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Polypharmacy is commonly encountered by providers caring for patients with medically complex and palliative care needs in many settings. The purpose of this quality improvement project was to measure the impact of an evidence-based educational deprescribing intervention on polypharmacy rate and provider confidence and knowledge in the nursing home. We invited providers working in 52 nursing homes to attend a 1-hour-long educational deprescribing session. Twenty-one nurse practitioners and 1 physician assistant across 11 states participated in the intervention. Provider confidence level related to deprescribing improved in all categories, with statistical significance demonstrated with both paired t test and Wilcoxon signed rank test (P <.001). The polypharmacy rate 3 months after the intervention decreased more in centers where a provider had attended the training. Additional open-ended data about experiences with and barriers to deprescribing were collected and analyzed. The findings from this quality improvement project demonstrate that an educational intervention focused on providers practicing in the nursing home setting can improve deprescribing confidence and reduce polypharmacy rates. These findings may be used to implement similar deprescribing education programs for palliative care nurses and providers that prioritize goals of care for patients living with serious illness. [ABSTRACT FROM AUTHOR]

Background: Palliative care and supportive care provided in the home for people with heart failure can improve quality of life, caregiver wellbeing and reduce healthcare costs. Identifying components of home-based palliative and supportive care in heart failure is useful to inform tailored care to people with heart failure. Aim: To identify and describe components of home-based palliative and supportive care in adults with heart failure. Design: A scoping review was undertaken in accordance with Joanna Briggs Institute guidelines. The protocol was registered prospectively with the Open Science Framework (https://doi.org/10.17605/OSF.IO/GHCME). Data sources: Embase, PubMed, CINAHL and Cochrane databases were searched from inception in May 2023 and re-run in January 2024. Original research focussed on palliative and supportive care in the home setting that included adults diagnosed with heart failure who have not undergone nor awaiting a heart transplant was included. Results: Results were extracted from 13 papers based on eight studies. The findings highlight that nurses supported by a multidisciplinary team, providing symptom management, patient and carer education and discussion of goals of care and advance care planning, facilitates home-based palliative and supportive care for people with heart failure. Conclusion: Ensuring patient and caregiver-centred care supported by a multidisciplinary team is essential to delivering home-based palliative and supportive care for people with heart failure. Further research focussed on the role of digital interventions in home-based palliative and supportive care, the composition of the multidisciplinary team and research which includes individuals across all stages of heart failure is needed. [ABSTRACT FROM AUTHOR]

Background: Adequate, balanced, and individualized nutrition, planned according to the patients' life expectancy in palliative care units, is crucial for maintaining essential functions. Aim: To determine the knowledge levels of nurses working in palliative care units regarding enteral nutrition practices and their perceptions of nutritional care quality in their units. Methods: This descriptive, cross-sectional study was conducted in 25 palliative care units located in Izmir, Türkiye, between June and September 2022. The study sample consisted of 205 nurses working in palliative care units. Data were collected using a Personal Information Form, an Enteral Nutrition Practices Knowledge Form, and the Nurses' Perceived Nutrition Care Quality Assessment Scale. The STROBE checklist was also utilized. Results: The study found that the majority of participating nurses (94.6%) were female, with 78.5% holding bachelor's degrees. The median knowledge score for enteral nutrition: 15 (range: 2–27), perceived care quality score: 36 (range: 9–45). Those with enteral nutrition training had significantly higher knowledge scores (p <.001); palliative care certificate showed no difference (p =.846). Nurses lacking nutrition counseling knowledge had lower perceived care quality scores (p =.001). Monthly tube feeding applications correlated positively with knowledge scores (r =.173, p =.013), unlike professional experience duration (p =.126) and time spent in palliative care (p =.839). Conclusion: Nurses working in the palliative care unit find the quality of nutrition care provided to patients in their clinics to be sufficient, and the level of knowledge regarding enteral nutrition is at a moderate level. However, in questions related to nursing care such as fluid requirements during enteral nutrition with enteral solutions that affect both nutritional care and medical treatment, maintaining the opening of the jejunostomy tube, and enteral drug administration, correct response rates were low. Low correct response rates on specific issues highlight a need for targeted educational interventions. [ABSTRACT FROM AUTHOR]

