BMJ Supportive & Palliative Care最新文献

Dignity therapy in cancer palliative care: meaning and resignification of life-a qualitative study. 癌症姑息治疗中的尊严治疗：生命的意义与重命：一项质性研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-07-01 DOI: 10.1136/spcare-2025-005692

Michelle Uchida Miwa, Carlos Eduardo Paiva, Ana Julia Sucupira Ferreira, Bianca Sakamoto Ribeiro Paiva

{"title":"Dignity therapy in cancer palliative care: meaning and resignification of life-a qualitative study.","authors":"Michelle Uchida Miwa, Carlos Eduardo Paiva, Ana Julia Sucupira Ferreira, Bianca Sakamoto Ribeiro Paiva","doi":"10.1136/spcare-2025-005692","DOIUrl":"https://doi.org/10.1136/spcare-2025-005692","url":null,"abstract":"Objectives: To understand how dignity therapy (DT) helps patients in the search for meaning and resignification of life.Methods: Qualitative, exploratory and descriptive study with DT interviews with 30 patients hospitalised in a palliative care unit. Narratives were analysed, categorised through Bardin's content analysis and complete speeches originated into legacy documents.Results: Categories were adjusted to reflect the essence of each Dignity Therapy Question Protocol question, identifying nine main themes: biography and significant life experiences, moments of vitality and personal fulfilment, personal legacy and meaningful memories, significant roles and personal accomplishments, key achievements and personal pride, important messages and reflections for loved ones, hopes and dreams for loved ones, life lessons and wisdom to share, and advice and guidance for loved ones. Subcategories related mainly to the importance of family and friends, childhood memories, achievements related to graduations, professional career, and material assets, births, parenting, child education and values transmission, gratitude, forgiveness, faith and spirituality, search for meaning in illness, the significance of the present moment, impermanence, social and artistic interactions, farewells, cause-and-effect actions, empathy and character.Conclusion: This study identified intrinsic topics and unique insights, providing an understanding of how DT helps restore or redefine purpose and meaning amid life-threatening illness.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538732","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}

引用次数: 0

Stable longitudinal symptom intensity in cancer patients during end-of-life palliative care at home: prospective cohort study. 癌症患者在家中临终姑息治疗期间稳定的纵向症状强度：前瞻性队列研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-07-01 DOI: 10.1136/spcare-2025-005556

Stefan Bergström, Hampus Hållberg, Anders Berglund, Michael Bergqvist, Georg Holgersson

{"title":"Stable longitudinal symptom intensity in cancer patients during end-of-life palliative care at home: prospective cohort study.","authors":"Stefan Bergström, Hampus Hållberg, Anders Berglund, Michael Bergqvist, Georg Holgersson","doi":"10.1136/spcare-2025-005556","DOIUrl":"https://doi.org/10.1136/spcare-2025-005556","url":null,"abstract":"Objectives: This study aimed to investigate the trajectory of symptom burden and quality of life in palliative cancer patients receiving home-based care in Sweden. The focus was on identifying key symptoms and their changes over time to evaluate the impact of palliative care teams.Methods: A cohort of 240 cancer patients enrolled in palliative home-care teams across three Swedish municipalities participated in this study. Symptoms were assessed using the Edmonton Symptom Assessment System at enrolment and at 1 month, 3 months and 6 months thereafter. Demographic data, symptom ratings and place of death were recorded. Statistical analyses included descriptive statistics, correlation assessments and Wilcoxon tests to identify symptom changes over time.Results: The most reported symptoms with moderate or severe intensity were lack of energy, reduced quality of life and lack of appetite. Symptom levels remained stable over time, with pain and lack of security showing temporary increases at 1 month and 3 months before returning to baseline at 6 months. Significant gender and living arrangement differences were observed: men reported higher energy deficits, while patients living alone experienced more insecurity. Correlation analysis revealed strong interconnections between symptoms, particularly well-being and quality of life.Conclusion: This study underscores the effectiveness of palliative home-care teams in maintaining symptom stability despite the progressive nature of cancer. While overall symptom burden did not worsen, specific areas, such as pain management and providing emotional security, may require targeted interventions. The findings highlight the importance of structured, patient-centred palliative care in improving end-of-life outcomes for cancer patients.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538733","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}

引用次数: 0

Venous thromboembolism and worse overall survival in gynaecological cancers: cohort study. 妇科癌症的静脉血栓栓塞和更差的总生存率：队列研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-30 DOI: 10.1136/spcare-2025-005488

Ingrid de Araujo Trugilho, Marcos José Pereira Renni, Giselle Coutinho Medeiros, Luiz Claudio Santos Thuler, Anke Bergmann

