Palliative medicine reports最新文献

{"title":"Nursing Support for Constipation in Palliative Care Units in Japan: A Multisite Cross-Sectional Study.","authors":"Kimiko Nakano, Yusuke Kanno, Kohei Kajiwara, Masamitsu Kobayashi, Miharu Morikawa, Yoshinobu Matsuda, Jun Kako","doi":"10.1089/pmr.2024.0087","DOIUrl":"10.1089/pmr.2024.0087","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the frequency with which nursing support for constipation is provided for patients with cancer during the prognostic months and weeks.</p><p><strong>Methods: </strong>An online cross-sectional survey was conducted anonymously among registered nurses in palliative care units across Japan. The frequencies of providing six types of nursing support (abdominal massage with essential oils, abdominal acupressure, auricular acupressure, self-management education, abdominal massage, and warm compresses) were surveyed.</p><p><strong>Results: </strong>Data were obtained from 539 nurses (response rate: 22.3%) from 162 facilities. The most frequently provided support was warm compression; the least frequently provided supports were auricular acupressure, abdominal massage with essential oils, and abdominal acupressure. In the prognostic weeks only, self-management education followed these support types.</p><p><strong>Conclusion: </strong>The investigation found that the six types of support were rarely implemented for relieving constipation in patients with cancer. Future research should investigate the factors hindering the provision of these supports.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"6 1","pages":"1-5"},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-Module Learning for Scaling Serious Illness Communication Skills Teaching: A Pilot Study in Family Medicine and Palliative Care.","authors":"Helen James, Paul Krueger, Daphna Grossman, Warren Lewin","doi":"10.1089/pmr.2024.0048","DOIUrl":"10.1089/pmr.2024.0048","url":null,"abstract":"<p><strong>Background: </strong>Serious illness communication (SIC) competency is essential for health care professionals. However, many clinicians receive little-to-no SIC training, and there is little evidence as to which teaching method is most feasible to incorporate into postgraduate curricula. Two e-modules were created to adapt high-yield knowledge to deliver asynchronous, time-efficient, standardized communication skills teaching. This project evaluated SIC e-module teaching feasibility, learner and faculty perceptions toward e-module learning on this topic, as well as learner confidence and skill usage post-completion.</p><p><strong>Methods: </strong>Family Medicine residents and palliative care fellows from two training sites were invited to asynchronously complete the e-modules on their own time and complete a survey to assess attitudes, perceptions, and needs toward them and impact on SIC skills immediately and 1-month post-completion. Faculty from the main site were also invited to view the e-modules and complete a survey immediately afterward assessing attitudes, perceptions, and feasibility on SIC e-module learning.</p><p><strong>Results: </strong>In total, 19/50 (38%) learners completed the e-modules and post-training survey and 14/19 (73%) of those learners completed the 1-month follow-up survey. In total, 13/60 (22%) faculty completed the survey. Participants liked the structure and design of the e-modules and felt they were appropriate for their learners' level of training, were effective, time-efficient, and provided relevant SIC information. Case-based video demonstrations were identified as the most useful teaching method. Most learners intended to use new skills in clinical practice, rewatched both e-modules within 1 month of initial viewing, and reported using learned skills in practice.</p><p><strong>Conclusion: </strong>E-module training provides a standardized method to scale postgraduate SIC skills teaching asynchronously and was well liked by learners and faculty. Barriers exist to completing them outside of a core curriculum. Early data suggest e-modules can be used iteratively and further research is needed to determine how their use impacts communication confidence and competency.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"571-577"},"PeriodicalIF":1.