BMJ Supportive & Palliative Care最新文献_第10页

Place of care and death preferences among recently bereaved family members: a cross-sectional survey. 新近丧亲家庭成员的护理地点和死亡偏好：一项横断面调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004697

Anna O'Sullivan, Cecilia Larsdotter, Richard Sawatzky, Anette Alvariza, Henrik Imberg, Joachim Cohen, Joakim Öhlén

{"title":"Place of care and death preferences among recently bereaved family members: a cross-sectional survey.","authors":"Anna O'Sullivan, Cecilia Larsdotter, Richard Sawatzky, Anette Alvariza, Henrik Imberg, Joachim Cohen, Joakim Öhlén","doi":"10.1136/spcare-2023-004697","DOIUrl":"10.1136/spcare-2023-004697","url":null,"abstract":"Objectives: The aim was: (1) to investigate preferred place for end-of-life care and death for bereaved family members who had recently lost a person with advanced illness and (2) to investigate associations between bereaved family members' preferences and individual characteristics, health-related quality of life, as well as associations with their perception of the quality of care that the ill person had received, the ill person's preferred place of death and involvement in decision-making about care.Methods: A cross-sectional survey with bereaved family members, employing descriptive statistics and multinominal logistic regression analyses.Results: Of the 485 participants, 70.7% were women, 36.1% were ≥70 years old, 34.5% were partners and 51.8% were children of the deceased. Of the bereaved family members, 52% preferred home for place of end-of-life care and 43% for place of death. A higher likelihood of preferring inpatient palliative care was associated with being female and having higher education, whereas a lower likelihood of preferring a nursing home for the place of care and death was associated with higher secondary or higher education. Partners were more likely to prefer hospital for place of care and nursing home for place of death.Conclusions: Home was the most preferred place for end-of-life care and death. Bereaved people's experiences of end-of-life care may impact their preferences, especially if they had a close relationship, such as a partner who had a higher preference for nursing home and hospital care. Conversations about preferences for the place of care and death considering previous experience are encouraged.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2904-e2913"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247375","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}

引用次数: 0

End-of-life care in multiple system atrophy: UK survey of patients and families. 多系统萎缩的临终关怀：英国患者和家属调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2024-005045

David Oliver, Andy Barrick, Christopher Kobylecki, Jalesh Panicker, Niall Quinn, Emma Rushton, Anette Schrag, Karen Walker, Kailash Bhatia

{"title":"End-of-life care in multiple system atrophy: UK survey of patients and families.","authors":"David Oliver, Andy Barrick, Christopher Kobylecki, Jalesh Panicker, Niall Quinn, Emma Rushton, Anette Schrag, Karen Walker, Kailash Bhatia","doi":"10.1136/spcare-2024-005045","DOIUrl":"10.1136/spcare-2024-005045","url":null,"abstract":"Objectives: People with multiple system atrophy (MSA) and their carers may have many concerns about their disease and the future. This survey of people with MSA and their carers aimed to increase understanding of end-of-life care and palliative care for this group.Methods: A survey was undertaken by the MSA Trust of people living with MSA and carers of those with the condition between August and October 2022.Results: 520 people responded: 215 people with MSA, 214 carers and 91 former carers. The modal class for age in people with MSA was 65-74 years, with 52% male. 76% of people living with MSA had thought to some extent about what they wanted to happen towards the end of their lives. 38% of respondents had discussed end-of-life care options with a healthcare professional and of those who had, over 81% found the conversation helpful. Nevertheless, for 37% of former carers, the death had been unexpected. Only a minority of people living with MSA had been referred for specialist palliative care. 65% of the former carers reported that they were satisfied with the quality of end-of-life care.Conclusion: People with MSA and their carers continue to face many complex physical and emotional issues that would benefit from palliative care. Discussions about care at the end of life were generally perceived as helpful, but although the deterioration was often discussed, many families seemed unprepared for the death. Palliative care services were involved but this appeared limited.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e3019-e3023"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975129","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}

引用次数: 0

Temporal trends in mortality location in patients with anal cancer in the USA: an analysis of the National Center for Health Statistics mortality data. 美国癌症肛门患者死亡率分布的时间趋势：美国国家卫生统计中心死亡率数据分析。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004571

Amir H Sohail, Caroline E Williams, Emily Schiller, Ivan B Ye, Ronald Orozco, Hazim Hakmi, Faisal Shahjehan, Hassam Ali, Manesh K Gangwani, Muhammad Aziz, Umar Hayat, Soban Maan, Aisha Akhtar, Matthew Symer

