BMC Palliative Care[JOURNAL]
Sun
200 papers
Spiritual intelligence and family caregivers' self-efficacy in end-of-life: a cross-sectional study.
Pinto CT, Coelho Â, Castro L … +2 more , Nunes R, Pinto S
BMC Palliat Care · 2026 Apr · PMID 42056978 · Full text
BACKGROUND: Burden influences caregiving experiences for family caregivers and patients. While family caregivers are crucial in end-of-life, their burden remains under-researched, particularly regarding the role of spiri...
BACKGROUND: Burden influences caregiving experiences for family caregivers and patients. While family caregivers are crucial in end-of-life, their burden remains under-researched, particularly regarding the role of spiritual intelligence in shaping this experience. OBJECTIVES: To explore the level and type of burden of family caregivers of palliative adult cancer patients and its relationship to variables related to: caregiver; patient; and caregiving process; exploring associated factors of burden. METHODS: A quantitative, cross-sectional study including adult, unpaid, primary family caregivers providing support in at least one daily life activity to adult cancer patients. Caregiver burden was assessed using the Zarit Caregiver Burden Scale and spiritual intelligence through Spiritual Intelligence Self-Assessment Inventory. Linear regression analysis was used to examine significant relationships. The study followed the STROBE guidelines for reporting observational research and ethical procedures were ensured. RESULTS: The mean burden level was intense, predominantly on burden subdimension "Expectations Towards Caregiving". Significant correlations were found between burden and caregiver age, social support, financial status, caregiver having chronic diseases or being on pain medication and resilience. The multivariable model identified key associated factors: caregiver's older age, having no social support, having other dependents, and lower resilience, explaining approximately 40% of the burden. Spiritual Intelligence subdimension of "Personal Meaning Production" was associated with lower burden on "Self-efficacy Perception" subdimension. CONCLUSIONS: Family caregivers face specific struggles. Policies should provide structured support and financial resources. Interventions to prevent burden should include resilience and spiritual intelligence training, aiming to improve caregivers' self-efficacy.
Assessing the feasibility of use and content validity of ICECAP-CPM with bereaved family members of young people who died from serious illness: a UK think-aloud study.
Floredin I, Mitchell PM, Husbands S … +2 more , Neilson S, Coast J
BMC Palliat Care · 2026 Apr · PMID 42050603 · Full text
BACKGROUND: The ICECAP-Close Person Measure (CPM) is a self-complete measure developed for use in economic evaluation to capture capability outcomes for those close to individuals at the end of life. Its appropriateness...
BACKGROUND: The ICECAP-Close Person Measure (CPM) is a self-complete measure developed for use in economic evaluation to capture capability outcomes for those close to individuals at the end of life. Its appropriateness for use with close persons of young people, aged 14–25, at the end of life has not yet been assessed. An initial assessment of its use with bereaved family members of young people with serious illness was undertaken. METHODS: To assess feasibility of use and content validity of the measure, bereaved participants were asked to ‘think aloud’ when completing the ICECAP-CPM. Interview transcripts were examined for errors in comprehension, retrieval, judgement and response by four raters. Qualitative data explored reasons for errors during measure completion and participants’ views about the measure. RESULTS: Nine cognitive interviews were undertaken with parents (five) and siblings (four) of young people who had died. The measure appeared to be understood by the majority of participants, but there were errors in completion (18%) and struggles (4%). Participants suggested the measure was relevant to their experience and covered broad areas important to them. CONCLUSIONS: Although completion errors were identified, the measure appears relevant for use with bereaved family members of young people with serious illness.
The dilemma of perioperative shared decision-making in an octogenarian with advanced cancer: fracture after stent placement and delayed palliative care.
Jiang W, Wang N, Fan X … +3 more , Zhao Y, Zhao Z, Zhang Y
BMC Palliat Care · 2026 Apr · PMID 42050584 · Full text
This report presents the perioperative course of an elderly patient with advanced cancer who suffered an unexpected fracture within 15 days after cardiac stent implantation. The case underscores the practical challenges...
This report presents the perioperative course of an elderly patient with advanced cancer who suffered an unexpected fracture within 15 days after cardiac stent implantation. The case underscores the practical challenges in clinical shared decision-making when multiple high-risk conditions converge, including limitations in applying existing guidelines and a delayed integration of palliative care. Therefore, it is essential to establish a systematic preoperative assessment protocol, identify palliative care needs, and promote patient-goal-directed clinical decision-making—a process in which the anesthesiologist can serve as a central coordinator.
Relational dynamics in dementia care: a qualitative study of Australian and Japanese family experiences.
Li X, Kikuchi A, Ohata H … +2 more , Nakata YI, Niikawa T
BMC Palliat Care · 2026 Apr · PMID 42050562 · Full text
BACKGROUND: Dementia is a progressive condition that disrupts not only the cognitive and functional abilities of those diagnosed but also the quality of their closest relationships. Family carers often face profound emot...