Background: Palliative care is defined as basic care that is provided for patients who suffer from pain and suffering due to illness. These cares are primarily provided by nurses, so their knowledge and attitude play a significant role in this area. In this study, the aim was to investigate nurses' knowledge and attitudes regarding palliative and supportive care, as well as related factors. Methods: The present study is a cross-sectional, descriptive study that was conducted on 370 nurses working in Shahid Behaeshti hospital randomly selected between February to May 2023 in Kashan, Iran. The questionnaire of demographic and professional information, knowledge and attitude was completed by the samples in the form of self-reporting. The data were analyzed using descriptive statistics, independent sample t-tests and univariate regression. Results: The mean knowledge score of nurses was 10.16 ± 2.16, and the attitude score was 55.32 ± 10.56. Knowledge scores were higher for nurses (p = 0.02), nurses with experience caring for dying patients (p = 0.002), and nurses with job satisfaction (p = 0.02). The mean attitude score among nurses who attended a palliative care training course was also higher (p = 0.03). There were several predictors of knowledge, including age, bachelor's degree, experience caring for a dying patient, being a head nurse, and job satisfaction (R2 = 0.062, Adjusted R = 0.055, p < 0.05). It was determined that work experience, experience with an ill patient, palliative care training and feeling the need to have training as predictors of attitudes towards palliative care (R2 = 0.129, Adjusted R = 0.110, p < 0.05). Conclusions: It is concluded that holding palliative care training courses and paying attention to the obstacles that prevent the implementation of this care are necessary and important in order to improve nurses' knowledge and attitudes. Significance: What is already known on this topic • Palliative care aims to reduce pain and make patients as comfortable as possible in their last days. • Globally, the need for palliative care has increased due to various factors. • Palliative care is beneficial in the early stages of diseases. What this study adds • Nurses' knowledge of palliative care is acceptable. • Nurses' attitude towards palliative care is low. • Implementation of palliative care training sessions can improve nurses' attitude towards palliative care. [ABSTRACT FROM AUTHOR]

Background: Demographic changes are leading to a rise in the demand for care services, with nursing homes (NHs) playing an increasingly important role in end-of-life care. Evidence suggests that NH residents at the end of life significantly benefit from hospice and palliative care and the implementation of advance care planning (ACP). In 2018, Germany passed a law to promote the implementation of ACP in NHs and to enable the refinancing of ACP services by the statutory health insurance funds. The present study aimed at assessing current hospice and palliative care structures, examining the implementation of ACP and identifying barriers to obtain approval for billing for ACP services under this specific legislative (§ 132 g SGB V). Methods: As a part of the "Gut-Leben" project, the present study administered a cross-sectional quantitative survey in 2023 to evaluate hospice and palliative care structures, the implementation of ACP, and barriers to ACP approval in German NHs. A questionnaire was distributed to a random sample of N = 1,369 NH managers. Responses were analyzed using descriptive statistical methods. Results: N = 330 NH managers responded to the questionnaire (24.1% response). The majority described the end-of-life care structures in their region as rather good (77.7; n = 256), and very strong collaboration was reported with general practitioners (54.7%), physiotherapists (42.9%), and palliative care physicians (38.6%). Awareness of the legislative for ACP was reported by n = 201 NHs (64.4%), and 100 (50.3%) of these NHs had already obtained approval. The primary barriers to approval identified by 68 NHs included a lack of available staff (48.5%; n = 33) and a small facility size (27.9%; n = 19). Conclusions: Although half of the NHs have implemented ACP, there is still a need to enhance awareness of the ACP legislative. These efforts should aim to reduce the existing barriers to approval, which could be achieved, for instance, by fostering collaboration between NHs or by cooperating with external ACP service providers. [ABSTRACT FROM AUTHOR]

Background: With burnout rates highly prevalent in palliative care nurses, it is important to have a holistic understanding of the causes of burnout and strategies both to prevent burnout and to cope with burnout. Aim: To understand the causes of burnout and strategies used to prevent and cope with burnout in palliative care nurses. This would allow the implementation of strategies on a personal level and organisational level to mitigate the effects of burnout. Methods: A thematic analysis to explore palliative care nurses' experiences and their interpretations. In total, 11 in-depth interviews and one focus group discussion with 19 nurses were conducted. The study participants were recruited from three palliative care units within a health cluster in Singapore and had at least 1 year of experience working in palliative care. Results: Five themes were identified: (a) description of burnout and its attributes; (b) factors that contribute to burnout; (c) triggers that initiate burnout; (d) coping with burnout; and (e) resilience to burnout. The nurses were competent in recognising signs of burnout and understood the use of coping strategies to manage burnout. They were also able to develop resilience to burnout through meaning-making and personal experiences. Significance of results: Helping palliative nurses find a deep purpose in their work builds resilience. Managers, organisation leaders, researchers and peers should look into ways to increase resilience in this group of nurses. [ABSTRACT FROM AUTHOR]

