Journal of Palliative Care最新文献

{"title":"Regional Priorities in Palliative Care Research: Adapting the Delphi Technique for the Philippines.","authors":"John Patrick C Toledo","doi":"10.1177/08258597241301134","DOIUrl":"10.1177/08258597241301134","url":null,"abstract":"<p><p>This correspondence emphasizes the use of the Delphi technique to set regional priorities in palliative and end-of-life care research. It offers a structured framework to develop research that aligns with the most pressing needs of patients and providers. This approach can be adapted to improve palliative care in resource-limited settings such as the Philippines.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"266-267"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460558","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":"\"How Do I Practise Palliative Care When I Don't Know How?\" Exploring the Impact of EPAN, An Online Educational Intervention on General Nurses in Singapore: An Evaluation Study.","authors":"Yi Ling Neo, Norasyikin Hassan, Jemima Koh, Rasidah Alias, Liyun Wang, Yazid Hussein, Yoke Ping Wong","doi":"10.1177/08258597241264454","DOIUrl":"10.1177/08258597241264454","url":null,"abstract":"<p><p><b>Objective(s):</b> The majority of deaths in Singapore (62.1%) occur in the hospital, but most nurses do not have palliative care (PC) education. An online e-learning course, \"Essential Palliative Care Approach for Nurses\" (EPAN), was developed to close the learning gap. The study aimed to evaluate the impact of EPAN on general nurses' knowledge, confidence, and attitude in delivering end-of-life care. <b>Methods:</b> Convergent parallel mixed methods design. <b>Results:</b> 1708 nurses (67%), mostly from inpatient and ambulatory settings, completed EPAN. Statistically significant increases in mean scores across knowledge, confidence, and attitude (p < 0.05) remained consistent immediately post-course and 3 months post-course. Respondents shared their intentions to change practice in the immediate post-course survey (n = 1155) and how they have practiced end-of-life care in the 3-month post-course survey (n = 777). Major categories from the content analysis included: (i) actualise confidence to deliver effective communication, (ii) making time and showing empathy in end-of-life care, (iii) advocating for end-of-life care, (iv) proactive collaboration with other healthcare professionals, (v) navigated and accepted end-of-life boundaries, and (vi) able to self-manage emotions. <b>Conclusions:</b> EPAN, developed within an Asian context, has demonstrated a significant impact on nurses' knowledge, confidence, and attitude in delivering end-of-life care. This has broader implications for general palliative care education in countries of similar cultural concerns.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"205-214"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762411","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":"Factors Influencing Knowledge, Attitudes and Behaviour Towards Engaging with Advance Care Planning: A Cross-Sectional Survey of Chinese Diaspora.","authors":"Zhuangshuang Li, Sonja McIlfatrick, Felicity Hasson, Esther-Ruth Beck","doi":"10.1177/08258597241301206","DOIUrl":"10.1177/08258597241301206","url":null,"abstract":"<p><p>ObjectiveAdvance care planning (ACP) is increasingly recognized as a public health priority globally, with cultural aspects influencing people's knowledge, attitudes, and behaviours toward ACP. Despite being one of the largest diaspora groups, the Chinese community remains under-researched in this area. This study aims to examine the knowledge, attitudes, and health behaviours related to ACP among Chinese diaspora within a region in the United Kingdom.MethodA cross-sectional online survey based on the Theory of Planned Behaviour was conducted with 284 Chinese adults recruited from four social and voluntary organisations in the United Kingdom.ResultsThe study found low awareness (15%) and knowledge (mean score: 2.26 ± 1.78) of ACP, with less than 5% of the participants engaging with ACP. This contrasted with participants' attitudes (17.24 ± 2.57) and behavioural intention (14.93 ± 3.26) toward ACP, which were generally positive. Behavioural intention was the strongest predictor of engaging with ACP (OR 3.29, 95% CI: 1.35-8.02, <i>p</i> = 0.01). Participants with previous end-of-life care experience had a better understanding of ACP; older age and higher knowledge of ACP were associated with more positive attitudes. Cultural beliefs associated with the level of family involvement, legal aspects, and the availability of information in one's first language was significant influences on engagement with ACP.ConclusionsDespite low awareness and engagement with ACP among the Chinese diaspora, positive attitudes and behavioural intention suggest potential for increased engagement. This could be achieved through culturally tailored interventions that address cultural influences and complexity surrounding legal requirements. Further research is needed to develop and test such interventions.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"233-243"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781889","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":"Enhancing Person-Centered Care in Advance Care Planning: A Community Health Nurse's Perspective.","authors":"Kamran Munawar","doi":"10.1177/08258597251319104","DOIUrl":"10.1177/08258597251319104","url":null,"abstract":"","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"244-245"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484670","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":"Development of Patient-Centered End-of-Life Care Quality Measures in China: A Modified Delphi Process.","authors":"Lumeng Li, Xiuquan Gong","doi":"10.1177/08258597241302297","DOIUrl":"10.1177/08258597241302297","url":null,"abstract":"<p><p><b>Objective:</b> Patient-centered care is widely recognized as a crucial component of high-quality end-of-life care. As this approach remains limited in China, this study sought to develop quality measures specifically tailored to end-of-life care within the country. <b>Methods:</b> Initial indicators were established through a comprehensive review of existing measures. Using the modified Delphi Method, a two-round survey with experts (n = 14) was applied to evaluate the importance of each item. <b>Results:</b> The authoritative coefficient of two rounds of expert consultation was 0.86 and 0.87, and the Kendall coefficient of concordance for the two rounds was 0.232 and 0.270 (P < 0.001), respectively, demonstrating an acceptable consensus among the experts. As a result, 31 key quality indicators were identified and deemed important. <b>Conclusions:</b> This study developed a scale for patient-centered end-of-life care quality measurement in China, consisting of six dimensions and 31 indicators. This scale lays a solid foundation for quality improvement initiatives and future development of patient-centered end-of-life care.