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Background: Leadership competencies are essential for the future development of the field of palliative and hospice care. However, a consensus on the core competencies of good leadership is not yet available. Objective: To elicit consensus on core leadership competencies in palliative care. Design: Based on a literature review, a list of 119 specific leadership competencies was compiled. Subsequently, a Delphi technique used three online survey rounds and a final expert consultation (the board of the European Association for Palliative Care [EAPC]) to assess the importance of these competencies. Setting/Participants: International experts in leadership in palliative care were identified from an online search and EAPC networks. Results: From the 194 international multiprofessional experts invited to participate, 99/78/64 took part in the 3 rounds. One hundred fifteen items from eight domains of leadership (research, advocacy and media, communication, teamwork, project management, organizational learning and sustainability, leading change, and personal traits) reached consensus and were deemed as important. Conclusions: The eight domains provide evidence for teaching of leadership competencies in palliative care. We recommend that exploring, identifying, and integrating leadership competencies in palliative care are given more attention in educational curricula and in training interventions. [ABSTRACT FROM AUTHOR]

Background: The fear of taking away hope hinders clinicians' willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients. Aim: The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer. Design: This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients' understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders. Setting/participants: Adult patients with advanced solid cancers recruited across 17 oncology clinics. Results: Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36–43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations. Conclusions: Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people's hopes. [ABSTRACT FROM AUTHOR]

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Both the posttraumatic stress and the posttraumatic growth are often cited in relation to cancer. The aim of this paper is to give a review of current research in this field and briefly outline new perspective on possible connections between these concepts. The integrative approach has been presented in this review as well as new challenges and directions for future research. The basic information about ongoing QOLOPstudy on posttraumatic stress and growth in pediatric oncology patients and their families is provided in a nutshell at the end. [ABSTRACT FROM AUTHOR]

Understanding of children's death concept increases its significance in a situation of serious illness of a child or in facing a loss of a close person. Our study describes the development of child's understanding of death from four different historical perspectives - psychoanalytic, cognitive, existential, naive-biological perspective. It points out primary components of the death-concept and variables that can modify its individual development such as age, cognitive development, personal experience of a child, religiousness of a family, anxiety of a child and parents and the communication about the topic in a family. The study summarizes risk arising from different understanding of death by children and adults, indicates decreasing age of construing matured death concept by children, discusses discrepancies of provided studies and suggests further research directions. [ABSTRACT FROM AUTHOR]

In the Czech Republic more than 70,000 patients with chronic incurable diseases need palliative care each year. In 50,000 this need is manageable in the context of general palliative care, 20,000 patients would greatly benefited from specialized palliative care. Most chronically ill patients (> 60 %) died in acute or post acute inpatient health care facilities. Here s the availability and quality of palliative care varies substantially. Inpatient hospices provide end of life palliative care to less than 3000 patients each year. Outpatient and mobile specialized palliative care services are available only to a few hundreds of patients.In the year 2016 palliative care at the appropriate professional level ("state of art") is not a generally available and guaranteed within Czech health care and social system. We perceive an urgent need for the systematic development of general and specialized palliative care at the level of education, healthcare organization and the development of new health and social services.