Primary palliative nursing in home health care (HHC) can be delivered to medically complex patients across the lifespan. Primary palliative nursing provides patient- and family-centered care for serious illness by alleviating the stress and symptoms of illness; coordinating care; and supporting the social, cultural, and psychological aspects of care. In this article, two case scenarios of patients in different phases of life serve as examples of primary palliative nursing in HHC. Key elements and challenges of delivering primary palliative nursing care in HHC are also highlighted. The authors discuss the key elements and challenges of primary palliative nursing in the home health care setting and offer two case scenarios of patients receiving such care. [ABSTRACT FROM AUTHOR]

This study explored nurses' experience of "good nursing care" in the context of caring for terminally ill and end-of-life patients, providing a foundation for improving patient care. Methods: We employed a qualitative research approach, integrating both inductive and deductive analysis methods. Data collection occurred from May 1 to August 1, 2023, involving nine nurses from intensive care units, hospice and palliative care wards, and nursing homes. All participants had at least two years of experience in caring for terminally ill and end-of-life patients. Data were collected through individual in-depth interviews and analyzed using Colaizzi's six-stage phenomenological method for inductive analysis, and a deductive method based on four taxonomies: client domain, client-nurse domain, practice domain, and environment domain. Results: A total of 172 meaningful statements were derived, with five themes and 57 (33.14%) statements in the client-nurse domain, including three phenomena (contact, communication, and interaction); eight themes and 91 (52.91%) statements in the practice domain, including three phenomena (mentalistic, enactment, and role related phenomenon); and five themes and 24 (13.95%) statements in the environmental domain, including three phenomena (physical, social, and symbolic). Conclusion: The 18 themes of good nursing care, as conceived and experienced by nurses who cared for terminally ill and end-of-life patients, underscore the importance of attentive nursing care. [ABSTRACT FROM AUTHOR]

Background: Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding end-of-life care and its consequential impacts. Research objectives: To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design: A qualitative descriptive approach was employed. Participants and research context: Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations: We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings: The moral distress-inducing factors and nurses' perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions: End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. [ABSTRACT FROM AUTHOR]

Introduction: This qualitative literature review explored the intersection of art, creativity, and the nurse–patient relationship in the context of oncology nursing. It delved into the perceptions and reflections of nurses as captured by Generative Artificial Intelligence (GAI) analysis from two specialized nursing databases. Methods: The protocol was registered on the Open Science Framework (OSF) Platform. A comprehensive search was conducted in CINAHL, the British Nursing Database, and the Nursing & Allied Health Database, using keywords related to art, cancer, creativity, nursing, and relationships. The extracted qualitative research studies were then analyzed using GAI to identify key themes and insights. Results: The analysis revealed profound considerations regarding the role of nurses in oncology and palliative patient care. Nurses acknowledged the spiritual dimension through religious and spiritual practices, while emphasizing authentic presence and empathic communication. They actively addressed patient concerns, adapted to challenges, and engaged in continuous professional development. The insights from the GAI interpretation underscored the significance of empathy, creativity, and artistry in nurturing meaningful nurse–patient connections. Conclusions: The GAI-enabled exploration provided valuable insights into several dimensions of care, emphasizing the importance of spiritual sensitivity, empathic communication, and ongoing professional growth. As technology and human care converge, integrating artistry into the nurse–patient relationship could enhance patient experiences, improve outcomes, and enrich the oncology nursing practice. [ABSTRACT FROM AUTHOR]

Introduction: In 2023, the German Society of Neurology published a new guideline on Parkinson's disease. An important section dealt with PD care concepts, which represent a particularly dynamic field of PD research, including their implementation in clinical practice. Parkinson's disease is the second most common age-associated neurodegenerative disease. Current estimates of the number of cases in the population describe a significant increase in prevalence in Germany by 2030 with higher proportions in rural areas, which also have a lack of sufficient PD care resources. Recommendations: In comparison with other international guidelines, which have so far mentioned palliative care and Parkinson's nurses in particular, the German S2k guideline expands the recommended concepts of PD care to include PD day clinics, inpatient complex treatment, and PD networks. Conclusion: Concepts of PD care guidelines are necessary because of the complex and rapidly evolving field of PD care provision. If applied appropriately, the potential for optimized care can be exploited and both the patient burden and the economic burden can be reduced. Given that modern care concepts have so far only been applied in a few regions, it is often impossible to generate broad evidence-based data, so that the evaluation of PD care concepts is partly dependent on expert opinion. [ABSTRACT FROM AUTHOR]