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"246-257"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796578","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":"Primary Care Providers' Perceptions of the CAPACITI Palliative Care Education Trial: A Qualitative Study of Experiences With Self-Directed and Facilitated Modalities.","authors":"Shilpa Jyothi Kumar, Valerie Bishop, Daryl Bainbridge, Frances Kilbertus, Kathy Kortes-Miller, Samantha Winemaker, Hsien Seow","doi":"10.1177/08258597251351432","DOIUrl":"https://doi.org/10.1177/08258597251351432","url":null,"abstract":"<p><p>ObjectiveCAPACITI (Community Access to PAlliative Care via Interprofessional Teams Improvement) is a virtual training program that teaches primary care providers how to incorporate an early palliative approach to care in practice. Building this capacity can help primary care providers better meet the needs of their seriously ill patients; however, there has been limited in-depth study as to the added benefits of active facilitation in on-line education. We completed a qualitative inquiry with CAPACITI participants to explore perceived differences in self-directed and facilitated e-learning to understand how these modalities contribute to change in practice.MethodsWe completed a qualitative analysis of semi-structured focus groups with primary care teams that participated in CAPACITI. This study was part of a cluster randomized controlled trial where teams were randomized to self-directed or facilitated modalities for each of the three CAPACITI modules. We followed a qualitative descriptive design, using a constant comparative approach to determine emergent themes to understand participant experience and preference in learning modality.ResultsWe conducted 63 focus groups throughout the trial, representing 42 unique teams, about a quarter of which had experienced both learning modalities at the time of the focus group. Qualitative analysis revealed three main themes: changes in thinking (ie identifying patients early in the illness trajectory), change in behavior (ie increased collaboration), and preference in learning modality and perceived benefits. Interestingly, we found no overwhelming preference in learning modality.ConclusionsSelf-directed and facilitated learning modalities were both perceived as effective in promoting changes in thinking and behavior among primary care providers across diverse care settings. Future studies should further explore the use of tailored facilitation such as simulated patient encounters and innovative coaching strategies to optimally promote behavior change in virtual palliative care education.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251351432"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530980","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":"Setting Regional Priorities for Palliative and End-of-Life Care Research Using a Delphi Technique Approach.","authors":"Nikolaos Efstathiou, Ping Guo, Wendy Walker, John I MacArtney, Cara Bailey","doi":"10.1177/08258597241264455","DOIUrl":"10.1177/08258597241264455","url":null,"abstract":"<p><p>ObjectiveIdentifying research priorities is very important for palliative and end-of-life care to ensure research is focused on evidence gaps. This project aimed to identify and prioritise palliative and end-of-life care research areas within the West Midlands region in United Kingdom (UK).MethodsA modified Delphi technique approach was used with palliative care stakeholders. The first round was item generation via rapid interviews. Data were analysed using content analysis and all the items were grouped into main categories. For round two, an online survey was conducted to present all the items from round one, and stakeholders were asked to rate the priority of items on a Likert-type scale (1 = not a priority to 7 = essential priority). Items that achieved consensus in round two were presented to the third round, where stakeholders ranked them in descending order.ResultsWe completed and analysed 56 rapid interviews which resulted in 158 research items under 15 categories. The research items were rated by 30 stakeholders and seven items which reached consensus were subsequently ranked in order by 45 stakeholders. The highest ranked item was 'Integrated care systems to prevent crisis', followed by three research items related to 'equity' in palliative care.ConclusionsOur research priorities, although unique for our region, mirror previously research priorities from other regions and countries. This suggests issues of integration and equity in palliative and end-of-life care remain unresolved, despite ongoing initiatives and research to address these issues.