{"title":"Venous thromboembolism and worse overall survival in gynaecological cancers: cohort study.","authors":"Ingrid de Araujo Trugilho, Marcos José Pereira Renni, Giselle Coutinho Medeiros, Luiz Claudio Santos Thuler, Anke Bergmann","doi":"10.1136/spcare-2025-005488","DOIUrl":"https://doi.org/10.1136/spcare-2025-005488","url":null,"abstract":"Purpose: To assess the association of venous thromboembolism (VTE) on the overall survival (OS) of patients with gynaecological cancer (GC) according to tumour topography.Methods: This study comprises a retrospective cohort of women diagnosed with GC (cervical (CC), uterine (UC), ovarian (OC), vaginal (VgC) and vulvar cancers (VvC)) submitted to Doppler limb ultrasonography or chest pulmonary angiography. OS was assessed considering death as an event, and the follow-up time was censored on the date of the last hospital visit. The Kaplan-Meier method and a Cox multiple regression model were applied, considering p<0.05 as statistically significant. This research was approved by the Research Ethics Committee under No. 2480677.Results: A total of 1885 women were included in this study. The most frequent cancer topography was CC (56.9%). Over half of the patients (53%) presented advanced disease staging, and 41% presented at least one thromboembolic event, while 74% evolved to death during the study period. The median OS of patients who developed VTE was 20.6 months, and of patients who did not present VTE was 39 months (p<0.001). When stratified by topography, an association with death was observed among patients who developed VTE for all analysed topographies, with an exceeded hazard ranging from 38% to 95%.Conclusion: Decreased survival times and association with death were observed in patients who developed VTE in CC, UC, OC, VgC and VvC cases.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526366","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}

引用次数: 0

Healthcare for adults with long-term neurological conditions: European Academy of Neurology Members Survey. 长期神经系统疾病的成人保健：欧洲神经病学学会成员调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-30 DOI: 10.1136/spcare-2025-005504

Katarina Rukavina, Alessandra Solari, Marianne de Visser, Ludo Vanopdenbosch, Magdalena Krbot Skoric, Maria Lolich, Lucia Pavlakova, David Oliver, Simone Veronese

{"title":"Healthcare for adults with long-term neurological conditions: European Academy of Neurology Members Survey.","authors":"Katarina Rukavina, Alessandra Solari, Marianne de Visser, Ludo Vanopdenbosch, Magdalena Krbot Skoric, Maria Lolich, Lucia Pavlakova, David Oliver, Simone Veronese","doi":"10.1136/spcare-2025-005504","DOIUrl":"https://doi.org/10.1136/spcare-2025-005504","url":null,"abstract":"Background: The number of people living with long-term neurological conditions (PwLTNC) in Europe is on the rise and they experience a variety of complex symptoms, often requiring hospital admissions. This survey explored challenges healthcare professionals are encountering when providing care for PwLTNC.Methods: A web-based survey was developed by the European Academy of Neurology (EAN) Scientific Panel on Palliative Care and disseminated by the EAN Scientific Department through the official mailing list, website and newsletter in the period 3 January 2024 to 27 February 2024. The United Nations' geoscheme for Europe was applied and differences between the North/West vs South/East/Greater European regions analysed.Results: A total of 153 EAN members (50% women, mean age 48 years) were participated. They expressed their dissatisfaction with the availability of long-term healthcare, including palliative care (60%), psychosocial (67%) and spiritual support (60%) offered to PwLTNC, their families and carers, the resources to provide healthcare for PwLTNC in medical emergencies and knowledge of acute medical staff about PwLTNC (45%). Dissatisfaction with the availability of resources needed to provide healthcare for PwLTNC, the psychosocial support offered to PwLTNC and the extent of advance care planning implementation was more frequently reported in South/East/Greater Europe compared with North/West Europe.Conclusion: This survey of the EAN members revealed dissatisfaction with long-term healthcare, including palliative care, offered to PwLTNC, their families and carers and pointed out healthcare disparities between the two European macroregions, with more critical figures in South/East/Greater Europe.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526365","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}

引用次数: 0

Reimagining cancer care in the USA: advancing supportive oncology through the Cancer Moonshot Program. 重塑美国的癌症护理：通过癌症登月计划推进支持性肿瘤学。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2025-005547

Arunkumar Krishnan, Beth York, Declan Walsh

引用次数: 0

Subcutaneous antibiotics in palliative medicine: Retrospective chart review. 姑息医学中的皮下抗生素：回顾性图表回顾。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2025-005676