This pilot study explored the feasibility of a Forever Heart Program and the impact it has on oncology nurses' perception of the dying experience and their own compassion competence. Guided by Kubler-Ross's framework, the Forever Heart Program consists of a gemstone keepsake offered to patients and families during end-of-life care to support the grieving process. A mixed-methods approach utilized pretest/posttest design in a convenience sample of oncology nurses in an academic medical center over a 3-month period. The study collected demographics, Compassion Competence Scale scores, and qualitative responses via survey and an optional focus group. Twenty-five nurses participated in the presurvey, and 14 participated in the postsurvey. Seven nurses attended the focus groups. Overall, compassion competence scores were high, both pre and post. Qualitative themes included appreciation, connection, positive nursing, patient and family experience/relationships, grieving guidance, program benefits, and process opportunities. Although the study did not show statistically significant differences in compassion, it did show program feasibility and the potential positive impact that keepsakes like the Forever Heart Program can have on nurses and their role in the dying experience. [ABSTRACT FROM AUTHOR]

The demand for palliative and end-of-life nursing is increasing with the aging US population. The American Association of Colleges of Nursing published recommendations for incorporating palliative and end-of-life care across nursing curriculum to prepare the future workforce. However, recommendations regarding teaching end-of-life content are limited. This project aimed to integrate and evaluate the outcomes of end-of-life education introduced in a prelicensure nursing program. Using a documentary created by the American Nurses Foundation, students had the opportunity to discuss common themes in end-of-life care, practice morgue care in the simulation laboratory, and practice reflective journaling. The students' preevaluations and postevaluations indicated that the educational program significantly increased their confidence in providing end-of-life care and support to patients and families, demonstrating the importance of end-of-life curricula in nursing school. [ABSTRACT FROM AUTHOR]

The evolving legal landscape associated with medical assistance in dying (MAiD) may pose significant challenges for hospice and palliative care professionals. In the United States, 10 states and 1 jurisdiction have passed legislation allowing MAiD. National organizations, such as the Hospice and Palliative Nurses Association, have created position statements to serve as guides to care. Given the clinical and ethical challenges associated with MAiD, a rapid review was conducted to provide current evidence for policymakers, health care professionals, and researchers to use when considering care management and policy initiatives. Using a systematic approach, publications related to MAiD between 2019 and 2024 were extracted and synthesized. The review provides definitions of terms that differentiate between MAiD, euthanasia, physician-assisted suicide, medically assisted death of the nonterminal patient, and death with dignity. A total of 23 articles were included in the review and categorized into 4 themes: (1) legal, regulatory, and policy concerns; (2) health care professional experience ofMAiD; (3) patient and caregiver experience of and communication about MAiD; and (4) disparate access to MAiD. [ABSTRACT FROM AUTHOR]

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Background/Objectives: Access to palliative care is an urgent global need. Countries with the greatest palliative care needs have limited access. In Cameroon, demand for palliative care is growing due to the rising incidence of life-limiting conditions. Identifying available palliative care services and programs could provide an understanding of access gaps and inform future roadmaps for palliative care development in the country. We aim to map available palliative care services, identify gaps and inform recommendations to promote early access to palliative care in Cameroon. Methods: We undertook a literature review of articles reporting any aspects of palliative care in Cameroon. We searched Embase, MEDLINE, Scopus, PsycINFO, CINAHL, PubMed and gray literature. Data were analyzed thematically using the World Health Organization model for the assessment of palliative care development. Results: We identified 41 articles reporting 21 organizations with some form of palliative care services such as clinical services, education, advocacy and research. These were led mostly by individual health care providers or private and faith-based organizations. Major palliative care initiatives included training in the form of workshops, and adult and pediatric outpatient, in-patient and community-based palliative care. There were few reports of oral morphine production, community engagement, advocacy and palliative care research. Conclusions: Progress in palliative care development was reported in five regions of Cameroon over the last two decades. Findings suggest the need for an intersectoral approach including government, community, and health care stakeholders to achieve sustainable palliative care. This could potentially ensure equitable access to palliative care in Cameroon. [ABSTRACT FROM AUTHOR]

