BMJ Supportive & Palliative Care最新文献

{"title":"Beyond the physical realm: exploring the relationship between spiritual well-being and spiritual care competence.","authors":"Dilek Olmaz, Gürkan Özden, Serap Parlar Kılıç","doi":"10.1136/spcare-2024-005075","DOIUrl":"10.1136/spcare-2024-005075","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the relationship between nurses' spiritual well-being and their competence in providing spiritual care, and to identify influencing factors among Turkish nurses.</p><p><strong>Methods: </strong>A descriptive and correlative design was employed, involving 520 nurses from two hospitals in eastern Turkey. Data were collected online using Google Forms, which included a demographic questionnaire, the three-factor Spiritual Well-being Scale and the Spiritual Care Competence Scale. The study was conducted between August 2019 and June 2020.</p><p><strong>Results: </strong>A significant positive correlation was found between nurses' spiritual well-being and their spiritual nursing competence (r=0.320, p=0.019). Factors, such as work duration, marital status, patient load, experience, education and information, influenced these attributes. Ageing has also been found to reduce well-being and competence.</p><p><strong>Conclusions: </strong>Nurses' spiritual well-being and competence in providing spiritual care were moderately positively and significantly correlated. Education, experience and engagement in religious activities enhanced these attributes. Future research should explore additional influencing factors and incorporate spirituality into nursing education to improve the quality of holistic care.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"491-497"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458000","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":"Mortality predictors for ICU end-of-life decisions: delta-SOFA and SAPS 3 - retrospective evaluation.","authors":"Maria Carmen Sala-Trull, Pablo Monedero, Francisco Guillen-Grima, Pilar Leon-Sanz","doi":"10.1136/spcare-2024-005357","DOIUrl":"10.1136/spcare-2024-005357","url":null,"abstract":"<p><strong>Objectives: </strong>End-of-life decisions in intensive care units (ICUs) are complex, influenced by patient severity, treatment efficacy and resource constraints. This study assessed the predictive value of delta-Sequential Organ Failure Assessment (SOFA) scores on days 2, 3 and 5, both independently and combined with Simplified Acute Physiology Score (SAPS) 3, for in-hospital mortality.</p><p><strong>Methods: </strong>A retrospective cohort study analysed ICU patients with stays of≥5 days from 2018 to 2020. Clinical data included SAPS 3 and SOFA scores at admission, 48 hours and on days 3 and 5, alongside mortality outcomes. Logistic regression and discriminant analysis identified mortality predictors and evaluated model performance.</p><p><strong>Results: </strong>Among 200 patients, 26% died in hospital. Non-survivors had significantly higher SAPS 3 scores (mean 51.9±11.9 vs 45.6±11.9 in survivors, p=0.001) and worsening SOFA scores, particularly on days 3 and 5. Combining SAPS 3 with delta-SOFA on day 5 produced an area under the receiver operating characteristic (AUROC) of 0.71 (95% CI: 0.63 to 0.79), indicating moderate predictive ability.</p><p><strong>Conclusions: </strong>Integrating the delta-SOFA score on day 5 with SAPS 3 improves in-hospital mortality predictions during prolonged ICU stays. Findings suggest early treatment limitations within 48 hours may be premature, as patient responses evolve and shared decision-making becomes more feasible over time.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"518-521"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440010","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":"The clock is ticking: can palliative care survive the dual crises of time and workforce shortages?","authors":"Raffaele Giusti, Giulio Ravoni, Giampiero Porzio","doi":"10.1136/spcare-2024-005345","DOIUrl":"10.1136/spcare-2024-005345","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"454-456"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448124","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":"Handgrip strength assessment in geriatric populations: digital dynamometers comparative study.","authors":"Nina Kemala Sari, Stepvia Stepvia, Muhana Fawwazy Ilyas, Siti Setiati, Kuntjoro Harimurti, Ika Fitriana","doi":"10.1136/spcare-2024-005245","DOIUrl":"10.1136/spcare-2024-005245","url":null,"abstract":"<p><strong>Background/objectives: </strong>Handgrip strength is a critical indicator of overall health, particularly in older adults, and is associated with frailty, sarcopenia and risk of adverse health outcomes. Precise and reliable measurement instruments are necessary to ensure accuracy in personalised diagnostic evaluations. This study aimed to assess the inter-instrument reliability and agreement between the Jamar Plus+ digital and Jamar hydraulic dynamometers in measuring handgrip strength.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to assess the handgrip strength of older individuals in the community aged more than 60, using the Jamar Plus+ digital and Jamar hydraulic dynamometers. The inter-instrument reliability and agreement between the devices were evaluated using Intraclass Correlation Coefficients (ICCs) and Bland-Altman analysis.