BACKGROUND: Dementia is a progressive condition that disrupts not only the cognitive and functional abilities of those diagnosed but also the quality of their closest relationships. Family carers often face profound emotional, relational, and cultural challenges as they adapt to these changes. While past studies have highlighted the grief and uncertainty associated with caregiving, less is known about how relational dynamics evolve over the dementia trajectory or how cultural contexts shape this process. This study aimed to explore how family caregivers in Australia and Japan experience and navigate relational change. METHODS: We conducted semi-structured, in-depth interviews with 38 family carers of people living with dementia (18 in Australia, 20 in Japan). Participants were recruited through community organisations, carer networks, and support groups. Interviews were transcribed verbatim in the original language (English or Japanese) and translated as required. Data were analysed thematically using Braun and Clarke's framework, with bilingual researchers ensuring cultural nuance and analytic fidelity. Rigour was supported through triangulation, peer debriefing, reflexive journaling, and adherence to the COREQ checklist. RESULTS: Four key themes were generated: (1) Dealing with Loss: carers described relational and personhood losses, including role reversals and the erosion of reciprocity; (2) Evolving Relational Practices: carers adapted activities, communication, and routines to sustain connection; (3) Reconciling with a Transformed Relationship: carers negotiated ambivalent states of grief, gratitude, and acceptance; and (4) Motivation to Care: carers identified drivers of care, including relational closeness, duty and reciprocity, health-related rationales, and cultural negotiation between collectivist and individualist norms. CONCLUSIONS: Relational change is a central yet under-recognised aspect of dementia caregiving. This study builds on previous literature around the impact of dementia on carers by showing how cultural logics and caregiving motivations shape relational adaptation. These findings indicate that caregiving support may benefit from greater attention to relational wellbeing, duty, and cultural meanings attached to caregiving. Culturally responsive approaches that recognise relational continuity may contribute to improving the quality of life of both carers and people living with dementia.
Deprescribing decisions in palliative care: a qualitative meta-synthesis of multi-stakeholder experiences and influencing factors.
Chen L, Wu Q, Zhang Y … +3 more , Qu Y, Lei G, Wang Z
BMC Palliat Care · 2026 Apr · PMID 42050502 · Full text
BACKGROUND: Deprescribing decisions in palliative care involve complex interactions among multiple stakeholders, yet the experiences and needs of those involved remain poorly understood and lack systematic integration. O...
BACKGROUND: Deprescribing decisions in palliative care involve complex interactions among multiple stakeholders, yet the experiences and needs of those involved remain poorly understood and lack systematic integration. OBJECTIVES: This review aims to synthesize qualitative evidence on the experience, needs and influencing factors of multi-stakeholder in deprescribing decisions within palliative care, and to identify the core challenges faced in clinical practice. DESIGN: A systematic review and meta-synthesis of qualitative studies. METHODS: Six electronic databases (PubMed, CINAHL, EMBASE, Web of Science, CNKI, and Wanfang) were searched from inception to November 8, 2025. The search strategy combined terms related to deprescribing, palliative care, and qualitative research. Two reviewers independently screened titles, abstracts, and full texts against predefined inclusion criteria. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) checklist for qualitative research, and data were synthesized using thematic integration. The review followed ENTREQ guidelines for reporting. RESULTS: Eight studies from four countries were included, exploring deprescribing experiences and needs of patients, family caregivers, and healthcare professionals. Thematic synthesis generated four overarching themes: complexity of decision-making, role variations among multiple-stakeholders, Communication strategies and trust-building, healthcare system and environment barriers. CONCLUSIONS: Effective communication among multiple-stakeholders is critical for addressing deprescribing challenges in palliative care. The differences in stakeholders' priorities and the barriers between the healthcare system and the environment are common challenges that need to be faced. These experiences and demands affect the appropriateness and feasibility of deprescribing decisions, and have a significant impact on optimizing deprescribing practices in palliative care, improving the quality of life and care delivery.
Palliative care symptoms of people living with rapidly progressive prion diseases: a systematic review.
Williams RT, White N, Kearns J … +7 more , McNiven K, Marasigan AR, Sampson EL, Evans CJ, Mead S, Kupeli N, EMBED‐Care Programme
BMC Palliat Care · 2026 Apr · PMID 42046045 · Full text
BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal dementia with an average prognosis of four to six months. Palliative care, as a holistic person-centred approach to supporting people and famili...
BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal dementia with an average prognosis of four to six months. Palliative care, as a holistic person-centred approach to supporting people and families affected by life-limiting illness, may be beneficial. However, despite the rapid disease trajectory, relatively little is known about the palliative care symptoms and concerns of this population. This systematic review identifies and reports the palliative care symptoms of people living with sporadic, iatrogenic, and acquired CJD. METHOD: Studies were included if they reported the symptoms of patients with a diagnosis of CJD (excluding inherited prion disease), using quantitative methodology. No date range was used to narrow the search, non-English language and non-peer reviewed papers were excluded. Searches for relevant studies published before December 2023 were conducted across five databases (including EMBASE, CINAHL, and PubMed) by eight independent reviewers. Methodological quality appraisal was undertaken using the Hawker Quality appraisal tool. Data on study characteristics and reported symptoms, were extracted. Identified symptoms associated with CJD were collated, and Artificial Intelligence assisted semantic clustering was performed to group symptoms into categories, the reported symptoms were tallied to identify those most commonly reported across the literature. A palliative care lens was then applied to classify symptoms as physical, psychological, social, or spiritual. The review protocol was registered with PROSPERO (CRD42020194294). RESULTS: The search yielded 8,503 unique citations; following title, abstract, and full-text screening, 30 papers were included in the final analysis, describing 4,434 participants. Across the included literature, 109 unique symptoms were identified, 374 in total when accounting for duplicates. Symptoms were categorised into 11 subsets: motor impairments (17.6%, 66/374 proportion of total number of symptoms); coordination, balance and vestibular issues (17.6%, 66/374); behavioural, psychiatric and emotional symptoms (23.5%, 88/374); speech and language disorders (10.1%, 38/374); visual and sensory disturbances (7.7%, 29/374); cognitive disorders (6.9%, 26/374); sleep disorders (6.6%, 25/374); other neurological symptoms (4.2%, 16/374); swallowing and nutrition issues (2.9%, 11/374); autonomic and sphincter dysfunction (1.3%, 5/374); and social symptoms (1.0%, 4/374). CONCLUSION: Findings align with established knowledge regarding the diverse and complex symptom burden in CJD, highlighting the potential challenges of symptom management. Motor and coordination impairments were most frequently reported, alongside behavioural and psychiatric disturbance. Limited evidence was identified regarding social or spiritual symptoms, quality of life, or symptom progression, as many studies focused primarily on improving early diagnosis. Further primary research is required to better understand the palliative care needs of people living with CJD to ensure comprehensive end-of-life care.
Experiences, perspectives and preferences for home-based palliative and supportive care: a qualitative study of individuals with heart failure and their carers.
Perera M, Parsonage W, Yates P … +1 more , Singh GK
BMC Palliat Care · 2026 Apr · PMID 42045895 · Full text
BACKGROUND: Palliative and supportive care provided in the home for individuals with heart failure and their carers can improve quality of life, reduce symptom burden and hospital admissions. However, enabling this care...
BACKGROUND: Palliative and supportive care provided in the home for individuals with heart failure and their carers can improve quality of life, reduce symptom burden and hospital admissions. However, enabling this care in accordance with what matters to individuals living with heart failure and their carers remains elusive. This research aimed to explore the experiences, perspectives and preferences of individuals with heart failure and their carers on home-based palliative and supportive care. METHODS: A qualitative study using semi-structured interviews was conducted with individuals with heart failure and carers, recruited from two tertiary care hospitals in Queensland, Australia. RESULTS: A total of eleven individuals with heart failure and ten carers participated. Their age ranged between 40 and 84 years. Most participants were female (n = 14, 66.7%). The themes derived from thematic analysis centred on: (a) diverse strategies for seeking emotional support, (b) acknowledging the importance of carers, (c) effective information and communication, (d) the value of home-visits, (e) telehealth enhances care (f) a circle of care: health professionals and social services supporting the individual and carer, and (g) planning for future care. CONCLUSION: Insights into the perspectives, experiences and preferences of individuals with heart failure and their carers are critical to delivering patient and carer centred palliative and supportive care in the home. Enhancing the circle of care through better communication, supporting carers and utilising telehealth, is required to deliver palliative and supportive care in the home in accordance with what matters to these individuals.
CARE-HOUSE: developing a framework for conceptualizing social implications of digital health technologies in palliative care.
Öhl N, Steigleder T, Hille EM … +10 more , Braun M, Weisser A, Mühlensiepen F, Vossiek M, Eskofier B, Kölpin A, Dabrock P, Forbes CC, Ostgathe C, Heckel M
BMC Palliat Care · 2026 Apr · PMID 42045873 · Full text
BACKGROUND: The use of digital health technologies holds potential benefits for palliative care. Their implementation is fundamentally shifting routines and care practices. These shifts entail social implications that ar...
BACKGROUND: The use of digital health technologies holds potential benefits for palliative care. Their implementation is fundamentally shifting routines and care practices. These shifts entail social implications that are complex, may emerge gradually and are challenging to identify. However, the social implications of digital health technologies are not conceptualized yet. This study addresses this gap by developing a framework on the social implications of digital technologies in palliative care, where the importance of social inclusion and interpersonal connection is particularly evident. METHODS: We assessed the potential social implications of digital health technologies’ use in palliative care through a sequential research design using qualitative empirical methods of social research. Alongside conducting an iterative narrative literature review, we held multidisciplinary expert consultations using a conceptual mapping method and focus groups involving researchers, clinicians, and a patient and public involvement group, analyzed with qualitative structured content analysis. RESULTS: Participants as well as the literature review identified key areas to the understanding and analysis of the social implications of digital health technologies in palliative care: principles and objectives of palliative care (patient-centered care, Total care, multiprofessional collaboration, relieving suffering, improving quality of life); the various actors involved in a specific care practice; the different roles they might have; the interactions among different actors; the tasks individual actors might carry out; the processes they are involved in; and the contexts they are embedded in. These factors were summarized and set out in the CARE-HOUSE Framework to conceptualize the social implications of digital health technologies’ use in palliative care and to support researchers in assessing the impacts of these technologies. CONCLUSIONS: The CARE-HOUSE Framework provides guidance for analyzing the social implications of digital health technologies in palliative care. It will be for future studies to evaluate the framework’s adaptability and scalability to diverse technologies and settings.