Background: Palliative care is required for a wide range of diseases. In order to promote the wider use of research results, clinical protocols, guidelines on best practices in palliative care, we need more scientific data. However, there are difficulties in applying an evidence-based approach to palliative care. The low level of adoption of evidence-based practice among palliative care nurses is a global problem, since nurses are the most numerous providers of medical services. The inability of nurses to follow new scientific data can negatively affect the quality of life of patients. Material and methods: The authors searched for scientific articles in English and Russian published till 2013 in the PubMed, Scopus, EBSCOhost, and Wiley databases. The study was conducted from June to September 2023. Forty-three publications were selected for the literature review. Results: The goal of evidence-based palliative care practice is to provide effective care to patients using available resources. Analysis of the level of knowledge and skills of nurses in evidencebased practice showed that nurses have low competence in evidence-based medicine. Although the level of education and work experience have a positive correlation. Administrators of medical organizations are not ready for changes in practice. Often nurses themselves do not have a sufficient level of competence in evidence-based practice. Funding and low human resources also significantly complicate scientific activities in the field of palliative care. However, existing studies demonstrate the positive impact of scientific data to improve the quality of life of seriously ill patients. Conclusion: At this stage of development of palliative care in many countries there is an urgent need for scientific research in the field of palliative care. Unwillingness to change, insufficient funding, low human resources, lack of knowledge entail difficulties in implementing a scientific approach. Solving the identified problems will improve the quality of palliative nursing care. Further research is needed to determine the best method for the successful implementation of evidence-based practice in nursing practice. [ABSTRACT FROM AUTHOR]

With cancer now the leading cause of death, the importance of palliative care importance is increasingly evident. However, the focus of current policies is on inpatient and home-based care, which neglects the specialized needs of outpatients and results in many not receiving timely palliative care. Integrating palliative care into outpatient clinics using standardized referral criteria and automated systems will allow for timely patient selection and intervention, early symptom management, and psychological support as well as promote patient autonomy in treatment decision-making. Specialized oncology palliative care nurses play a crucial role in related assessment, care planning, and implementation activities. They help patients and families cope with disease progression and end-oflife care through education and support. Early outpatient palliative care benefits many patients and families, realizing a holistic and comprehensive care model. [ABSTRACT FROM AUTHOR]

Background: Nurses occupy a pivotal role in the provision of palliative care, acting as frontline providers who address the physical, emotional, social, and spiritual needs of patients. The complexities inherent in palliative care frequently give rise to ethical dilemmas that significantly impact nurses' decision-making and patient interactions. It is therefore essential to gain an understanding of nurses' perceptions of ethical issues, quality of life, and adherence to patient rights in order to enhance the care delivered in these settings. Aim: This study aims to assess the ethical issues encountered by nurses in palliative care, evaluate their quality of life, and measure their understanding and adherence to patient rights. Methods: A quantitative cross-sectional survey was conducted among a sample of 85 nurses working in palliative care settings, specifically within the Oncology Department and Pain Clinic at a Specialized Hospital in Egypt. A stratified random sampling technique was employed. The data were collected using standardised questionnaires, including the Ethical Issues Scale (EIS), the Nursing Quality of Life Scale (NQOLS), and the Patient Rights Questionnaire (PRQ). The validity and reliability of these instruments were established prior to the commencement of the study. The collected data were subjected to mean and standard deviation (SD) calculations. Statistical analyses, including the calculation of Pearson correlation coefficients, were conducted. Results: The study sample comprised a diverse cohort of nurses, with a mean age of 40 years. The ethical issues were evaluated, yielding a mean score of 4.03 (SD = 0.74) on the EIS, with the highest score for "Patient Care" (M = 4.2, SD = 0.7). The overall quality of life mean score was 6.75, with the working dimension exhibiting the highest mean score at 7.1. The PRQ results indicated a high level of awareness regarding patient rights, with a total mean score of 49.5 (SD = 6.8). The results of the correlation analysis indicated a moderate positive correlation between ethical issues and patient rights (r = 0.52, p < 0.01), and ethical issues and quality of life (r = 0.45, p < 0.01). Conversely, a weaker correlation was found between quality of life and patient rights (r = 0.40, p < 0.05). Conclusions: The findings elucidate the ethical challenges confronted by nurses in palliative care and their ramifications for the quality of life and adherence to patient rights. It is imperative that nurses engaged in palliative care undergo continuous education and training in order to enhance their ethical decision-making abilities and thereby improve the quality of care they provide. Recommendations: It is imperative that strategies be developed to support nurses in addressing ethical dilemmas, to promote awareness of patient rights, and to enhance their overall quality of life through targeted interventions and resources. Clinical trial: No clinical Trial. [ABSTRACT FROM AUTHOR]