John Curtin, Keith Eldridge, Mary-Elodine D'silva, Paul Howard

{"title":"Subcutaneous antibiotics in palliative medicine: Retrospective chart review.","authors":"John Curtin, Keith Eldridge, Mary-Elodine D'silva, Paul Howard","doi":"10.1136/spcare-2025-005676","DOIUrl":"https://doi.org/10.1136/spcare-2025-005676","url":null,"abstract":"Objectives: To investigate the use and safety of subcutaneous (SC) antibiotics for infection and symptom control in the palliative setting.Methods: We conducted a retrospective chart review of the use of SC antibiotics since it was introduced to our palliative care service 7 years ago. All records were examined to ascertain therapeutic aim and tolerability.Results: SC antibiotics were administered to 87 patients (79% had cancer) on 112 occasions (for infection, 105/112, or symptom control, 7/112) in the inpatient hospice or home. 85% wanted to avoid hospitalisation and requested active treatment in situ. Reasons for SC rather than intravenous administration included venous fragility and lack of an available cannulator. Piperacillin/tazobactam was the most common antibiotic given. Of the occasions when treating for infection, the respiratory tract was the most common site; half survived beyond 21 days. Of those used for symptoms, antibiotics appeared helpful in 3/7. Adverse events led to discontinuation in 7/112 (Clostridium difficile, generalised rash or SC site problems in 1, 1 and 5/112, respectively).Conclusions: SC antibiotics appear well tolerated in the palliative setting and could be a useful option in selected patients who want to avoid hospitalisation but receive active treatment in situ. Thus, we believe that further research is warranted.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511503","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}

引用次数: 0

Serotonin syndrome as a cause of delirium. 血清素综合征是谵妄的原因。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2025-005472

Edward Adi Pranoto, Aaron Bak Ong Wong

引用次数: 0

Nutrition impact symptom monitoring and weight loss outcomes: a longitudinal radiotherapy study. 营养对症状监测和减肥效果的影响：一项纵向放射治疗研究。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2024-004939

Amaia Urrizola, Olav Dajani, Nina Aass, Ellen Bjerkeset, Marianne Jensen Hjermstad, Stein Kaasa, Pål Klepstad, Aleksandra Pirnat, Ida Raaness, Hanne Steinsheim, Asta Bye

{"title":"Nutrition impact symptom monitoring and weight loss outcomes: a longitudinal radiotherapy study.","authors":"Amaia Urrizola, Olav Dajani, Nina Aass, Ellen Bjerkeset, Marianne Jensen Hjermstad, Stein Kaasa, Pål Klepstad, Aleksandra Pirnat, Ida Raaness, Hanne Steinsheim, Asta Bye","doi":"10.1136/spcare-2024-004939","DOIUrl":"10.1136/spcare-2024-004939","url":null,"abstract":"Objectives: Nutrition impact symptoms (NIS) are associated with weight loss (WL), and decreased energy intake in cross-sectional studies. We aimed to ascertain associations between changes in NIS burden, energy intake and WL over time in patients with advanced cancer.Methods: Adult patients from an observational radiotherapy study for painful bone metastases self-reported NIS and WL using the Patient-Generated Subjective Global Assessment tool (PG-SGA) at baseline and week eight (W8). NIS burden, the sum of NIS per patient, categorised as 0, 1-2 and ≥3 with changes defined as 2-point differences from baseline to W8 were used. Energy intake was assessed by 24-hour recall interviews.Results: 111 patients (72.1%) were analysed and grouped by NIS burden; 0 NIS (44.1%), 1-2 NIS (30.6%) and ≥3 NIS (25.2%). Patients with NIS burden of ≥3 reported higher baseline WL compared with those with 1-2 or 0 NIS (46.4% vs 18.2% vs 10.2%, respectively, p=0.002). At W8, 21 patients (19%) reported improved NIS burden, accompanied by a lower proportion of severe (≥5%) new-onset WL (19% vs 42.1%) and higher energy intake (median 29.6 vs 21.2 kcal/kg) than those with worsened NIS burden (17.1%).Conclusions: NIS management may improve energy intake and prevent WL, emphasising the importance of systematic follow-up and interventions.Clinicaltrialsgov registration: NCT02107664.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"522-525"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305372","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}

引用次数: 0

HCN channels: novel therapeutic targets for peripheral neuropathic pain. HCN通道：治疗周围神经性疼痛的新靶点。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2025-005509

Paul Howard

引用次数: 0

Assisted dying in practice: Australian lessons for the Terminally Ill Adults (End of Life) Bill. 协助死亡的实践：澳大利亚临终成人（生命终结）法案的教训。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2025-06-27 DOI: 10.1136/spcare-2025-005606

Alex Hughes

引用次数: 0