Journal of Palliative Care最新文献

{"title":"Deathbed Etiquette - The Guide: A Qualitative Study Exploring the Views of Practitioners on its Introduction into End-of-Life Care Settings.","authors":"Mette Kragh-Furbo, Maddy French, Lesley Dunleavy, Sophie Hancock, Karen Sanders, Margaret Doherty, Amy Gadoud","doi":"10.1177/08258597231158325","DOIUrl":"10.1177/08258597231158325","url":null,"abstract":"<p><p><b>Objectives:</b> It is common for relatives to feel uncertain about what to expect at the bedside of a dying loved one. The Centre for the Art of Dying Well together with clinical, academic and communications experts created a 'Deathbed Etiquette' guide offering information and reassurance to relatives. This study explores the views of practitioners with experience in end-of-life care on the guide and how it might be used. <b>Methods:</b> Three online focus groups and nine individual interviews were conducted with a purposive sample of 21 participants involved in end-of-life care. Participants were recruited through hospices and social media. Data were analysed using thematic analysis. <b>Results:</b> Discussions highlighted the importance of effective communication that normalises experiences of being by the bedside of a dying loved one. Tensions around the use of the words 'death' and 'dying' were identified. Most participants also expressed reservations about the title, with the word 'deathbed' found to be old-fashioned and the word 'etiquette' not capturing the varied experiences of being by the bedside. Overall, however, participants agreed that the guide is useful for 'mythbusting' death and dying. <b>Conclusion:</b> There is a need for communication resources that can support practitioners in having honest and compassionate conversations with relatives in end-of-life care. The 'Deathbed Etiquette' guide is a promising resource to support relatives and healthcare practitioners by providing them with suitable information and helpful phrases. More research is needed on how to implement the guide in healthcare settings.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"162-167"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9474007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends, Predictors, and Potential Disparities of Palliative Care Utilization Among Older Adults With Hip Fractures: A Retrospective Analysis of the National Inpatient Sample, 2016-2020.","authors":"Yuji Yamada, Takaaki Kobayashi, Patrick Ten Eyck, Renee Ren, Shigeki Fujitani, Fred Ko","doi":"10.1177/08258597241290982","DOIUrl":"10.1177/08258597241290982","url":null,"abstract":"<p><p><b>Objectives:</b> To assess the trends in palliative care consultation utilization and identify associated factors among older adults hospitalized with hip fractures in the United States between 2016 and 2020. <b>Methods:</b> We conducted a retrospective cohort study using data from the National Inpatient Sample from 2016 to 2020. The study included patients aged 65 and older admitted to hospital with a primary diagnosis of hip fracture. We identified palliative care consultations using ICD-10 code Z51.5. Multivariate logistic regression analyses were performed to identify predictors of palliative care utilization, adjusting for demographics, clinical variables, and hospital characteristics. <b>Results:</b> A total of 293,749 admissions for hip fractures were identified, of which 9546 (3.2%) had palliative care consultations. A consistent upward trend was seen in the proportion of patients receiving palliative care consultations across all fracture types. Patients of color (Black: odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.65-0.83; Hispanic: OR = 0.67, 95% CI: 0.60-0.75 compared to White), those in lower-income quartiles (lowest: OR = 0.81, 95% CI: 0.76-0.87 compared to highest), smaller hospital size (OR = 0.84, 95% CI: 0.79-0.89 compared to large), and rural hospital (OR = 0.63, 95% Cl: 0.59-0.68, compared to urban teaching) were associated with fewer palliative care consultations. <b>Conclusion:</b> The number of palliative care consultations during hip fracture hospital admission was low, although the proportion increased over time. Significant disparities were observed and further research should explore barriers to palliative care access and develop strategies to enhance its delivery across diverse healthcare settings.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"120-128"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Non-Family Paid Helpers Providing Palliative Care to Stroke Patients: The Toll of Professional Informal Caregiving in a Job Lacking Recognition.","authors":"Jing Jing Su, Hammoda Abu-Odah, Jonathan Bayuo, Rose Sin Yi Lin, Xiaoling Luo, Alex Molassiotis","doi":"10.1177/08258597231210138","DOIUrl":"10.1177/08258597231210138","url":null,"abstract":"<p><p><b>Background:</b> Employing non-family paid helpers has become a prevalent practice across North America, Europe, and Asia, which families adopt to alleviate the stroke care burden, allowing family to take a break from their obligations and perform other social activities. However, paid helpers' experiences of providing palliative care to stroke patients are under-explored. This study aimed to explore the caregiving experiences of non-family paid helpers providing palliative care to stroke patients. <b>Method:</b> A qualitative descriptive study was undertaken using purposive sampling and semi-structured individual in-depth interviews. Thematic analysis was used for data analysis. <b>Results:</b> Seventeen participants (mean age: 51.23 years) were included, predominantly being female (88%), and their caregiving