Palliative care and vascular surgery: status quo, needs, barriers and current challenges from the perspective of vascular surgery specialists.
Rechenmacher M, Schnell A, Schulz M … +4 more , Herr W, Schierling W, Pfister K, Mair R
BMC Palliat Care · 2026 Apr · PMID 42032635 · Full text
BACKGROUND: Palliative care is a concept for all patients suffering from life threatening diseases. It is not limited to cancer patients or to the last few days of life. Current research on diseases and concomitant diagn...
BACKGROUND: Palliative care is a concept for all patients suffering from life threatening diseases. It is not limited to cancer patients or to the last few days of life. Current research on diseases and concomitant diagnoses in vascular surgery suggests a high need for palliative care. Specific palliative concepts for vascular medicine are still lacking. METHODS: We conducted a study on the subjective views of experts in vascular surgery in Germany using a qualitative interview method to examine various aspects of palliative care in vascular surgery. RESULTS: A total of 609 relevant text passages were identified and coded into seven main categories and 43 subcategories. The coding categories were as follows: description of the current situation of care in vascular surgery, identification of palliative vascular surgery patients’, description of palliative care symptoms requiring treatment, methods for identifying palliative vascular surgery patients, desired effects of palliative care interventions, barriers to implementation of palliative care, and the role and needs of relatives. CONCLUSIONS: The results of this study suggest that vascular surgery palliative patients may represent a specific group of patients, necessitating the development of a customised palliative care concept to the specific needs of this group. The specific requirements for the care of these patients and numerous barriers currently prevent adequate palliative care of these patients. The results of our study, which we were able to extract from interviews with experienced vascular surgeons and their insights into everyday clinical practice, confirm the conclusions drawn in published clinical studies and supplement them with further aspects, which together appear necessary for improved care of this patient group in the future. Central aspects to be considered include suitable training of vascular surgeons for a comprehensive understanding of palliative care, as well as advance care planning and written standards defining the situations in which palliative care should routinely be offered.
The general public's perceptions of advance care planning (ACP) in the Asia-Pacific region: a systematic review.
Pokpalagon P, Chambers S, Singh GK … +1 more , Yates P
BMC Palliat Care · 2026 Apr · PMID 42026598 · Full text
BACKGROUND: Populations are rapidly ageing. Advance Care Planning (ACP) is an important activity to help prepare for future healthcare needs. Little is known of the perceptions of the general public of the Asia-Pacific r...
BACKGROUND: Populations are rapidly ageing. Advance Care Planning (ACP) is an important activity to help prepare for future healthcare needs. Little is known of the perceptions of the general public of the Asia-Pacific region in relation to these activities. Within the context of the Asia-Pacific region, this review aimed to explore awareness of, attitudes towards, experiences of, and the needs, wishes, and/or expectations related to ACP/Advance Directives (AD) of the general public. METHODS: The systematic review protocol was registered with PROSPERO (December 17, 2023): CRD42023491109). PubMed, CINAHL, PsycINFO, Embase, and Emcare databases were searched 2013 to 2023 for primary research, of any design, that reported perspectives and experiences of the general adult public of the Asia-Pacific region relating to their awareness, attitudes, experience, and expectations of ACP/AD. The literature searches were updated in PubMed to 31 December 2025. Selected studies were quality appraised using the Mixed Methods Appraisal Tool. Findings were synthesised using Cochrane’s narrative synthesis approach. RESULTS: Out of 3,275 records retrieved, 14 studies were included in this review. This review found that awareness of ACP/AD among the general public in the Asia-Pacific region is relatively low and it was not uncommon for them to know nothing about substitute decision maker decision makers and other terms related to ACP/AD. While they believe ACP is necessary and important, only a minority have had previous discussions regarding ACP and the reported completion of AD was minimal. Various factors that influence people’s willingness to engage in ACP/AD were found, such as wanting legal parameters to protect patient autonomy. Expectations of medical professionals to have good communication skills when discussing ACP were highlighted as well as the need for legal parameters to support ADs. CONCLUSION: This review highlights that awareness of ACP/AD among the general public in the Asia-Pacific region is low. As proven by the small number of papers which informed this review, more robust studies are needed on various aspects of this topic in the context of the Asia-Pacific region. Such studies would inform the best ways to move forward in improving the awareness and knowledge of, and to improve attitudes towards, ACP/AD to ensure people’s treatment decisions are discussed, documented, respected and enacted.
The LiverCare intervention: implementing structured palliative care in hepatology - a multicenter mixed-methods feasibility study in patients with cirrhosis.
