{"title":"Caring for a Patient with Inoperable Hip Fracture.","authors":"Arouba Imtiaz, Amelia Collins, Fiona Rawlinson, Antony Johansen","doi":"10.1136/spcare-2025-005440","DOIUrl":"https://doi.org/10.1136/spcare-2025-005440","url":null,"abstract":"<p><p>Hip fractures pose significant challenges, particularly in managing severe incident pain in people who are not fit for surgery. We present the case of an older man with multiple comorbidities who was managed non-operatively. Standard opioids caused sedation with limited pain relief. Patient-controlled analgesia (PCA) with intravenous fentanyl provided effective, short-acting relief, allowing the patient to remain alert and engage in care. This case highlights PCA as a practical option for managing incident pain in selected palliative patients.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198229","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}
Lorna Fraser, Anna-Karenia Anderson, Ian Chi Kei Wong, George Peat, Emily Harrop
{"title":"Paediatric palliative care prescribing: midazolam multicentre pilot study.","authors":"Lorna Fraser, Anna-Karenia Anderson, Ian Chi Kei Wong, George Peat, Emily Harrop","doi":"10.1136/spcare-2024-005343","DOIUrl":"https://doi.org/10.1136/spcare-2024-005343","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141356","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":"Physical activity, fatigue, kinesiophobia and quality of life in prostate cancer.","authors":"Yunus Çolakoğlu","doi":"10.1136/spcare-2025-005604","DOIUrl":"https://doi.org/10.1136/spcare-2025-005604","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141360","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}
Alice Marie Gains, Nima Moghaddam, Michael Baliousis, Sanchia Biswas
{"title":"Virtual reality interventions for mental health and well-being in palliative care: systematic review and narrative synthesis - outcomes, techniques, processes and mechanisms.","authors":"Alice Marie Gains, Nima Moghaddam, Michael Baliousis, Sanchia Biswas","doi":"10.1136/spcare-2024-005342","DOIUrl":"https://doi.org/10.1136/spcare-2024-005342","url":null,"abstract":"<p><strong>Purpose: </strong>This review systematically synthesises the evidence on changes in mental health and wellbeing observed in palliative care patients following virtual reality (VR) interventions.</p><p><strong>Methods: </strong>In July 2024, systematic searches were conducted across five databases (Embase, PsycINFO, Medline, CINAHL Complete and Academic Search Complete), supplemented by hand searches and citation chaining. Search concepts included \"virtual reality\" and \"palliative care\". Inclusion criteria were established for adults receiving VR interventions in palliative care settings, limited to English language articles published in peer-reviewed journals. Study designs, sample characteristics, key findings, participant experiences and author interpretations were extracted.Each study included in the narrative synthesis was quality appraised.</p><p><strong>Results: </strong>Of the 1264 citations identified, 13 studies were deemed eligible for inclusion in this review. A narrative synthesis approach was used. Studies were evaluated of mixed quality. Reported changes include reduced pain, anxiety and depression, as well as improvements in mood and quality of life. While few changes reached statistical significance, qualitative reports corroborated the presence of meaningful change. Few participants reported adverse effects. Authors most frequently attributed the observed changes to distraction, with additional mechanisms proposed including cognitive processing, choice and immersion.</p><p><strong>Conclusions: </strong>While distraction is often assumed to be the primary mechanism of action for VR interventions in palliative care, this claim lacks robust empirical evidence as few studies directly assess distraction or degree of immersion. Future research should investigate the efficacy of VR interventions and elucidate the underlying mechanisms of change in mental health and well-being in this population.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085919","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}
Donna Wakefield, Chantelle Forster, Julie Christie
{"title":"Equitable care for patients with cancer experiencing homelessness.","authors":"Donna Wakefield, Chantelle Forster, Julie Christie","doi":"10.1136/spcare-2025-005580","DOIUrl":"https://doi.org/10.1136/spcare-2025-005580","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085914","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}
Heli Mikkonen, Minna Hökkä, Tiina Saarto, Jan-Henry Stenberg, Kristiina Junttila
{"title":"Psychosocial interventions and health-related quality of life in adults with incurable cancer: systematic review.","authors":"Heli Mikkonen, Minna Hökkä, Tiina Saarto, Jan-Henry Stenberg, Kristiina Junttila","doi":"10.1136/spcare-2024-005043","DOIUrl":"https://doi.org/10.1136/spcare-2024-005043","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the effects of psychosocial interventions in improving health-related quality of life (HRQoL) in adult patients with incurable cancer.</p><p><strong>Methods: </strong>A systematic search was performed in the MEDLINE, PsycINFO, CINAHL, Scopus and Medic databases to identify randomised controlled trials, quasi-experimental studies and cohort studies from 2004 to March 2024 aiming to influence HRQoL or psychosocial well-being.