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated Factors for Quality of Life, Anxiety, and Depression in Patients with Chronic Heart Failure and Their Family Caregivers: A Cross-Sectional Study in Japan.","authors":"Mayumi Niitani, Hiroyuki Sawatari, Yuri Takei, Naoko Yamashita","doi":"10.1089/pmr.2024.0056","DOIUrl":"10.1089/pmr.2024.0056","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers (FCs) need to provide regular assistance and good quality care to patients to prevent the deterioration of chronic heart failure (CHF); therefore, they may have physical and mental distress. However, physical and mental distress in FCs of patients with CHF in Japan is unclear.</p><p><strong>Objective: </strong>This study aimed to clarify the quality of life (QoL), anxiety/depression, and associated factors in patients with CHF and their FCs.</p><p><strong>Design: </strong>We conducted a multicenter cross-sectional survey using a questionnaire between 2016 and 2017 among patients with CHF and their FCs. Demographic data were extracted from medical records. Health-related QoL and anxiety/depression were assessed using the Short Form-12 and the Hospital Anxiety and Depression Scales, respectively.</p><p><strong>Results: </strong>Of 286 patients and FCs (response rate 57.2%), the physical component summary and mental component summary (MCS) scores of FC were higher than those of patients (<i>p</i> < 0.001 and <i>p</i> = 0.047, respectively). The incidence of anxiety and depression in patients with CHF was 7.0% and 10.8%, respectively, whereas that in FC was 10.1% and 12.6%. In multivariable analysis, the MCS score of FC was associated with the MCS score of patients (β = 0.22, <i>p</i> < 0.001). Anxiety in FC was associated with anxiety (β = 0.30, <i>p</i> < 0.001) in patients, respectively.</p><p><strong>Conclusions: </strong>It is necessary to carefully monitor the physical and mental condition of patients with CHF and provide palliative care in collaboration with the palliative care team as needed. Stabilizing the patient's physical and mental condition through palliative care may also help alleviate the suffering of FC.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"585-594"},"PeriodicalIF":1.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland.","authors":"Reino Pöyhiä, Sari Hämäläinen, Karen Neoh, Annamarja Lamminmäki","doi":"10.1089/pmr.2024.0050","DOIUrl":"10.1089/pmr.2024.0050","url":null,"abstract":"<p><strong>Objectives: </strong>Restrictive blood transfusion policy has been shown to be effective in managing anemia. However, treatment of anemia in palliative (PC) and end-of-life (EOL) care remains understudied. The aim of this study was to examine Finnish PC physicians' attitudes and practices in the management of anemia.</p><p><strong>Methods: </strong>A structured questionnaire asking clinicians about how they treat anemia in PC was developed with a focus on blood transfusion. In addition, a previously published collection of clinical case scenarios was included. Physician's recall of their use of red blood cell (RBC) transfusions in 2021 was also asked. The questionnaire was first delivered at an annual meeting of the Finnish Association for Palliative Medicine in 2022 and subsequently, a Webpropol form was emailed to the members of the society.</p><p><strong>Results: </strong>A total of 94 (28%) doctors at an average age of 46.5 years responded. Of these 80% were specialists and 75% had a special competence in palliative medicine. RBC transfusions were given in less than 25% of patients, average hemoglobin was b ≤ 78 g/L. Transfusions were given for clinical symptoms such as fatigue, angina, and weakness without systematic measurement of symptom severity. Hematinic levels were investigated, but iron was given seldom. Clinical scenarios were answered similarly as previously in the UK. National guidelines for anemia in early PC or EOL care are lacking but would be deemed to be helpful by one-third of those who completed the questionnaire.</p><p><strong>Conclusion: </strong>Physicians apply the restrictive policy in blood transfusions for PC patients in Finland. Other treatments for anemia are not often used. Both prospective studies and national guidelines are needed.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"578-584"},"PeriodicalIF":1.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of Competence and Need for Continuing Education in Nonspecialist Palliative Care Settings-A Qualitative Study of Views from Finnish Health Care Professionals.","authors":"Hanna Hävölä, Anu Helmikkala, Anu Viitala, Elina Kiviniemi, Pauli Lamppu, Heidi Keronen, Minna Hökkä","doi":"10.1089/pmr.2024.0060","DOIUrl":"10.1089/pmr.2024.0060","url":null,"abstract":"<p><strong>Background: </strong>The need for palliative care (PC) is increasing due to the growing number of chronic diseases and an aging population. As such, the requirement to ensure the provision of PC is evident. This calls for PC competence for nurses working in nonspecialist PC settings.