experiences with patients ranged from four to 26 years. Participants shared that monetary compensation offset the exhaustion, familial and health sacrifices of palliative caregiving. They emphasized emotional self-management through accepting and coping or avoiding and distancing, and appreciated rewarding appraisals from stroke patients and family members. They also expressed a lack of recognition from the public, being invisible to the healthcare system/professionals, and insecurity in employment rights. <b>Conclusions:</b> Findings support the need for governmental initiatives to subsidize families in employing helpers to provide palliative care. Helpers perceived monetary compensation and a reciprocal caregiving relationship as the primary motives for providing care. Public recognition of this role as a helper in caregiving, contractual employment rights, and being recognized by the healthcare system and healthcare professionals are considerations in promoting quality care and alleviating a health care burden. The findings may contribute to further understanding of the experiences of non-family paid helpers in a job lacking recognition when delivering palliative care in a hospital for stroke patients. Evidence-based interventions that enhance reciprocity and recognition should be considered as part of the global initiatives to support paid helpers in palliative care.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"103-112"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"(No) Oral Health in Palliative Care Patients: Predisposing Factors and Treatment.","authors":"Maria de Lurdes da Costa Martins, Cláudia Gaspar Dias de Barros","doi":"10.1177/08258597231212305","DOIUrl":"10.1177/08258597231212305","url":null,"abstract":"<p><p>ObjectiveTo describe mouth disorders in patients undergoing palliative care (PC); to identify predisposing factors for oral disorders and pharmacological and nonpharmacological strategies.MethodsObservational, exploratory, correlational, and descriptive study about mouth disorders of patients admitted to a hospital specializing in PC in Portugal, between November 6, 2019, and July 31, 2020. The data collection instrument was a questionnaire and the consultation of the patient's clinical file. It was obtained the previous authorization of the ethics committee and the patient's informed consent. Data were analyzed using the SPSS® software (V.26).ResultsThe sample was 46, 56.52% were over 71 years old, and the male sex ratio of 63.04%. Most of the patients had an advanced oncological disease, were polymedicated, had missing teeth, and no regular hygiene habits. Xerostomia and oral candidiasis were the most identified problems. Patients with oncological diseases have more probability to suffer from mouth disorders (<i>P</i> = .047), compared to noncancer patients. Patients with frequent oral hygiene have fewer mouth disorders (rp = -0.304; <i>P</i> = .040). There is a considerable improvement in the tongue coating with an increase in oral hygiene (<i>P</i> = .005). Mouth care plays is important in patient comfort (n = 45; 97.83%) and nonpharmacological strategies are effective for the relief of xerostomia (n = 35; 94.59%).ConclusionsNonpharmacological strategies are effective in the treatment of xerostomia and tongue coating. More information to determine the effectiveness of the strategies in the treatment of mouth disorders is necessary.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"113-119"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Homecare in Chronic Liver Disease: A Cohort Analysis of Factors and Outcomes Associated with Home Palliative Care in Patients with End-Stage Liver Disease.","authors":"Hugo M Oliveira, Céu Rocha, Maria Francisca Rego, Rui Nunes","doi":"10.1177/08258597241296116","DOIUrl":"10.1177/08258597241296116","url":null,"abstract":"<p><p><b>Objective:</b> The prevalence and mortality of chronic liver disease has risen significantly. In end-stage liver disease (ESLD), the survival of patients is approximately 2 years. Despite the poor prognosis and high symptom burden, integration of palliative care in ESLD is reduced, and the majority of patients continue to die in inpatient care. We aim to assess predictors and outcomes of home palliative care, as well as factors associated with death at home in patients with ESLD. <b>Methods:</b> Retrospective cohort study of patients with ESLD, followed by a palliative care team between 2017 and 2022. Information regarding patient demographics, ESLD etiology, decompensations, and interventions was collected. Two-sided tests were used to identify factors associated with home palliative care. <b>Results:</b> We analyzed 75 patients: 44% had home palliative care and 33% died at home. ESLD patients with home palliative care were older (72.52 vs 64.45; <i>p</i> = 0.002), had a longer palliative care intervention time (149.97 ± 196.23 vs 43.69 ± 100.60 days; <i>p</i> = 0.007), higher rates of ascites or hepatic encephalopathy (χ² = 11.024; <i>p</i> = 0.029), and hepatocarcinoma (90.9% vs 64.3%; <i>p</i> = 0.007). Patients with home palliative care had a reduction in-hospital admissions (2.61 vs 1.06; <i>p</i> = 0.000) and a greater probability of death at home (66.7% vs 33.3%; <i>p</i> = 0.000). Patients who died at home (33.3%) were older (72.20 vs 64.40; <i>p</i> = 0.000) and had longer palliative care intervention time (178.80 ± 211.78 vs 46.28 ± 99.67 days; <i>p</i> = 0.006). <b>Conclusion:</b> Home palliative care in ESLD differs based on demographics and disease complications, with a positive impact of homecare translated into a reduction in hospital admissions and an increased probability of death at home.