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Background: Though randomized controlled trials of non-pharmacological palliative care interventions have shown positive outcomes, findings are often generalized with limited consideration for the impact of the influence of race, ethnicity, nationality, or religion on said outcomes. Aim: To identify trends and gaps in global reporting of racial, ethnic, nationality, and religious demographics in non-pharmacological palliative care randomized controlled trials. Design: We conducted a scoping review guided by the Joanna Briggs methodology, Data sources: Global randomized controlled trials published in English, between 1999 and 2021 extracted from databases: Cochrane, PubMed, and Scopus. Inclusion criteria were non-pharmacological palliative care interventions for people with serious conditions reporting on one or more of the demographics of race, ethnicity, nationality, or religion. Results: Our review included 131 (44%) articles published from 19 countries, predominantly the USA (n = 84, 64%). Most studies focused on cancer (n = 71, 54%) in inpatient settings (n = 85, 64%). Race was the most commonly reported demographic (n = 93, 70%), followed by ethnicity (n = 54, 41%), religion (n = 46, 35%), nationality (n = 20, 15%). Within racial reporting, 86 (92%) indicating a majority White/Caucasian sample. Only 14 (10%) articles provided context connecting participant demographics to intervention outcomes. Demographic data was discussed only as a limitation to generalizability in 18 cases (41%). Conclusions: Improving greater transparency in study reporting of social and historical context about population demographics, including specific demographic data collected, may better identify unmet palliative needs, facilitate cross-cultural interpretation, and improve adaptation and implementation of non-pharmacological palliative care interventions. [ABSTRACT FROM AUTHOR]

Although co-occurring cognitive impairment and physical disability in older adults is common, there is little understanding of how this group perceives their ability to do their daily activities. This study used photovoice to explore how older adults with MCI/early dementia and physical disability without and with care partners (dyads) perceive challenges with their daily activities. Photovoice is a visual research methodology to capture participants' insight on aspects of their daily lives. No known studies have taken this approach to explore the experiences of older adults with MCI/early dementia and co-occurring physical disability. We used a cross-sectional, exploratory research design to understand participants' (n = 12) experiences in their home environment. Photos and participant thoughts on the photos were categorized based on the Blackfoot Breath of Life Theory and the Hierarchy Model of Needs in Dementia, an adaptation of Maslow's Model. Notable findings included: awareness of physical/cognitive difficulties by older adults, solutions for ADL difficulty in persons with MCI/early dementia, care partners' difficulty recognizing pain without the presence of severe emotional or physical responses, reducing mood severity, and self-esteem needs met with structured, memory-issue adapted, meaningful activities. Older adults with co-occurring physical disability and MCI/early dementia identified both physiological and psychological needs despite challenges impacting their cognition. Photovoice evoked daily situations of these individuals and revealed the importance of developing individualized intervention elements for older adults with dementia and physical disability. [ABSTRACT FROM AUTHOR]

Background: Patient navigation (PN) improves cancer-related care, especially care among vulnerable populations who have limited access to medical and preventive care. The Cancer Navigation and Survivorship Network (CaNSuN), established in 2018, aims to connect, educate, and share evidence-based practices among navigators in Pennsylvania. Objectives: To conduct an environmental scan to increase understanding of navigation in Pennsylvania and identify strategies to better support and strengthen PN. The scan sought to describe characteristics of navigators, funding for and primary location of PN, measures of success, and important challenges. Methods: A 19-question survey was developed, piloted, and then administered in September 2021. The survey was initially distributed to the 169 CaNSuN newsletter subscribers and members of the Pennsylvania Cancer Coalition with a request to complete the survey and distribute the survey to colleagues. Additionally, requests were emailed to health system partners, state Department of Health, American Cancer Society, and community- based organizations. Descriptive and bivariate analyses were conducted. Results: Of the 82 complete responses, 77% were from nurse navigators and community health workers and were almost equally divided between working in community, clinical, and hospital settings. Navigators reported being in the field, on average, for 6 years. Challenges identified were lack of clarity on the role (32%), lack of guidelines for navigation (28%), measuring program success (28%), and funding (25%). About 40% reported their positions were funded by a hospital, and 20% by nonprofits. Patient satisfaction (50%) and time to treatment (24%) were the most common measures used to evaluate success. Significant relationships were observed between the navigator type and work setting, involvement at different stages of the cancer continuum, evaluation methods, and challenges. Conclusion: Results identified opportunities to strengthen support for both navigators and navigation systems in Pennsylvania. Navigation is a growing field with many navigators being new to the role. Groups like CaNSuN can provide professional development and facilitate a statewide learning community of navigators. CaNSuN can advocate for systems and policy change that will better support PN. [ABSTRACT FROM AUTHOR]