Grønkjær LL, Jacobsen BG, Teisner AS … +8 more , Bager P, Hamberg ML, Mendahl J, Marsaa K, Guldin MB, Kimer N, Lauridsen MM, O Connell MB
BMC Palliat Care · 2026 Apr · PMID 42021258 · Full text
BACKGROUND: Liver cirrhosis is associated with high symptom burden, psychological distress, and substantial unmet supportive care needs. Although early palliative care improves outcomes in other serious diseases, it rema...
BACKGROUND: Liver cirrhosis is associated with high symptom burden, psychological distress, and substantial unmet supportive care needs. Although early palliative care improves outcomes in other serious diseases, it remains under integrated in hepatology. This study evaluated the feasibility of a structured palliative care intervention for patients with cirrhosis and their informal caregivers. METHODS: LiverCare is a multicenter, mixed-methods feasibility study conducted across four Danish hepatology departments. Eligible patients were identified using the Supportive and Palliative Care Indicators Tool. The intervention comprised structured, repeated palliative care conversations delivered by trained hepatologists and liver nurse specialists alongside routine clinical care. Between August 2023 and July 2024, 42 patients and 25 informal caregivers were enrolled. Outcomes included anxiety, depression, quality of life, caregiver burden, and qualitative interviews. Feasibility was evaluated using the RE-AIM framework. RESULTS: Of 68 eligible patients, 42 were enrolled (62%). All completed the first conversation; 27 and 12 completed the second and third conversations, respectively. Patient-reported outcomes on anxiety, depression, and quality of life remained stable during follow-up. Caregiver burden decreased over time. Qualitative findings demonstrated enhanced communication, emotional validation, and facilitated future care planning. Across all conversations, 128 clinical actions were initiated. The intervention was delivered with high fidelity and was perceived as relevant and meaningful. CONCLUSIONS: Structured palliative care integrated within hepatology was feasible and acceptable and was associated with reduced caregiver burden. These findings support further evaluation in a larger controlled study and inform implementation of palliative care in advanced liver disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT05431946, registered 24 June 2022.
SPICT as a predictive tool for outcomes of 1-year in patients with neurological disorders: a cohort study.
Peng M, Cai X, Wang F … +3 more , Liu Y, Shi W, Huang S
BMC Palliat Care · 2026 Apr · PMID 42010635 · Full text
BACKGROUND: The Supportive and Palliative Care Indicators Tool (SPICT) is designed to identify patients with deteriorating health and palliative care needs. Its predictive validity in a dedicated neurological inpatient p...
BACKGROUND: The Supportive and Palliative Care Indicators Tool (SPICT) is designed to identify patients with deteriorating health and palliative care needs. Its predictive validity in a dedicated neurological inpatient population, particularly for a comprehensive set of clinical and functional outcomes, remains underexplored. METHODS: In this prospective cohort study, we enrolled 337 patients with neurological disorders during hospitalization. Baseline assessments included a demographic characteristics questionnaire, disease-specific scales, and the SPICT. Physicians also subjectively assessed each patient’s palliative care needs. All patients completed one-year follow-up assessments after discharge, including length of hospital stay, number of unplanned hospitalizations, complications, Karnofsky Performance Status (KPS), Barthel Index (BI), frailty status, vital status, palliative care referral willingness, and palliative care referral. RESULTS: At baseline, 152 patients (45.1%) were SPICT-positive, whereas physicians identified only one patient (0.3%) as having palliative care needs, indicating poor agreement (κ = 0.007, p = 0.451). At one-year follow-up, 301 patients were included in this study, and SPICT-positive patients demonstrated significantly worse outcomes compared to the SPICT-negative group: longer hospital stay, greater complications and mortality, increased frailty severity, and significantly lower KPS and BI scores (all p < 0.001). No significant difference was found in number of unplanned hospitalizations, palliative care referral preference, and palliative care referral (p > 0.05). CONCLUSION: These findings support the use of SPICT as a systematic, evidence-based tool for early identification of neurological disorders patients at higher risk for poor one-year outcomes. SPICT is not intended as a referral engine but rather as an upstream screening tool to facilitate goal of care discussions, advance care planning, and longitudinal monitoring for neurology patients.
Early diagnostic tools in palliative care in Morocco: healthcare professionals' knowledge, perceptions, and barriers at Ibn Sina University hospital centre.
Zguiouar R, Hamdoune M, Gantare A
BMC Palliat Care · 2026 Apr · PMID 42001052 · Full text
BACKGROUND: Palliative care (PC) in Morocco is still developing, with limited integration of standardised assessment and diagnostic tools in clinical practice. This study aimed to explore healthcare professionals’ knowle...