Background: Recently, the concept of expanded terminal sedation emerged to describe using sedation at the end of life in cases beyond the usual use. Using this sedation could be a stressful ethical encounter for healthcare providers. Case: In this paper, we describe a case of a Muslim palliative care nurse who cared for a patient with cancer who requested expanded terminal sedation. The palliative care nurse described that his initial response to the expanded terminal sedation order was refusing to start the sedation because he believed the patient was not terminally ill and was concerned about killing him, which is prohibited according to his religious beliefs. Further, the nurse perceived the patient's psychological distress and his verbalization of wishing to die peacefully as a concealed request for euthanasia, especially since he was not imminently dying. Finally, the nurse reported being frustrated and uncertain about the care, especially since he did not receive appropriate psychological counseling from professional personnel. Conclusions: any case beyond the usual conditions for terminal sedation should be carefully examined, especially when nurses' religious beliefs or moral values contradict it. If sedation should be administered, adequate preparation of healthcare providers should be arranged, including discussing with them the goals of care and the rationale for sedation before and after initiating it. Generating a policy for conscientious objections, allowing nurses to express their own emotions and concerns in a supportive environment are suggested approaches to preserve their wellness. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Method Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution To explore healthcare workers' experiences of end of life care for people with an intellectual disability.A descriptive qualitative study.Semi‐structured interviews were conducted with 28 healthcare workers who cared for older people with an intellectual disability at their end of life. Data were analysed using thematic analysis and reported according to the COREQ guidelines.Three major themes emerged: not joining up the dots, living the life desired in one's last days and dealing with death and beyond.Gaps emerged in the care of the person with intellectual disability. Pain assessment and pain management were particular challenges. End of life care was not always effectively planned, and earlier intervention, including end of life conversations, were needed. More needs to be done in terms of education for healthcare workers, and especially those in the acute care setting and palliative care services who may be unfamiliar with the needs of this cohort.There is little consensus or understanding about the palliative care needs of those with intellectual disability. There are often specific challenges around providing palliative care particularly in relation to healthcare staffs' knowledge and confidence in understanding palliative care needs of this group and indeed communicating and assessing particular needs. Staff require educational preparation and training in palliative care to address the particular needs of this cohort.This study revealed that there are gaps emerging in the care of the person with intellectual disability at the end of life. Pain assessment and pain management are particular challenges that require urgent attention.There was no patient or publication contribution in this specific study, although IDS‐TILDA has a client representative and advisory committee that advise on all aspects of project design and management. [ABSTRACT FROM AUTHOR]

Purpose: This descriptive survey was conducted to identify the factors influencing nurses’ end-of-life nursing attitudes, particularly focusing on spiritual well-being and death awareness among nurses in internal medicine and surgical departments. Methods: In total, 176 nurses from five medical centers in Korea completed a structured questionnaire. Data were collected on nurses’ general characteristics, end-of-life nursing attitudes, spiritual well-being, and awareness of death. Multiple regression analysis was conducted to examine the factors affecting nurses’ end-of-life nursing attitudes. Results: A significant difference in end-of-life nursing attitudes was observed according to the nursing department. Nurses in the internal medicine sector (wards and intensive care units) demonstrated significantly better end-of-life nursing attitudes than those in the surgical sector (surgical intensive care units). Death awareness exhibited a significant positive association with end-of-life nursing attitudes. The factors influencing nurses’ end-of-life nursing attitudes included a higher level of death awareness, and working in an internal medicine ward as opposed to a surgical intensive care unit. Conclusion: Nurses working in internal medicine wards exhibited higher levels of end-of-life nursing attitudes, indicating the need to develop specialized training programs in end-of-life care for surgical departments. In addition, it is necessary to improve nurses’ death awareness. [ABSTRACT FROM AUTHOR]

Background: The Law of 2 February 2016 creating new rights for the sick and people at the end of life, Law called Claeys-Leonetti consecrates the deep sedation and continues maintained until death. The wish of the majority of French people is to favour death at home but this requires prerequisites and organizational requirements to ensure a quality palliative approach. Objective: Determine if the recommendations have been applied during the implementation of deep and continuous sedation maintained until death at home and identify the barriers to the application of these recommendations. Methods: Observational, descriptive study, carried out by directed questionnaire, among general practitioners and liberal nurses who contributed to the implementation at home of a deep and continuous sedation maintained until death between 2016 and 2019, supported by the ARPEGE Palliative Care Network. The questionnaire was submitted to General Practitioners and Liberal Nurses from June to October 2022 via hetero-telephone exchange. The evaluation was carried out on ten criteria defining the quality of the performance of sedation. Results: We collected 26 testimonies of sedation. On average, 7.6 criteria were followed out of the ten studied. The provisions of the law are relatively well applied, particularly as regards the designation of a trusted person, the information received by the patient, and the initiation of sedation by a nurse in the presence of a doctor. However, the lack of availability and foresight on the part of healthcare professionals has sometimes led to difficulties. Conclusion: To ensure a quality palliative approach, health professionals must be trained in palliative culture, family members must be informed and accompanied, and the expertise of palliative care team is fundamental. It is essential to anticipate end-of-life situations. This helps to ensure quality palliative care at home. [ABSTRACT FROM AUTHOR]