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"258-265"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762412","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":"Place of Death in Patients with Motor Neuron Disease and the Association with Comorbidities During the Coronavirus Disease 2019 Pandemic: A Population-Based Analysis.","authors":"Jaime Raymond, Björn Oskarsson, Theodore Larson, Suraya Mohidul, David Kevin Horton, Paul Mehta","doi":"10.1177/08258597251349627","DOIUrl":"https://doi.org/10.1177/08258597251349627","url":null,"abstract":"<p><p>ObjectiveMotor neuron disease (MND) is a progressive neurological disorder with no known cure that damages motor neurons. The purpose of this analysis is to examine the place of death for MND patients in the United States during the coronavirus disease 2019 (COVID-19) pandemic and to investigate the extent of specific comorbidities.MethodsWe obtained death certificate and associated comorbidities data for all U.S. MND deaths from 2018 to 2021 and conducted a population-based cross-sectional analysis of the deaths pre-COVID-19 (2018-2019) and during COVID-19 (2020-2021). We hypothesized that place of death and comorbidities associated with place of death for MND patients in the United States were altered during the COVID-19 pandemic in comparison to the 2 years period before the pandemic.ResultsWe analyzed 30 066 MND deaths (14 562 pre-COVID-19 and 15 504 during COVID-19) aged 20 years and older. During COVID-19, MND deaths at home increased (54.4% vs 45.5% pre-COVID). Hispanic individuals had an increased likelihood of dying at home compared to a nursing home or hospice (OR = 1.57, 95%CI: 1.22-2.02), but a decreased likelihood compared to a hospital (OR = 0.61, 95% CI: 0.51-0.72). Among the top comorbidities listed, there was a 27.8% increase in diabetes mellitus and a 20.2% increase in essential hypertension during COVID-19. During COVID-19, diabetes mellitus was more commonly reported as a comorbidity for deaths occurring in hospitals (OR = 1.40, 95%CI: 1.03-1.89) or at home (OR = 1.26, 95%CI: 1.03-1.55), while essential hypertension was more commonly reported with deaths at home (OR = 1.17, 95%CI: 1.01-1.36).ConclusionOur analysis showed an increase in at-home MND deaths as well as certain comorbidities during the COVID-19 pandemic, suggesting MND patients had a higher likelihood of death from non-COVID-19 comorbidities.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251349627"},"PeriodicalIF":1.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318634","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":"Invisible Pillars With Hidden Burdens: A Scoping Review on the Challenges of Informal Caregivers for Older Adults in Home-Based Palliative Care.","authors":"Swasati Handique, Soeun Jang, Michael Bennett, Scott D Ryan","doi":"10.1177/08258597251348262","DOIUrl":"https://doi.org/10.1177/08258597251348262","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to show evidence from existing literature about the experiences and challenges managed by informal caregivers of older adults in home-based palliative care. <b>Methods:</b> A scoping review was conducted using Arksey and O'Malley's framework. Eight electronic databases, Academic Search Complete, AgeLine, APAPsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Global Health, Medline, PsycINFO, Social Work Abstracts, and Web of Science from the EBSCO platform were searched. After full text review, data were extracted and charted. Major themes were established following thematic content analysis. <b>Results:</b> A total of 3859 records were yielded through the electronic database search. After duplicate removal and screening of titles/abstracts and full-texts, a total of 11 studies were included. From these 11 studies, themes were identified: (1) exhaustion and health deterioration, (2) the strain of multifaceted obligations, (3) insufficient medical support and training for caregivers, (4) lack of respite care, and (5) financial strain in caregiving. There is a need for large-scale evaluations of interventions and informal caregivers should be engaged in this process. <b>Conclusions:</b> There is a need to recognize and support a wide array of informal caregivers socially and financially to help them obtain more services and resources. Policymakers need to make more accessible resources and the existing benefits more customized to the unique needs of the informal caregivers of home-based palliative patients.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251348262"},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287063","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 Care Knowledge, Attitudes, and Self-Competence of Nurses Working in Hospital Settings.","authors":"Mona Ibrahim Hebeshy, Darcy Copeland","doi":"10.1177/08258597251341981","DOIUrl":"https://doi.org/10.1177/08258597251341981","url":null,"abstract":"<p><p>ObjectiveWith the growing need to integrate palliative care into healthcare systems, nurses in hospital settings often provide care for patients with life-limiting conditions, many of whom lack formal education in palliative care. This study aimed to assess knowledge, attitude, and self-competence of nurses working in hospital settings regarding palliative care.MethodsThis study evaluated 129 hospital nurses in Colorado. It used the Palliative Care Quiz for Nursing, the Frommelt Attitude Toward Care of the Dying Scale, and the Palliative Care Nursing Self-Competency Scale to assess their knowledge, attitudes, and perceived self-competence.ResultsThe mean scores were knowledge, 11.69 (SD = 2.8); attitudes, 123.35 (SD = 11.44); and self-competence, 167.5 (<i>SD</i> = 31.5). The lowest scores were in psychosocial and spiritual care. Nurses generally feel competent; however, they often lack confidence in addressing patients' social and spiritual needs. They experienced unease when discussing death and exhibited paternalistic attitudes. Significant differences were found in educational background, nursing experience, personal caregiving experience, and practice setting. Positive correlations exist between attitudes, knowledge, and self-competence, indicating that greater knowledge and competence were associated with better attitudes toward end-of-life care.ConclusionsThis study highlights the need for educational interventions focusing on communication skills, pain management, psychological and spiritual care, and patient-centered care to improve nurses' competence in delivering high-quality palliative care in hospital settings.</p>","PeriodicalId":51096,"journal":{"name":"Journal of Palliative Care","volume":" ","pages":"8258597251341981"},"PeriodicalIF":1.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259344","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}