BACKGROUND: Palliative care (PC) in Morocco is still developing, with limited integration of standardised assessment and diagnostic tools in clinical practice. This study aimed to explore healthcare professionals’ knowledge, perceptions, and use of early diagnostic tools in PC at Ibn Sina University Hospital Centre, Rabat, and to identify contextually appropriate tools and barriers to their implementation within the Moroccan healthcare context. METHODS: A qualitative, descriptive study was conducted at Ibn Sina University Hospital Centre between March and September 2025. Semi-structured, face-to-face interviews were held with 56 healthcare professionals involved in palliative and end-of-life care across multiple departments. Participants were recruited through purposive sampling. Data were transcribed verbatim and analysed thematically following Braun and Clarke’s framework. RESULTS: Fifty-six healthcare professionals (43 nurses, 13 physicians) participated. Six major themes emerged. Most interviewers reported limited knowledge and irregular use of early diagnostic tools such as Pallia 10 and PICT, mainly due to insufficient training, lack of standardised protocols, heavy workload, and cultural factors. While Pallia 10 was preferred for its simplicity and compatibility with clinical routines, PICT was valued for its psychosocial and multidimensional perspective. Participants highlighted the need for cultural and linguistic adaptation, multidisciplinary collaboration, and institutional support. CONCLUSIONS: Integrating early diagnostic tools into Moroccan PC could enhance early identification, care coordination, and quality of life for patients. However, successful implementation requires national strategies, continuous professional training, and culturally sensitive adaptation to bridge the gap between theoretical recognition and practical use.
Echoes of the burdened souls: psycho-social and spiritual turmoil in advanced cancer patients receiving palliative care.
Farheen N, Alam A, Bhuiyan AKMMR … +3 more , Khalequzzaman M, Mamun MR, Chowdhury MK
BMC Palliat Care · 2026 Apr · PMID 42001051 · Full text
BACKGROUND: Psycho-spiritual suffering is a critical yet often overlooked aspect of advanced cancer. In Bangladesh, patients commonly present at late stages, when their emotional, social, and spiritual needs are rarely a...
BACKGROUND: Psycho-spiritual suffering is a critical yet often overlooked aspect of advanced cancer. In Bangladesh, patients commonly present at late stages, when their emotional, social, and spiritual needs are rarely addressed. This study explored the lived experiences of advanced cancer patients to understand their psychological, social, and spiritual challenges. METHODS: A qualitative phenomenological approach was used. Twenty-four adult patients admitted to the Palliative Medicine ward at Bangladesh Medical University were purposively sampled. Semi-structured, in-depth interviews were conducted in Bengali, audio-recorded, and transcribed verbatim. Data were analyzed using inductive thematic analysis following Braun and Clarke’s framework. Observations and field notes captured non-verbal cues and contextual details. Ethical approval was obtained (BMU/2024/1707), and written informed consent was obtained from all participants. RESULTS: Analysis identified four interrelated themes: Living with uncertainties and despair, Conflicting thoughts, Aspects of interpersonal and social relationships, and Unspoken distress and seeking debriefing. These themes profoundly reflected uncertainties, despair, conflicting thoughts of feeling like burden, guilt, shame, social withdrawal, hastening death or suppressed grief to protect loved ones. Distorted familial terms, and spiritual distress from fleeting thoughts of afterlife and need for debrief were expressed. CONCLUSIONS: Advanced cancer patients face complex psycho-social and spiritual turmoil beyond physical symptoms. Integrating structured psychological counselling, spiritual support, and family-centered interventions, advance care planning in palliative care can help preserve dignity, reduce multidimensional suffering, and enhance meaning at the end of life.
Effective practices and transdisciplinary team-based approaches in home palliative care for terminal cancer patients: a qualitative descriptive study.
Yoshida M, Yamauchi E, Suyama K
BMC Palliat Care · 2026 Apr · PMID 41992265 · Full text
BACKGROUND: In Japan, approximately 60% of patients with cancer prefer to spend their final days at home, yet only 11.8% die at home. Contributing factors include uneven distribution of community resources and difficulti...
BACKGROUND: In Japan, approximately 60% of patients with cancer prefer to spend their final days at home, yet only 11.8% die at home. Contributing factors include uneven distribution of community resources and difficulties in multidisciplinary collaboration. We aimed to qualitatively identify key practices in home-based palliative care that should be shared among professionals within a transdisciplinary team approach, which may offer solutions to these challenges. METHODS: Between November 2021 and March 2022, semi-structured interviews were conducted with 13 professionals—physicians, nurses, care managers, care workers, pharmacists, and medical social workers—affiliated with institutions that provide more than 12 cases of home-based end-of-life care annually. We used reflexive thematic analysis to code the data, extracted subcategories and main categories, and inductively developed the themes. RESULTS: We identified 625 codes, 66 subcategories, and nine categories, which were integrated into three themes. Theme 1 (Iterative Communication & Coordination) described repeated alignment of prognosis and care goals among teams, patients, and families, supported by real-time information sharing. It also illustrated how teams recalibrated care direction in response to subtle changes in patient conditions or family perspectives. Theme 2 (Family Readiness & Relational–Emotional Support) captured practices that strengthened caregivers’ psychological readiness and emotional stability by alleviating burden, responding sensitively to distress, and fostering meaningful connections. This theme also highlighted that caregiver needs fluctuate throughout the illness trajectory, requiring tailored and ongoing engagement from multiple professionals. Theme 3 (Proactive Preparedness & Resource Orchestration) encompassed anticipatory symptom management, coordination of financial/practical resources, and flexible cross-disciplinary role-sharing to ensure timely responses at home. Proactive preparation—such as securing medications, anticipating care gaps, and coordinating resources across institutions—played a crucial role in preventing crises and sustaining home care. Collectively, these integrated practices enabled resource-conscious, transdisciplinary support that contributed to the realisation of home deaths in resource-limited settings. CONCLUSIONS: These findings inform education and system design by clarifying how transdisciplinary teams integrate iterative communication, caregiver support, and proactive preparation to provide flexible, comprehensive care, even in resource-limited settings, thereby offering a foundation for developing transferable training frameworks and implementation strategies across diverse care contexts.