</p><p><strong>Objective: </strong>The aim was to describe the views of Finnish health care professionals relating to PC competencies and the development needs for continuing education in nonspecialist PC settings.</p><p><strong>Design: </strong>A qualitative study design.</p><p><strong>Setting/subjects: </strong>The data were compiled via an e-survey from health care professionals working in nonspecialist PC settings in Finland; 281 participants answered the open question: \"Tell us what you think about the competencies in palliative care.\"</p><p><strong>Measurements: </strong>The data were analyzed using inductive content analysis.</p><p><strong>Results: </strong>The description of PC competence was categorized into four main categories, including 64 subcategories. The main category containing the largest number of reduced expressions (<i>f</i> = 303) was \"Perceived level of PC competence and development needs.\" The competence in PC was also identified as \"Perceived need for continuing education in different palliative care competencies\" (<i>f</i> = 243), \"Building the foundations of one's own competence\" (<i>f</i> = 133), and \"Factors related to the work organization and connected to the competence enhancement\" (<i>f</i> = 84).</p><p><strong>Conclusion: </strong>The health care professionals in nonspecialist PC settings recognize the importance of ensuring competence and the need for continuous and regular education. The results of this study can be utilized in the planning of continuing education and in targeting it correctly.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"553-562"},"PeriodicalIF":1.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Terminally Ill Cancer Patients' Self-Assessments and Nurses' Assessments Agree on Cancer-Related Fatigue? A Cross-Sectional Study.","authors":"Mizuki Matsuda, Hideyuki Honma, Yu Koyama, Yuuka Kashiwagi, Mika Hattori, Yoshifumi Matsumoto, Yasuo Saijyo, Sayuri Sakai","doi":"10.1089/pmr.2024.0064","DOIUrl":"10.1089/pmr.2024.0064","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue (CRF) is a distressing symptom in patients with terminal cancer. It is often under-assessed or remains unrecognized among health care professionals due to difficulties in identifying symptoms. However, fatigue ratings have not been studied extensively in incurable, terminally ill cancer patients with palliative intent or in nurses who provide daily care in palliative care teams or units.</p><p><strong>Objective: </strong>This study examined the agreement between nurses' assessments and terminally ill cancer patients' self-assessments of CRF.</p><p><strong>Methods: </strong>The correlation between patients' scores on the Cancer Fatigue Scale (CFS) and nurses' scores on the Japanese version of the Support Team Assessment Schedule (STAS-J) was matched in patient-nurse pairs. Paper versions of the questionnaires were answered by the patients and nurses at the time of the temperature check.</p><p><strong>Results: </strong>Twenty-eight participants in 14 pairs with valid responses were included. There were 10 cases (71.4%) of agreement between the patients' and nurses' assessments of fatigue via the CFS and STAS-J, respectively. Among the four cases (28.6%) of incongruence, two (14.3%) were underestimated, and two were overestimated. Significant correlations were observed between the STAS-J and physical fatigue (rs = 0.66, <i>p</i> < 0.01), but total fatigue (rs = 0.47, <i>p</i> = 0.09), affective fatigue (rs= -0.09, <i>p</i> = 0.75), and cognitive fatigue (rs = 0.52, <i>p</i> = 0.06) showed no significant correlation.</p><p><strong>Conclusion: </strong>Differences were primarily observed in affective fatigue; therefore, nurses must carefully consider affective fatigue when assessing fatigue in patients with terminal cancer.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"563-570"},"PeriodicalIF":1.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of, Barriers to Performing, and Educational Practices of Interventional Procedures for Refractory Pain in Cancer Patients: A Nationwide Survey of Designated Cancer Hospitals in Japan.","authors":"Yoshihisa Matsumoto, Yuko Uehara, Akio Mizushima, Toshifumi Kosugi, Miyuki Sone, Naoki Nakamura, Mitsunori Miyashita, Tatsuya Morita, Takuhiro Yamaguchi, Eriko Satomi","doi":"10.1089/pmr.2024.0028","DOIUrl":"https://doi.org/10.1089/pmr.2024.0028","url":null,"abstract":"<p><strong>Background: </strong>Because of the limitations of pharmacological therapy, nonpharmacological therapies including intervention procedures are also important for quality of cancer pain management.