{"title":"Temporal trends in mortality location in patients with anal cancer in the USA: an analysis of the National Center for Health Statistics mortality data.","authors":"Amir H Sohail, Caroline E Williams, Emily Schiller, Ivan B Ye, Ronald Orozco, Hazim Hakmi, Faisal Shahjehan, Hassam Ali, Manesh K Gangwani, Muhammad Aziz, Umar Hayat, Soban Maan, Aisha Akhtar, Matthew Symer","doi":"10.1136/spcare-2023-004571","DOIUrl":"10.1136/spcare-2023-004571","url":null,"abstract":"Objectives: Investigate trends in where patients died of anal cancer in the USA.Methods: Retrospective cohort study using the US National Center for Health Statistics Wide-Ranging ONline Data for Epidemiologic Research platform from 2003 to 2020; all patients with death certificates listing anal cancer as the underlying cause of death in the USA. Main outcome measure of location of patient death: inpatient facility, home, hospice, nursing home/long-term care facility and other.Results: There were a total of 16 296 deaths with anal cancer as the underlying diagnosis during the study period. The crude rate increased from 0.191 per 100 000 deaths in 2003 to 0.453 per 100 000 deaths in 2020. Over the study period, 22.4% of patient deaths occurred in inpatient facilities, 44.9% at home, 12.2% at hospice facilities and 13.1% at nursing homes/long-term care facilities. The percentage of deaths occurring in hospice facilities increased from 1.0% to 13.3% during the study period. Deaths at home also increased from 42.7% in 2003 to 55.8% in 2020. Meanwhile, inpatient deaths decreased from 33.5% in 2003 to 14.4% in 2020.Conclusions: There has been a significant increase in the proportion of patients with anal cancer dying at home or hospice from 2003 to 2020.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2746-e2750"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109110","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

Development of a measure of clinicians' self-efficacy for medical communication (SEMC). 开发临床医生医疗沟通自我效能（SEMC）测量工具。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/bmjspcare-2022-003593

David B Feldman, Mark A O'Rourke, Benjamin W Corn, Matthew F Hudson, Naimik Patel, Rajiv Agarwal, Valerie L Fraser, Heidi Deininger, Lauren A Fowler, Marie A Bakitas, Robert A Krouse, Ishwaria M Subbiah

{"title":"Development of a measure of clinicians' self-efficacy for medical communication (SEMC).","authors":"David B Feldman, Mark A O'Rourke, Benjamin W Corn, Matthew F Hudson, Naimik Patel, Rajiv Agarwal, Valerie L Fraser, Heidi Deininger, Lauren A Fowler, Marie A Bakitas, Robert A Krouse, Ishwaria M Subbiah","doi":"10.1136/bmjspcare-2022-003593","DOIUrl":"10.1136/bmjspcare-2022-003593","url":null,"abstract":"Objectives: Studies of clinician-patient communication have used varied, ad hoc measures for communication efficacy. We developed and validated the Self-Efficacy for Medical Communication (SEMC) scale as a standard, quantitative measure of clinician-reported skills in communicating difficult news.Methods: Using evidence-based scale development guidelines, we created two 16-item forms of the SEMC, one assessing communication with patients and one assessing communication with families. Clinicians providing oncological care in four organisations were invited to participate and provided consent. Participant demographics, responses to the SEMC items and responses to convergent and discriminant measures (those expected to relate strongly and weakly to the SEMC) were collected online. We performed analyses to determine the convergent and discriminant validity of the SEMC as well as its reliability and factor structure.Results: Overall, 221 oncology clinicians (including physicians, residents, fellows, medical students, nurses, nurse practitioners and physician assistants) participated. The patient and family forms both demonstrated high internal consistency reliability (alpha=0.94 and 0.96, respectively) and were strongly correlated with one another (r=0.95, p<0.001). Exploratory factor analysis demonstrated that the SEMC measures a unitary construct (eigenvalue=9.0), and its higher mean correlation with convergent (r=0.46) than discriminant (r=0.22) measures further supported its validity.Conclusions: Our findings support the SEMC's validity and reliability as a measure of clinician-rated communication skills regarding conducting difficult conversations with patients and families. It provides a useful standard tool for future research in oncology provider-patient serious illness communication.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2671-e2678"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9733580","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

Hospice inpatient care models: cross-sectional inequality survey. 安宁疗护住院护理模式：横断面不平等调查。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2024-005019