Patients receiving inpatient palliative care often face physical and psychological uncertainties during transitions out of the hospital. Family caregivers often take on responsibilities to ensure patient safety, quality of care, and extend palliative care principles, but often without support or training, potentially compromising their health and well-being. This study tested an eight-week intervention using video visits between palliative care nurse interventionists and caregivers to assess changes in caregiver outcomes and patient quality of life. This randomized controlled trial, conducted from 2018 to 2022, enrolled adult caregivers in rural or medically underserved areas in Minnesota, Wisconsin, and Iowa. Eligible caregivers included those caring for patients who received inpatient palliative care and transitioned out of the hospital. The intervention group received teaching, guidance, and counseling from a palliative care nurse before and for eight weeks after hospital discharge. The control group received monthly phone calls but no intervention. Caregiver outcomes included changes in depression, burden, and quality of life, and patient quality of life, as reported by the caregiver. Of those consented, 183 completed the intervention, and 184 completed the control arm; 158 participants had complete baseline and eight-week data. In unadjusted analyses, the intervention group and their care recipients showed statistically significant improvements in quality of life compared to the control group. Improvements persisted in adjusted analyses, and depression significantly improved. No differences in caregiver burden were observed. Addressing rural caregivers' needs during transitions in care can enhance caregiver outcomes and improve patient quality of life. [ABSTRACT FROM AUTHOR]

Background: The need for nurses to provide high-quality palliative care in clinical settings is increasing with the expansion of the need for palliative care. This study aimed to identify the degree of willingness to provide palliative care among nurses in Korea, and to explore factors that influence this willingness. Methods: Participants were 160 nurses employed in five general hospitals in South Korea, with a clinical career of over one year. Data were collected using an online questionnaire between January and February 2023, that assessed nurses' knowledge and perception of palliative care, meaning of life, compassion competence, and degree of willingness to provide palliative care. Differences in willingness to provide palliative care based on general characteristics were analysed using an independent t-test and one-way analysis of variance. Correlations between the research variables and willingness to provide palliative care were analysed using Pearson's correlation coefficients. Hierarchical regression was conducted to explore the factors affecting willingness to palliative care. Results: The degree of willingness to provide palliative care among nurses was 74.43 ± 9.73 (Range 50–100). In the final model, it was found that the willingness to palliative care was affected in the order of: compassion competence (β = 0.48, p <.001), perception of palliative care (β = 0.18, p =.005), and clinical experience (β = 0.15, p =.026). The explanatory power of the model was 41.4% (F = 17.01; p <.001). Conclusions: Perceptions of palliative care, clinical experience, and compassion competence were identified as factors influencing nurses' willingness to provide palliative care. Based on this study, it is necessary to provide education and training that includes content that can increase nurses' awareness of palliative care and improve their compassion competence to promote their willingness to provide palliative care. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim(s) Design Methods Results Conclusion Implication for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution The aim of this study is to examine the association between modifiable structural and process factors and self‐reported as well as observed pain in Swiss residential long‐term care residents.Sub‐study of a multicentre cross‐sectional survey.Institution, unit, and staff data were collected from September 2018 to October 2019 in 118 residential long‐term care institutions in Switzerland's German‐ and French‐speaking regions using paper questionnaires. Resident data were exported during the same period from routine data sets.In this study, 6213 residents from 86 residential long‐term care institutions were included. Modifiable structural factors such as institutions having access to geriatricians, nursing experts and a palliative care team, the presence of a pain guideline on the unit and good teamwork among care workers were associated to less pain in residents.It is possible for residential long‐term care institutions to improve pain in residents and to optimise the quality of care by providing access to geriatricians, nursing experts and a palliative care team, working with a pain guideline and fostering teamwork.Residential long‐term care institutions can modify and implement modifiable structural factors which can reduce pain in residents to optimise residents' quality of life and quality of care.Improved pain management in residential long‐term care institutions can lead to optimised quality of care and quality of life for individual residents.STROBE checklist.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of leadership competence potential in palliative care nursing is a relatively underexplored aspect. The results presented in the paper demonstrate how challenging it is to investigate this issue, yet how crucial it is for palliative care organizations and the entire healthcare system. Design/methodology/approach: The study involved nurses working in entities providing palliative and hospice care from 12 provinces. A diagnostic survey method was used in the study, which guided the selection criterion for the survey technique. Findings: Leadership competencies among palliative care nurses need to be further developed, especially in the context of changing healthcare requirements and challenges. Actions aimed at strengthening them are a particularly important aspect of nurses' professional development. Research limitations/implications: Leadership as a dynamic and continuous process is observed among the professional group of nurses, which presents both a challenge and underscores the necessity of support and further development to enhance palliative care provision. Research conducted as part of the work can serve as a stimulus to conduct it on a larger sample of respondents to make it more representative. Practical implications: Leadership competencies among palliative care nurses need to be further developed, especially in the context of evolving healthcare demands and challenges. Actions aimed at strengthening these competencies are a crucial aspect of nurses' professional development. In palliative care, prepared interdisciplinary teams that understand their roles and competencies, and collaborate effectively, will play a key role. Social implications: Demographic and epidemiological changes, as well as the necessity to invest in human resources, contribute to the dynamic development of nursing globally and in Poland. This growth primarily involves the allocation of new competencies and professional rights. Unlike some professions, nursing belongs to a field characterized by diverse competencies and skills that evolve depending on postgraduate education completed. Originality/value: The article addresses an extremely important topic, demonstrating the significance of developing leadership competencies among palliative care nurses. It presents both leadership potential, self-assessment, and the need for developing specific skills. The article can serve as a guide on how to better manage human resources in palliative care facilities. [ABSTRACT FROM AUTHOR]

