR for inpatients in palliative care. The aim of this qualitative, descriptive study was to explore the expectations of in-patients suffering from incurable cancer and their relatives about VR, in particular individualized VR images of the patients' own home.</p><p><strong>Methods: </strong>Semi-structured interviews with inpatients suffering from incurable cancers and their relatives in three medical settings (palliative care, hematology, radiotherapy) of a German university hospital. Qualitative content analysis about expected benefits and concerns regarding VR-videos showing their private home; defining the main topics deductively and the subcategories inductively. We also assessed the patients' subjective perspective on their remaining time to live to estimate the impact of double awareness on the results. The Patient Advisory Board informed the study protocol and conduct.</p><p><strong>Results: </strong>We interviewed 15 patients (8 men; age M = 63.4, SD = 11.34; range 39-82) under palliative care, and four relatives. We organized the interview content in 6 themes (general interest, desired content, non-desired content, expected benefits, concerns, and irregularities) and 26 sub-themes. Most patients and relatives were interested in using VR during hospital treatment. They often preferred viewing nature or tourist sites over seeing their home or family. Reasons could be linked to privacy concerns and the general desire for distraction from the current situation that they specified with their expectation of well-being, a break from the patient-experience, the pursue of curiosity, and the VR evoking fond memories.</p><p><strong>Conclusion: </strong>VR seems to be of interest for palliative cancer patients, especially as distraction and relief from their illness. The desired content can be very different, so a choice from a selection of VR-content should be made available. If patients want to see videos of their own home, recordings by relatives instead of study or hospital staff seem to meet the need for privacy.</p><p><strong>Trial registration: </strong>Registered at Deutsches Register Klinischer Studien; registration number: DRKS00032172; registration date: 11/07/2023. https://drks.de/search/de/trial/DRKS00032172.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"254"},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570080","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":"Perceived risk of death among patients with advanced cancer: a qualitative directed content analysis.","authors":"Guojuan Chen, Zhangxian Chen, Huimin Xiao, Jianwei Zheng, Shangwang Yang, Hong Wu","doi":"10.1186/s12904-024-01584-3","DOIUrl":"10.1186/s12904-024-01584-3","url":null,"abstract":"<p><strong>Background: </strong>Risk perception with respect to death is a prerequisite for patients with advanced cancer when the time comes to make medical decisions. However, the nature of death risk perception remains unclear.</p><p><strong>Method: </strong>In-depth interviews were conducted with 28 patients with advanced cancer who were recruited from two hospitals and one home-based hospice in Fujian, China. Interviews were transcribed and directed content analysis applied. The Tripartite Model of Risk Perception was used as a theoretical framework.</p><p><strong>Results: </strong>Patients with advanced cancer perceived their risk of death in different ways. Professional communication about death risk and data-driven risk perception were common in clinical settings. Affective influences, inherent cognition, and comparisons to others or oneself also contributed to the subjects' self-perceived death risk.</p><p><strong>Conclusion: </strong>This theory-informed qualitative study clarifies the nature of the perceived risk of death among patients with advanced cancer. The study findings offer healthcare providers a more nuanced understanding of the perceived risk of death among patients with advanced cancer.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"252"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559128","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":"Cultural adaptation and validation of the Sinhala version of the spiritual needs assessment for patients (S-SNAP) questionnaire.","authors":"Udayangani Ramadasa, Shehan Silva, Suraj Perera, Sarath Lekamwasam","doi":"10.1186/s12904-024-01579-0","DOIUrl":"10.1186/s12904-024-01579-0","url":null,"abstract":"<p><strong>Background: </strong>Spiritual support for patients and caregivers of critically ill patients is associated with improved quality of life. This aspect, however, is not incorporated into the current care pathways in Sri Lanka. The Spiritual Needs Assessment for Patients (SNAP) questionnaire, comprised of 3 domains: psychosocial, spiritual and religious, gives a platform for clinicians to assess the spiritual needs of those patients. This study presents the results of validation of the Sinhala version of the SNAP (S-SNAP) questionnaire.</p><p><strong>Methods: </strong>The SNAP was translated from English to Sinhala using the standard forward and backward translation process. After verifying the content validity, unambiguity and clarity of items in a focused group discussion, and a pilot study, the pre-final version was tested among 267 volunteers with cancer selected from three state-run cancer care institutions. Data were analysed for internal consistency and item-total correlations. Factor analysis was done using Varimax rotation with Kaiser normalization. A Scree plot was also made to determine the number of factors.</p><p><strong>Results: </strong>The mean (SD) age of subjects was 63.2 (11.4) years. The total S-SNAP score ranged from 22 to 88 (maximum 88). The overall Cronbach's alpha was 0.94 while item-total correlations varied from 0.26 to 0.87. Total SNAP score showed inverse correlations with age, Charleson Comorbidity index and Barthel index while a positive correlation was seen with the Karnofsky performance status scale (p < 0.05). Kaiser-Meyer-Olkein value of 0.92 (P = < 0.001) for Bartlett's test indicated adequate sampling and non-linearity of factors. The scree plot showed a four-factor structure explaining 76% variation. Meaning of life and relationship with a supernatural being and religious rituals are loaded as 2 different factors. Worries, fears and forgiveness are grouped as the third factor while relaxation, coping and sharing feelings are loaded separately.</p><p><strong>Conclusions: </strong>The S-SNAP is a reliable and valid tool to assess spiritual suffering among patients with cancers conversant in the Sinhala language.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"253"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559127","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":"Health care utilization at the end of life in Parkinson's disease: a population-based register study.","authors":"Breiffni Leavy, Elisabet Åkesson, Johan Lökk, Torbjörn Schultz, Peter Strang, Erika Franzén","doi":"10.1186/s12904-024-01581-6","DOIUrl":"10.1186/s12904-024-01581-6","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of health care utilization at the end of life in Parkinson's disease (PD) is sparse. This study aims to investigate end of life health care utilization, characterized by emergency room (ER) visits, receipt of specialized palliative care (SPC), and acute hospital deaths in a Swedish population-based PD cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on deceased patients (≥ 18 years) with a PD diagnosis during their last year of life (n = 922), based on health care-provider data from Region Stockholm´s data warehouse, for the study period 2015-2021. Univariable and multivariable logistic regression analyses tested associations and adjusted Odds ratios (aORs) were calculated.</p><p><strong>Results: </strong>During the last month of life, approx. half of the cohort had emergency room (ER) visits and risk of frailty (measured by Hospital Frailty Risk Score) significantly predicted these visits (aOR, 3.90 (2.75-5.55)). In total, 120 people (13%) received SPC during their last three months of life, which positively associated with risk for frailty, (aOR, 2.65 (1.43-4.94, p = 0.002). In total, 284 people (31%) died in acute hospital settings. Among community-dwellers, male gender and frailty were strongly associated with acute hospital deaths (aOR, 1.90 (1.15-3.13, p = 0.01) and 3.70 (1.96-6.98, p < 0.0001)).</p><p><strong>Conclusions: </strong>Rates of ER visits at end of life and hospital deaths were relatively high in this population-based cohort. Considering a high disease burden, referral to SPC at end of life was relatively low. Sex-specific disparities in health care utilization are apparent. Identifying people with high risk for frailty could assist the planning of optimal end-of-life care for people with PD.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"23 1","pages":"251"},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523446","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}