What are fathers' experiences of neonatal-perinatal palliative care? A Scoping review.
Redman H, Thomas F, Clancy M
BMC Palliat Care · 2026 Apr · PMID 41992174 · Full text
Whilst there is a burgeoning body of research exploring parental experiences of neonatal-perinatal palliative care, a major limitation is fathers’ under-representation as research study participants. The paucity of liter...
Whilst there is a burgeoning body of research exploring parental experiences of neonatal-perinatal palliative care, a major limitation is fathers’ under-representation as research study participants. The paucity of literature relating to fathers’ experiences means there is scant evidence to guide those with a remit to support them. Understanding is needed on how fathers cope, accept loss, and grieve, and how notions of fatherhood and masculinity affect men’s experiences and support.This scoping review aims: (a) to provide an in-depth overview of the current state of knowledge around fathers’ experiences of neonatal palliative care; and (b) to understand the ways in which fathers have been engaged as participants in existing research. Seven electronic databases were searched for qualitative studies concerning fathers’ experiences of neonatal palliative care, complimented by manual searches and grey literature searches. A total of 22 studies met the inclusion criteria. Three main analytical themes were identified, arranged temporally following fathers’ experiences from the point of diagnosis to bereavement and beyond: (1) fathers’ experiences of finding out and decision making; (2) fathers experiences in and out of the care environment; and (3) fathers’ experiences of grief and bereavement.This scoping review finds that whilst the existing research provides a useful starting point for understanding fathers’ experiences of neonatal palliative care, there is a need for interdisciplinary research that explores fathers’ experiences in more depth, to inform and improve care and support available to fathers during this difficult time.
Identifying palliative care needs in children with acute lymphoblastic leukemia: validation of the Chinese paediatric palliative screening scale (C-PaPaS).
Nueraili A, Jiang J, Wang H … +8 more , Zhu X, Yu Y, Cao P, Fu Y, Li J, Yu L, Cheng L, Zhai X
BMC Palliat Care · 2026 Apr · PMID 41992173 · Full text
BACKGROUND: Timely identification of pediatric palliative care (PPC) needs is essential to improving the quality of life for children with life-threatening illnesses. The Paediatric Palliative Screening Scale (PaPaS) has...
BACKGROUND: Timely identification of pediatric palliative care (PPC) needs is essential to improving the quality of life for children with life-threatening illnesses. The Paediatric Palliative Screening Scale (PaPaS) has been validated internationally, but it has not yet been evaluated in mainland China, where PPC infrastructure remains limited and fragmented. The aim of this study is to adapt the PaPaS into Chinese and evaluate its diagnostic performance in identifying PPC needs among children with acute lymphoblastic leukemia (ALL) during induction chemotherapy. METHODS: This retrospective diagnostic accuracy study included children aged 0–18 years newly diagnosed with ALL who initiated induction therapy under the CCCG-ALL-2020 protocol at a tertiary pediatric hospital in China (August 2020–August 2023). The Chinese version of the PaPaS (C-PaPaS) was developed through forward–backward translation and expert review. Scores were retrospectively assigned using electronic medical records. Receiver operating characteristic (ROC) analysis was used to assess diagnostic performance and identify the optimal cutoff. RESULTS: Among 153 patients, 28.1% received PPC interventions. Median C-PaPaS scores were significantly higher in the PPC group (23 [IQR 17–25]) than in the non-PPC group (15 [14–19]; P < 0.001). At a cutoff score of > 22, the C-PaPaS demonstrated high sensitivity (93.0%) and moderate specificity (41.8%), with an area under the ROC curve of 0.79 (95% CI: 0.71–0.87). CONCLUSIONS: The C-PaPaS demonstrated strong sensitivity and moderate discriminative accuracy in identifying PPC needs among children with ALL. It may serve as a useful triage tool to support early palliative integration, especially in settings with limited PPC infrastructure.
Factors affecting access to palliative care in the emergency department for older adults with serious life- limiting illnesses: a qualitative study.
Jehloh L, Maropi A, Nilmanat K … +1 more , Bourbonnais A
BMC Palliat Care · 2026 Apr · PMID 41987141 · Full text
BACKGROUND: Offering palliative care to older adults with serious illnesses can be challenging in the emergency department. Understanding the factors that affect access to palliative care in this context is crucial for i...