</p><p><strong>Objective: </strong>To clarify the availability of, number performed, barriers to performing, and educational practices of four interventional procedures (celiac plexus neurolysis/splanchnic nerve neurolysis, phenol saddle block, epidural analgesia, and intrathecal analgesia) in designated cancer hospitals.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Designated cancer hospitals certified by the Japanese Government.</p><p><strong>Methods: </strong>We administered self-administered questionnaires to collect general information about the facility and interventional procedures for refractory cancer pain between January and April 2021.</p><p><strong>Results: </strong>Questionnaires were sent to 402 facilities, and we received 199 valid responses (49.5%). Regarding availability, 36.7%-59.8% of the designated cancer hospitals reported that each procedure was available. Regarding the frequency of these procedures performed in the past 3 years, medians ranged from 1 to 4 times for each procedure. Among designated cancer hospitals, 44.7-65.8% reported the presence of barriers. Barriers such as \"no/few physicians technically able to perform the procedure,\" \"inability to follow-up after the procedure is implemented,\" and \"the facilities to which patients may be referred after implementation are limited\" were particularly pronounced. Training and treatment practice were provided by 30.7-55.8% of designated cancer hospitals for the procedures. Moreover, 12.6%-15.6% of designated cancer hospitals educated physicians and nurses responsible for cancer care in the region about pain treatment for the procedures.</p><p><strong>Conclusions: </strong>Our findings suggest that designated cancer hospitals need to improve the availability, training, and education of interventional procedures.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"543-552"},"PeriodicalIF":1.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Contemplative Medicine to Harness Compassion in the Palliative Care Setting: Lessons Learned.","authors":"Milagros D Silva, Brigit C Palathra","doi":"10.1089/pmr.2024.0020","DOIUrl":"https://doi.org/10.1089/pmr.2024.0020","url":null,"abstract":"<p><strong>Background: </strong>Burnout is common among palliative care clinicians caring for patients with a serious illness. Contemplative medicine is an emerging approach that aims to utilize Buddhist concepts of mindfulness, insight, and compassion to address unspoken suffering in clinicians.</p><p><strong>Objectives: </strong>To introduce and share contemplative medicine practices with Hospice Palliative Medicine (HPM) fellows participating in two academic programs in New York.</p><p><strong>Methods: </strong>Pilot educational sessions in contemplative medicine were conducted following a Contemplative Medicine Fellowship's relationship-centered and cohort-based curriculum. A short survey assessing HPM fellows' attitudes toward core competencies in contemplative medicine was administered to seven HPM fellows.</p><p><strong>Results: </strong>Participants agreed that being present with those who are suffering are healing acts by themselves and that contemplative medicine can complement HPM fellows' skillsets when providing care to patients with serious illnesses. Common themes like \"being awake\" and \"low self-compassion\" were discussed by participants during the sessions. Techniques like pausing and mindful breathing were found helpful to practice throughout a busy workday.</p><p><strong>Discussion: </strong>Incorporating contemplative medicine practices into an HPM fellowship may provide opportunities to (1) promote learner emotional development and (2) teach learners self-awareness of how difficult emotions can affect communication with patients.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"537-542"},"PeriodicalIF":1.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Does \"Palliative\" Mean? Sentiment, Knowledge, and Public Perception Concerning Palliative Care on the Internet since the COVID-19 Pandemic.","authors":"Joachim Peters, Maria Heckel, Eva Breindl, Christoph Ostgathe","doi":"10.1089/pmr.2024.0057","DOIUrl":"https://doi.org/10.1089/pmr.2024.0057","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the public perception of palliative care during and after the pandemic. Assuming that analyzing online language data has the potential to collect real-time public opinions, an analysis of large online datasets can be beneficial to guide future policymaking.