Suzanne Tween, Roger William Smith, Charlotte Chamberlain, Jane Gibbins

{"title":"Hospice inpatient care models: cross-sectional inequality survey.","authors":"Suzanne Tween, Roger William Smith, Charlotte Chamberlain, Jane Gibbins","doi":"10.1136/spcare-2024-005019","DOIUrl":"10.1136/spcare-2024-005019","url":null,"abstract":"Objectives: Hospices provide a range of services including inpatient units (IPUs) and care in people's homes. 40 000-50 000 patients use IPUs in the UK per year. Little published data exist on IPU models. This paper explores the structure and funding of IPU across the Southwest (SW) of England (population 5.6 million), alongside impact of COVID-19.Methods: An electronic survey of all 13 IPUs. Data collated, tabulated and compared with national commissioning guidance.Results: A 92% survey response rate revealed large variation in bed availability per 250 000 of SW population: 2.5-18.2. Referrals and admissions per IPU bed per year ranged from 16 to 38.2 (or 39-127 per 100 000 population) and 21.7 (mean), respectively. There was significant workforce variability: 1.3-12.7 nurses per 7.5 hospice beds, 1.2-7.2 consultants per 20 hospice beds, varying multidisciplinary team members with many unfilled posts. National Health Service (NHS) funding ranged from 10% to 75% of total costs. During COVID-19, 4 of 12 hospices reduced bed capacity, while half described increased integration with other teams outside of the hospice.Conclusion: There is significant regional variability suggesting inequality in hospice bed availability per 250 000 population. There is also considerable variability in workforce, alongside the proportion of NHS funding. Such variability implies little is known about the optimal IPU model. This provides new meaningful information about the structure and funding of hospices, with further research needed to consider these differences on the impact on patient and family experiences and outcomes. The sustainability and opportunities of integration and collaboration across care settings are also paramount.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2519-e2522"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490910","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

The European Certificate in Essential Palliative Care in Lebanon: Adaptation and Pilot. 黎巴嫩基本姑息治疗欧洲证书：适应和试点。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2024-005071

Silva Dakessian Sailian, Farah Demachkieh, Janane Hanna, Najibe Khalil, Marie Claire Mouhawej, Celine Bakri, Max Watson

引用次数: 0

Palliative Care Curriculum and Training Plan for community health workers. 为社区卫生工作者提供姑息关怀课程和培训计划。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004527

Olivia Monton, Aida Abou-Zamzam, Shannon Fuller, Tracy Barnes-Malone, Amn Siddiqi, Alison Woods, Jae Patton, Chidinma A Ibe, Fabian M Johnston

{"title":"Palliative Care Curriculum and Training Plan for community health workers.","authors":"Olivia Monton, Aida Abou-Zamzam, Shannon Fuller, Tracy Barnes-Malone, Amn Siddiqi, Alison Woods, Jae Patton, Chidinma A Ibe, Fabian M Johnston","doi":"10.1136/spcare-2023-004527","DOIUrl":"10.1136/spcare-2023-004527","url":null,"abstract":"African American patients are less likely than White patients to access palliative care. Community health workers (CHWs) are non-clinical public health workers who may address this gap. We developed a Palliative Care Curriculum and Training Plan for CHWs as part of an ongoing randomised controlled trial evaluating the effectiveness of a CHW palliative care intervention for African American patients with advanced cancer. This study aimed to determine whether the Palliative Care Curriculum and Training Plan leads to gains in knowledge, perceived competence on CHW study-based tasks, and satisfaction among CHWs. The curriculum was delivered over 3 months using synchronous, asynchronous and experiential training components. CHWs were assessed through survey questionnaires and semistructured interviews. We trained a total of three CHWs, one from each of our enrol ment sites: Johns Hopkins Hospital, TidalHealth Peninsula Regional and University of Alabama at Birmingham Hospital. CHWs demonstrated an increase in knowledge, with a mean pre-training test score of 85% (SD 10.49) and post-training test score of 96% (SD 4.17). The training led to increases in perceived competence among CHWs. Areas for future training were identified. This curriculum serves as a template for CHW training focused on palliative care, oncology and health disparities.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2972-e2976"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10918023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238335","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}

引用次数: 0

Personal legacy and treatment choices for serious illness: a scoping review. 个人遗产与重病治疗选择：范围界定综述。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004439

Marlaine Figueroa Gray, Sarah Randall, Mateo Banegas, Gery W Ryan, Nora B Henrikson