</p><p><strong>Results: </strong>A total of 109 participants with a mean age of 66±5.3 years were included in this study. The Jamar Plus+ digital dynamometer recorded significantly higher handgrip strength measurements (27.0±7.1 kg) compared with the Jamar hydraulic dynamometer (21.0±6.7 kg). The ICCs between the two devices ranged from 0.67 to 0.70, indicating moderate reliability. Bland-Altman analysis revealed a consistent overestimation of handgrip strength by the Jamar Plus+ digital dynamometer, with systematic biases of 4.8 kg in men and 6.26 kg in women compared with the Jamar hydraulic dynamometer.</p><p><strong>Conclusion: </strong>The Jamar Plus+ digital dynamometer consistently overestimated handgrip strength compared with the Jamar hydraulic dynamometer, but both devices demonstrated moderate reliability. The Jamar Plus+ showed greater responsiveness to variations in strength. Selecting appropriate diagnostic tools is crucial for optimising individualised health assessments in older adults.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"473-479"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771358","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":"The Namaste of caring.","authors":"Nandini Vallath, Vidya Viswanath, Ann Maria Roy","doi":"10.1136/spcare-2025-005518","DOIUrl":"10.1136/spcare-2025-005518","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"457-459"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953762","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":"Acupuncture in obstetrics: delivery room integrative medicine for anxiety and pain.","authors":"Eran Ben-Arye, Tal Biron-Shental, William E Rosa, Noah Samuels, Oz Levy, Yael Keshet, Shunit Armon, Orit Gressel, Reuven Kedar, Aviv Messinger, Revital Lev Ari, Anat Lavie, Neta Atzil, Bosmat Ben Zohar, Cara Ferrer Sokolovski, Ido Solt, Hila Yaffe, Gil Shechter Maor, Moti Levy, Esther Maor-Sagie, Danit Katz Shtern, Gali Stoffman, Reut Ben Ze'ev, Maayan Lahav Sher, Betty Zidenberg, Shlomi Sagi, Elad Schiff","doi":"10.1136/spcare-2025-005512","DOIUrl":"10.1136/spcare-2025-005512","url":null,"abstract":"<p><strong>Objectives: </strong>Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel.</p><p><strong>Methods: </strong>A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding.</p><p><strong>Results: </strong>22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files.</p><p><strong>Conclusions: </strong>Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"535-541"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961597","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":"Assisted dying: is any healthcare option 100% perfect?","authors":"Claud Regnard, Leonie Herx, Amy Profitt, Matt Dore, Rob George","doi":"10.1136/spcare-2025-005686","DOIUrl":"https://doi.org/10.1136/spcare-2025-005686","url":null,"abstract":"","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":"144511500","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":"Serial fascia iliaca blocks for pathological hip fracture pain.","authors":"Adam Christopher Baker","doi":"10.1136/spcare-2025-005514","DOIUrl":"10.1136/spcare-2025-005514","url":null,"abstract":"<p><p>It is estimated that one in ten palliative care patients may benefit from a peripheral nerve block, and although many hospices have growing links and collaboration with pain colleagues, delays still persist, time our patients may not have. This case report documents serial fascia iliaca blocks performed in a hospice by a palliative care doctor, with significant benefits for a patient's pain and quality of life. It highlights that palliative care doctors may benefit from learning to deliver a handful of specific nerve blocks as part of their training.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"463-465"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075947","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":"Mortality rate and palliative sedation in an acute palliative care unit.","authors":"Sebastiano Mercadante, Alessio Lo Cascio, Alessandra Casuccio","doi":"10.1136/spcare-2023-004669","DOIUrl":"10.1136/spcare-2023-004669","url":null,"abstract":"<p><strong>Aim: </strong>To assess the mortality rate and the use of palliative sedation (PS) in an advanced long-standing acute palliative care unit (APCU) METHODS: The charts of patients who died and eventually received PS, consecutively admitted to the APCU for 4 years, were reviewed. Patients' characteristics and symptom intensity were recorded at admission, 3 days before death and the day before death (T0, T-3, T-end, respectively). For patients who were administered midazolam for PS, initial and final doses of drugs, as well as duration of PS until death, were recorded.</p><p><strong>Results: </strong>One hundred and forty-eight patients died in APCU (8.9%), and 45 of them (30.4%) received PS. Younger patients and those reporting high levels of dyspnoea at T-3 and T-end were more likely to be sedated (p=0.002, p=0.013 and 0.002, respectively). The mean duration of PS was 27.47 hours. Mean initial and final doses of midazolam were 35.45 mg/day (SD 19.7) and 45.57 mg/day (SD 20.6), respectively (p=0.001).</p><p><strong>Conclusion: </strong>Mortality rate in APCU was very low. As a percentage of the number of deaths, PS rate was similar to that reported in other settings. PS does not seem to accelerate impending death.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"526-529"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058169","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":"Immunotherapy and palliative medicine: opportunities and challenges.","authors":"Nessa Keane, Lynda McSorley, Leona Reilly","doi":"10.1136/spcare-2024-005362","DOIUrl":"10.1136/spcare-2024-005362","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"453"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448122","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}