</p><p><strong>Objectives: </strong>To identify long-term effects of the COVID-19 pandemic on the public perception of palliative care and palliative care-related misconceptions on the Internet (worldwide) through natural language processing (NLP).</p><p><strong>Design: </strong>Using large language model NLP analysis, we identified public attitudes, opinions, sentiment, and misconceptions about palliative care on the Internet, comparing a corpus of English-language web texts and X-posts (\"tweets\") (02/2020-02/2022) with similar samples before (02/2018-02/2020) and after the pandemic (03/2022-02/2024).</p><p><strong>Setting: </strong>The study is a statistical analysis of website and social media data, conducted on six large language corpora.</p><p><strong>Results: </strong>Since the COVID-19 pandemic, palliative care situations are more often portrayed as frightening, uncertain, and stressful, misconceptions about the activities and aims of palliative care occur on average 44% more frequently, especially on the social media platform X.</p><p><strong>Conclusions: </strong>The impact of the COVID-19 pandemic on public discussion on social media continues to persist even in 2024. Insights from online NLP analysis helped to determine the image of palliative care in the Internet discourse and can help find ways to react to certain trends such as the spread of negative attitudes and misconceptions.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"512-520"},"PeriodicalIF":1.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Complex Intervention to Support the Use of Sedative Drugs in Specialist Palliative Care (iSedPall).","authors":"Saskia Kauzner, Manuela Schneider, Maria Heckel, Carsten Klein, Claudia Bausewein, Eva Schildmann, Jeremias Bazata, Stefanie Kolmhuber, Sabine H Krauss, Beatrice Odierna, Constanze Rémi, Jan Schildmann, Alexander Kremling, Christian Jäger, Kerstin Ziegler, Christoph Ostgathe","doi":"10.1089/pmr.2024.0042","DOIUrl":"10.1089/pmr.2024.0042","url":null,"abstract":"<p><strong>Background: </strong>The option of intentional sedation to relieve intolerable suffering from treatment-refractory symptoms may elicit a feeling of safety for patients and informal caregivers as a last resort if the situation becomes unbearable. Many health care professionals feel uncomfortable and insecure in conducting intentional sedation due to specific challenges. We developed a complex intervention to support best practice use of sedative drugs in specialist palliative care in Germany based on previously published recommendations. This article aims at reporting the development of the intervention.</p><p><strong>Methods: </strong>The development of the intervention was based on theory and existing evidence with active stakeholder participation and patient and public involvement, following the updated Medical Research Council (MRC) Framework on complex interventions. A \"Theory of Change,\" drawing on expert-approved best practice recommendations and applying user-centered methods, fostered the development. The process encompassed study preparation, development of the elements of the intervention, and designing the multimodal intervention. For reporting, we adhere to the Guidance for Reporting Intervention Development framework.</p><p><strong>Results: </strong>The intervention is aimed at health care professionals working in specialist palliative care (inpatient and homecare settings) and consists of several components: (1) a screening tool, (2) the individual elements of the intervention, and (3) educational material for health care professionals to support them using the intervention. Additional information material was developed for patients and informal caregivers. Despite the benefits of stakeholder involvement, we faced some barriers due to limited health care staff and time resources and reservations regarding research in general.</p><p><strong>Discussion: </strong>A pilot study is planned for testing the overall feasibility of the intervention and exploring possible benefits for health care professionals to inform a subsequent fully powered implementation study. To deal with the challenges, we stayed in contact with the health care teams, maintained transparency, and provided opportunities for active participation.</p>","PeriodicalId":74394,"journal":{"name":"Palliative medicine reports","volume":"5 1","pages":"527-536"},"PeriodicalIF":1.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}