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"129-136"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Determinants of Palliative Care Utilization Among Patients With Metastatic Upper Tract Urothelial Carcinoma in the National Cancer Database.","authors":"Christopher Connors, Olamide Omidele, Micah Levy, Daniel Wang, Juan Sebastian Arroyave, Nir Tomer, Sophia Jacobi, William Mayleben, Ketan Badani, Reza Mehrazin, Michael Palese","doi":"10.1177/08258597241297962","DOIUrl":"10.1177/08258597241297962","url":null,"abstract":"<p><p><b>Objective:</b> To identify patterns of palliative care usage and identify determinants of palliative intervention using a large contemporary cohort of patients with metastatic upper tract urothelial carcinoma (mUTUC). <b>Methods:</b> The National Cancer Database was queried from 2004 to 2020 for patients with mUTUC. Patients with a prior malignancy, non-mUTUC, and missing follow up or palliative care information were excluded. Demographics and baseline characteristics were compared between patients with mUTUC who received palliative care and those that did not. Trends in annual palliative care usage were assessed via logistic regression. Univariate and multivariate logistic regression models were used to identify predictors of receipt of palliative care. <b>Results:</b> Four thousand and forty-four patients with mUTUC were included in the final cohort, among which 908 received palliative care (22.5%) and 3136 did not (77.5%). We found that the utilization of palliative care increased significantly from 2004 (15.0%) to 2019 (23.1%), <i>P</i> < .001. Additionally, on multivariate analysis we found that a recent year of diagnosis, receipt of a prior nonsurgical treatment paradigm, and an overall survival <6 months were independent predictors of palliative intervention, all <i>P</i> < .001. On the other hand, undergoing treatment at a minority serving hospital and older age were associated with lower likelihood of receiving palliative care, both <i>P</i> < .001. <b>Conclusions:</b> There is a low but increasing trend of utilization of palliative care among patients with mUTUC. Expansion of palliative care services, particularly among older patients and those at minority-serving hospitals, remains a key opportunity to improve quality of life and enhance patient-centered care among those with mUTUC.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"137-146"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiating Prognostic Talk During Hospice Multidisciplinary Team Meetings: A Conversation Analytic Study.","authors":"Andrea Bruun, Nicola White, Linda Oostendorp, Patrick Stone, Steven Bloch","doi":"10.1177/08258597241286347","DOIUrl":"10.1177/08258597241286347","url":null,"abstract":"<p><p><b>Objective:</b> Guidelines recommend that patients' prognoses should be discussed by the palliative care multidisciplinary team. However, there is a lack of evidence on how multidisciplinary teams carry out prognostic discussions, and especially how prognostic talk is initiated during team meetings. This study explored how prognostic talk is initiated and responded to during meetings of a hospice multidisciplinary team. <b>Methods:</b> Video-recordings of 24 inpatient multidisciplinary team meetings in a UK hospice were collected from May to December 2021. A total of 65 multidisciplinary team members participated in the meetings. Recordings were transcribed and analysed using Conversation Analysis. <b>Results:</b> Prognostic talk was initiated during multidisciplinary team members' patient case presentations. Case presentations followed a certain template, and prognoses could be initiated as responses to template items such as the patient's Phase of Illness and Karnofsky's Performance Status score and the patient's main diagnosis and issues. Prognoses also occurred as accounts for a lack of template item responses. Beyond the patient case presentation, prognostic talk was initiated in relation to discharge planning. Prognoses appeared with sequences of assessments that accounted for them. When a prognosis was provided, it received confirming minimal responses from other team members. <b>Conclusions:</b> Patients' prognoses were embedded into other care discussions during meetings of a hospice multidisciplinary team. These findings can be used to inform the development of clinical guidelines and interventions aiming at improving multidisciplinary team discussions around prognosis in the future.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"183-189"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Decedents' Hospital End-of-Life Care Documentation: A Retrospective Review of Patient Records.","authors":"L Russell, R Howard, M Street, C E Johnson, D Berry, E Flemming-Judge, S Brean, L William, J Considine","doi":"10.1177/08258597231170836","DOIUrl":"10.1177/08258597231170836","url":null,"abstract":"<p><p><b>Objective:</b> International standards of end-of-life care (EOLC) intend to guide the delivery of safe and high-quality EOLC. Adequately documented care is conducive to higher quality of care, but the extent to which EOLC standards are documented in hospital medical records is unknown. Assessing which EOLC standards are documented in patients' medical records can help identify areas that are performed well and areas where improvements are needed. This study assessed cancer decedents' EOLC documentation in hospital settings. <b>Methods:</b> Medical records of 240 cancer decedents were retrospectively evaluated. Data were collected across six Australian hospitals between 1/01/2019 and 31/12/2019. EOLC