</p><p><strong>Results: </strong>The systematic search yielded 635 articles. After the removal of duplicates, screening of titles and abstracts, assessment of eligibility and screening of the reference list of included studies, 17 studies were included in the review, and a narrative synthesis was conducted. The delivery of psychosocial interventions varied considerably. They were most often structured, individual, performed in person or remotely, and applied multiple combined methods. Professionals delivering the intervention most often had a background in psychology, nursing or social work. The most frequent outcomes were quality of life, depression and anxiety, measured using multiple different tools. Of the studies, 35% reported significant sustainable improvements. The results favoured individual intervention and the multiple-method approach.</p><p><strong>Conclusions: </strong>The interventions presented as psychosocial interventions have their own characteristics and nature, but evidence of their efficacy is limited. There is an apparent need for research and discussion regarding the definitions, differences and relationships between psychosocial, psychological, social and spiritual interventions in cancer care.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085917","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":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/spcare-2025-005605","DOIUrl":"https://doi.org/10.1136/spcare-2025-005605","url":null,"abstract":"","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075946","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}
Geena Kelly, Claire Kruger, Ita Harnett, Camilla Murtagh
{"title":"Blood transfusions in palliative medicine and symptom control in solid tumours.","authors":"Geena Kelly, Claire Kruger, Ita Harnett, Camilla Murtagh","doi":"10.1136/spcare-2025-005406","DOIUrl":"10.1136/spcare-2025-005406","url":null,"abstract":"<p><strong>Introduction: </strong>Fatigue and breathlessness are among the most distressing symptoms for palliative care patients and may be related to underlying anaemia. Red cell concentrate (RCC) transfusion is a common intervention, yet its efficacy in improving these symptoms in palliative populations remains unclear.</p><p><strong>Methods: </strong>This retrospective chart review examined the impact of RCC transfusion on fatigue, breathlessness and functional status in 33 patients admitted to a hospice inpatient unit over 30 months. Symptom and functional scores were assessed pre-transfusion, and at 14 and 30 days post-transfusion, using the Palliative Care Outcomes Collaboration Symptom Assessment Scale, Australian Karnofsky Performance Status (AKPS) and Resource Utilisation Groups-Activities of Daily Living (RUG-ADL) tools.</p><p><strong>Results: </strong>Results showed that fatigue scores improved in 58% of patients, with sustained improvement at 30 days in 36%. A statistically significant reduction in fatigue was observed at 14 days post-transfusion (p=0.02). However, the impact on breathlessness was limited, with only 18% of patients reporting improvement, and no significant changes in mean breathlessness scores over time. Functional status, measured by AKPS and RUG-ADL, declined in 36% and 27% of patients, respectively, likely reflecting the progressive nature of terminal illness.</p><p><strong>Conclusions: </strong>While RCC transfusion demonstrated potential for alleviating fatigue, particularly in the short term, its effects on breathlessness and functional status were limited. The high mortality rate (30% at 30 days) and small sample size highlight the challenges of research in this population. These findings support the role of RCC transfusion in managing fatigue in palliative care, though further prospective studies are warranted.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668632","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}
Camilla Lykke, Birgit Jurlander, Per Sjøgren, Geana Paula Kurita, Ann-Dorthe Zwisler, Lene Vibe Høyer, Niels Tønder, Sille Larsen, Inge Eidemak, Ola Ekholm
{"title":"Caregivers' impact in heart failure: a cross-sectional study.","authors":"Camilla Lykke, Birgit Jurlander, Per Sjøgren, Geana Paula Kurita, Ann-Dorthe Zwisler, Lene Vibe Høyer, Niels Tønder, Sille Larsen, Inge Eidemak, Ola Ekholm","doi":"10.1136/spcare-2024-005262","DOIUrl":"https://doi.org/10.1136/spcare-2024-005262","url":null,"abstract":"<p><strong>Objectives: </strong>Caregivers play a pivotal role in supporting patients with heart failure (HF). Caregiving may be associated with significant impact on the caregivers' health. This study aimed at exploring the impact of caregiving in relation to self-rated health, anxiety and depression compared with the general Danish population.</p><p><strong>Methods: </strong>A cross-sectional exploratory study was conducted with caregivers of adult patients with HF New York Heart Association (NYHA) II, III and IV from the Department of Cardiology at the North Zealand Hospital in Denmark. Patients with HF were asked to indicate the caregiver ≥18 years to participate. Assessment of caregivers included the Zarit Burden Interview, Patient Health Questionnaire-4 and the 36-item Short-Form Health Survey.</p><p><strong>Results: </strong>Of 127 included caregivers, 119 completed the questionnaire (96 women). The mean age was 67 years (range 28-87 years). Overall, 31% of caregivers found caregiving burdensome. The heaviest burden was found in caregivers of patients with the highest symptom burden and NYHA class (p=0.005). Caregivers had 1.63 (95% CI: 1.00 to 2.66) times higher odds of reporting signs of anxiety than individuals in the general population. However, caregivers had 1.88 (95% CI: 1.09 to 3.25) times higher odds of rating their health as good than the general Danish population.</p><p><strong>Conclusions: </strong>Our finding of a higher proportion of caregivers reporting good health compared with the general population is in keeping with other recent studies. However, educational and supportive interventions supporting caregivers in providing care while maintaining their own health should still be considered.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977125","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}