BACKGROUND: Offering palliative care to older adults with serious illnesses can be challenging in the emergency department. Understanding the factors that affect access to palliative care in this context is crucial for improving the quality of life for older adults and reducing the cost of aggressive treatments in the emergency department. The factors identified from the perspective of older adults, family caregivers and healthcare providers are unknown in context of Thailand and should be considered to improve access. This study aimed to describe the factors that influence access to palliative care in the emergency department for older adults with serious life- limiting illnesses from various perspectives. METHODS: A descriptive qualitative study was conducted in a community with five older adults, and five family caregivers and a hospital with ten healthcare providers were purposively recruited and participated in semi-structured interviews. Thematic analysis was used to analyze the data. RESULTS: Five themes described the factors affecting the access to palliative care in the emergency department that is, organizational support, training, cultural competence, attitude towards palliative care, and the traditional nature of the emergency department's mission. CONCLUSION: Healthcare providers should be trained in palliative care to improve their skills in providing effective palliative care for older adults with life-limiting illnesses and FG in the emergency department.
Moral injury and influencing factors among palliative care nurses : a cross-sectional study.
Xu Y, Ji X, Zhang L … +1 more , Zhou Y
BMC Palliat Care · 2026 Apr · PMID 41987120 · Full text
BACKGROUND: Moral injury has emerged as an important ethical and psychosocial concern in healthcare. Palliative care nurses frequently encounter ethically challenging situations and sustained emotional demands, yet evide...
BACKGROUND: Moral injury has emerged as an important ethical and psychosocial concern in healthcare. Palliative care nurses frequently encounter ethically challenging situations and sustained emotional demands, yet evidence on the extent of moral injury and its associated factors remains limited. METHODS: A cross-sectional, descriptive and correlational survey. Convenience sampling was used to recruit palliative care nurses working in palliative care services in Anhui and Jiangsu provinces, China, between December 2025 and February 2026. Participants completed a demographic/work-related questionnaire, the Moral Injury Symptom Scale–Health Professional (MISS-HP), and the Emotional Labor Scale. Data were analysed using t-tests/ANOVA, Pearson correlation, and stepwise multiple linear regression. RESULTS: Of 361 nurses approached, 349 provided valid responses (96.7%). The mean MISS-HP total score was 48.96 ± 17.35, suggesting that moral injury scores among palliative care nurses were relatively elevated. In the multivariable model (adjusted R²=0.386), higher moral injury was associated with being male, being unmarried, having a higher education level, experiencing major ethical dilemmas more frequently in the past year, lower perceived support from leaders/colleagues, and higher emotional labour (all p < 0.05). CONCLUSION: The findings suggest that moral injury symptoms among palliative care nurses were relatively elevated. Emotional labour was positively correlated with moral injury, indicating that nurses with higher emotional labour tended to report greater moral injury symptoms. In addition, demographic characteristics and work-related factors, including gender, marital status, educational attainment, frequency of major ethical dilemmas, and perceived organisational support, were significantly associated with moral injury. These findings highlight the importance of strengthening organisational support and developing strategies to manage emotional labour in order to mitigate moral injury and support nurses’ well-being.
Family perceptions of palliative care consultations for nursing home residents.
Boakye A, Cagle J, Tucker G … +5 more , Ersek M, Floyd AC, Elftmann H, Zhang P, Unroe KT
BMC Palliat Care · 2026 Apr · PMID 41987115 · Full text
OBJECTIVES: Palliative care (PC) consultations, often facilitated by providers external to nursing homes (NHs), can reduce unwanted hospitalizations and improve decision-making and communication for nursing home (NH) res...
OBJECTIVES: Palliative care (PC) consultations, often facilitated by providers external to nursing homes (NHs), can reduce unwanted hospitalizations and improve decision-making and communication for nursing home (NH) residents. However, limited literature has documented the specific elements within PC consultations that drive positive outcomes. Given the critical role of family members, especially for residents with cognitive impairment, this study aimed to: (1) identify actions and interactions during recent PC consultation visits, and (2) summarize family perceptions of these visits. METHODS: Using a descriptive qualitative research design, family caregivers (N = 22) from five NHs across two states (Indiana and Maryland) were recruited to be interviewed within approximately one month of a PC consultation. These family caregivers had participated in a clinical trial of PC. Semi-structured interviews were transcribed, analyzed using thematic content analysis and finalized for discussions. RESULTS: Most family caregivers were adult children (59.1%), were female (81.9%), and Black (54.6%). Four interaction themes emerged regarding PC consultations interactions: they (1) promoted physical comfort, (2) supported family members, (3) attended to residents’ social needs, and (4) provided next steps/care planning. Four themes on perceived benefits of consultation visits were identified. Visits (1) improved residents’ quality of life, (2) provided recommendations/referrals, (3) kept family members informed, and (4) supported family members. DISCUSSION: Family caregivers had favorable impressions of PC consultation visits and provided insights into specific interactions during visits. Garnering the perspectives of family caregivers involved in PC consultations is vital for designing interventions that better support residents with cognitive impairment and their families. Findings reinforce the importance of expanding access to PC consultations in NHs that prioritize family involvement. TRIAL REGISTRATION: The UPLIFT project was registered on ClinicalTrials.gov NCT04520698 on 8/17/2020.
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