documentation related to Advance Care Planning (ACP), resuscitation planning, care of the dying person, and grief and bereavement care was reviewed. Chi-square tests assessed associations between EOLC documentation and patient characteristics, and hospital settings (specialist palliative care unit, sub-acute/rehabilitation care settings, acute care wards, and intensive care units). <b>Results:</b> Decedents' mean age was 75.3 years (SD 11.8), 52.0% (n = 125) were female, and 73.7% lived with other adults or carers. All patients (n = 240; 100%) had documentation for resuscitation planning, 97.6% (n = 235) for Care for the Dying Person, 40.0% for grief and bereavement care (n = 96), and 30.4% (n = 73) for ACP. Patients living with other adults or carers were less likely to have a documented ACP than those living alone or with dependents (OR 0.48; 95% CI 0.26-0.89). EOLC documentation was significantly greater in specialist palliative care settings than that in other hospital settings (<i>P</i> < .001). <b>Conclusion:</b> The process of dying is well documented among inpatients diagnosed with cancer. ACP and grief and bereavement support are not documented enough. Organizational endorsement of a clear practice framework and increased training could improve documentation of these aspects of EOLC.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"168-175"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9349825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Patients' Preferences for Levels of Life-Sustaining Treatment: A 2-Year Follow-Up Study.","authors":"Mette A Smith, Anne C Brøchner, Helene K Nedergaard, Hanne I Jensen","doi":"10.1177/08258597251329842","DOIUrl":"https://doi.org/10.1177/08258597251329842","url":null,"abstract":"<p><p>ObjectiveThere is increasing interest in advance care planning (ACP) and the implementation of various forms of ACP. The purpose of ACP is to define patients' goals and preferences for future medical treatment and care for patients nearing the end of life (EOL). The aim of this study was to investigate adherence to patients' preferences for levels of life-sustaining treatment in emergency situations, as documented in a Danish POLST (Physician Orders for Life-Sustaining Treatment) form.MethodsA retrospective journal review was conducted 2 years after the conversation with the patients about their wishes for treatment and care at EOL. Medical records included electronic hospital records, nursing home records, and general practice records. Patients were assessed nearing EOL and included in the study based on a negative response to the \"surprise.\"ResultsA total of 120 patients and nursing home residents were included in the study. Overall, there were 2148 contacts with the healthcare system, of which 31 were emergency situations, where the patients were not capable of expressing their own wishes. In 4 contacts (12%), the patients (4) received treatment discordant with their wishes, as documented in the POLST form (and medical record).ConclusionsOur study shows that patients assessed nearing EOL are a patient group with many contacts with the healthcare system, and the results indicate that having had an ACP conversation and the wishes documented is useful to avoid unwanted treatment in emergency situations.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251329842"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrinsic Gratitude's Impact on Professional Trajectory: A Qualitative Interview Study With Palliative Care Team Members.","authors":"Hui-Ching Weng, Wei-Shu Lai, Duan-Rung Chen","doi":"10.1177/08258597251326760","DOIUrl":"https://doi.org/10.1177/08258597251326760","url":null,"abstract":"<p><p>ObjectivesPalliative care is emotionally demanding, yet extrinsic gratitude can improve job satisfaction. While intrinsic gratitude is effective in preventing burnout, the focus of existing research is mainly on extrinsic gratitude received by clinicians. This study aims to examine the role of intrinsic gratitude in clinicians within the emotionally demanding field of palliative care, assessing its impact on professional development and potential for broader community benefit.MethodsUtilizing purposive sampling, we recruited a diverse group of palliative care professionals from 10 hospitals, focusing on full-time staff with at least two years of experience in palliative care. Of the 23 clinicians, 12 (five physicians, six nurses, and one social worker) were recruited because they spontaneously expressed profound gratitude toward others.ResultsTwelve of twenty-three clinicians maintained a positive outlook despite the inherent challenges of their field. Intrinsic gratitude, especially toward team members like nurses, emerged as a pivotal support mechanism. Through its transformative dimensions of empathic engagement, self-elevation, and humility, this gratitude strengthened their professional resilience and trajectory and had a ripple effect on their personal lives, influencing familial relationships and broader societal interactions.ConclusionsThis is the first research focusing on clinicians' spontaneous expressions of gratitude. This study provides new insights into understanding the clinicians' intrinsic gratitude, its impact on their professional trajectory, and harnessing its potential benefits for broader community outreach. Through a reflective process incorporating gratitude, clinicians may be empowered to develop their self-coping mechanisms and nurture inner resilience while caring.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251326760"},"PeriodicalIF":1.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}