{"title":"Personal legacy and treatment choices for serious illness: a scoping review.","authors":"Marlaine Figueroa Gray, Sarah Randall, Mateo Banegas, Gery W Ryan, Nora B Henrikson","doi":"10.1136/spcare-2023-004439","DOIUrl":"10.1136/spcare-2023-004439","url":null,"abstract":"Background: Legacy-how one hopes to be remembered after death-is an unexplored and important dimension of decision-making for people facing serious illness.Objectives: We conducted a scoping review to answer the following research questions: (1) How do people making treatment choices conceive of legacy? and (2) What treatment choices do people make with legacy in mind?Eligibility criteria: Participants included people facing serious illness who discussed how they wanted to be remembered after their own death, or how they hoped to impact others, as they made treatment choices. Studies in English published between 1990 and 2022 were included.Sources of evidence: We conducted searches in electronic databases including Medline/PubMed, CINAHL, PsycInfo, SocialWork, AnthropologyPlus, Web of Science, ProQuest and EMBASE databases.Data synthesis: We used an electronic screening tool to screen abstracts and review full-text articles suitable for inclusion. We analysed included articles using Atlas.ti. We constructed tables and narratively synthesised the findings.Results: We identified three major intersecting legacy goals that influence choices people facing serious illness make about their treatment and health behaviours, and the types of choices people make with legacy in mind. The three legacy goals are: remembrance of the individual self, remembrance of the social self and impact on others' well-being.Conclusions: We identify the importance of legacy to patient treatment choices. Understanding for whom this construct is important, what types of legacy goals people hold and how those goals impact treatment choices is necessary to provide patient-centred whole-person care to people facing serious illness.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2302-e2315"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545576","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}

引用次数: 0

Palliative physiotherapy in community settings for people with terminal illness. 临终病人社区环境中的姑息性物理治疗。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004179

Anat Woldman, Hadass Goldblatt, Michal Elboim-Gabyzon

{"title":"Palliative physiotherapy in community settings for people with terminal illness.","authors":"Anat Woldman, Hadass Goldblatt, Michal Elboim-Gabyzon","doi":"10.1136/spcare-2023-004179","DOIUrl":"10.1136/spcare-2023-004179","url":null,"abstract":"Objectives: The need for palliative care is constantly growing worldwide. Palliative care is typically provided by a multidisciplinary team in community-based facilities. As part of this team, physiotherapists can effectively address prevalent symptoms, such as pain, breathing difficulties and reduced functional capacity. A few studies reported low physiotherapy services' utilisation by people who require palliative care. Israel was rated among countries having the highest level of palliative care integration in the array of basic medical services in a global survey. This study's purpose was to explore, for the first time, the scope of palliative physiotherapy treatments that home dwelling people receive in Israel.Methods: A retrospective chart review of people who had been referred to home hospice care during the year 2019.Results: A total of 1587 people were included in this study, of which only 34.7% received community-based physiotherapy treatments during the last 6 months of their lives. People treated by palliative physiotherapy usually received a short intervention of 1-3 treatments, with an average of 5.37 treatments. No differences were found regarding age, gender and geographical location in relation to metropolitan area between people who had received such treatments and people who had not. A high socioeconomic place of residence rating and the presence of chronic life-limiting illness or progressive neurological disorder significantly predicted the possibility of receiving physiotherapy treatments.Conclusions: Future studies should explore the inhibiting and promoting factors for receiving palliative physiotherapy treatments, focusing on persons' comorbidities and their sociodemographic characteristics.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2719-e2725"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9448352","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

Parent experience of advance care planning: reconstructing meaning - grounded theory. 预先照护计划的父母经验:重建意义基础理论。

IF 2 4区医学

BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI: 10.1136/spcare-2023-004348

Helen Elizabeth Bennett, Sue Duke, Alison Richardson

{"title":"Parent experience of advance care planning: reconstructing meaning - grounded theory.","authors":"Helen Elizabeth Bennett, Sue Duke, Alison Richardson","doi":"10.1136/spcare-2023-004348","DOIUrl":"10.1136/spcare-2023-004348","url":null,"abstract":"Objectives: Parents have unique experience of caring for their child with a life-limiting illness and significant insight into the experience of advance care planning. However, little is known about how they experience and manage this process. Our objective was to understand parents' experience of advance care planning for their child.Methods: Data collected through semistructured interviews and documents using a constructivist and situational grounded theory approach. Parents with experience of end-of-life decisions or advance care planning for a child (age 0-17 years) with a life-limiting condition or life-threatening condition.Results: 13 parents participated; 11 interviews were undertaken with analysis of 9 advance care plans. Parents were interviewed separately (n=9) or together (n=2).Overarching and inter-related categories, realisation, reconciling multiple tensions and building confidence and asserting control explained the actions and processes of parents' experience of advance care planning. The arising theory, reconstructing meaning through advance care planning, describes how the process of advance care planning, enables parents to make 'good' decisions in complex medical situations and despite the emotional distress, has therapeutic value.Conclusion: This study confirms parents want to engage in advance care planning, use the process to continuously reorientate their values alongside treatment decisions and that offers a therapeutic value not previously recognised. This requires healthcare professionals to reframe their approach to advance care planning conversations valuing parents' voices and desire for a sense of control and empowering them to make future decisions that offer hope and build resilience to face the future death of their child.","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"e2726-e2736"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226768","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}

引用次数: 0