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Background: Palliative care provided to frail and dying older persons in nursing homes results in intense emotions for residents and their relatives as well as for healthcare professionals. In France, scant attention has been given to how nursing home professionals manage their emotions when providing palliative care. This study analysed the emotional demands of providing palliative care in the nursing home context, the emotional strategies used by healthcare professionals to navigate such demands, and how these demands affect their emotional wellbeing. Methods: This qualitative study used a multiple case study approach. We purposively selected nine nursing homes from three geographical provinces in France with diverse ownership statuses (public, private, associative). Individual interviews and focus group discussions were held with 93 healthcare professionals from various occupational groups employed in the participating nursing homes. Data was collected from April 2021 to September 2022 and was analysed using thematic content analysis. Results: Data revealed that providing palliative care to dying residents within the nursing home context results in intertwined rewarding and exhausting emotional experiences for healthcare professionals. Professionals have to utilize multifaceted emotional strategies to navigate these experiences, including suppressing and modifying emotions and distancing themselves emotionally from residents to protect themselves from emotional suffering. Participants noted a lack of formal space to express emotions. Unrecognized emotional labour undermines the wellbeing of healthcare professionals in nursing homes, whereas acknowledging emotions enhances satisfaction and gives enhanced meaning to their crucial role in resident care. Conclusion: Acknowledging emotional labour as an inevitable component of providing palliative care in nursing homes is critical to supporting healthcare professional wellbeing, resilience, and retention, which may ultimately improve the quality of care for dying residents. Ensuring quality care and supporting the emotional wellbeing of nursing home professionals requires an organisational culture that considers emotional expression a collective strength-building resource rather than an individual responsibility, in hopes of shaping a new culture that fully acknowledges their humanity alongside their professional skills. Trial registration: ClinicalTrials.gov ID: NCT04708002; National registration: ID-RCB number: 2020-A01832-37, Registration date: 2020-12-03. [ABSTRACT FROM AUTHOR]

Background: Chronic, non-malignant diseases (CNMD) like chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and dementia in advanced stages are very burdensome for patients. Timely palliative care with strong collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams can reduce symptom burden, hospitalization rates, hospitalization costs and overall healthcare costs. The KOPAL-study on strengthening interprofessional collaboration for patients with palliative care needs tested the effect of an intervention comprising of a SPHC nurse assessment and an interprofessional case conference. This qualitative evaluative study explores patients', proxies' and their associates' motivation to participate in the KOPAL-study and views on the (benefits of the) intervention. Methods: We interviewed 13 male and 10 female patients as well as 14 proxies of patients with dementia and six associates of study participants using a semi-structured interview guide. All interviews were digitally recorded, transcribed verbatim and analysed with deductive-inductive qualitative content analysis. Results: Motivation for participation was driven by curiosity, the aim to please the GP or to support research, respectively to help other patients. Few interviewees pointed out to have expected positive effects for themselves. The nurse visit was evaluated very positively. Positive changes concerning health care or quality of life were reported sparsely. Most study participants did not prepare for the SPHC nurse assessment. They had no expectations concerning potential benefits of such an assessment, the interdisciplinary case conference and an early integration of palliative care. The majority of interviewees reported that they did not talk about the nurse visit and the interprofessional case conference with their GPs. Conclusion: Our results lead to the conclusion that SPHC nurses can serve as an advocate for the patient and thereby support the patients' autonomy. GPs should actively discuss the results of the interdisciplinary case conference with patients and collaboratively decide on further actions. Patient participation in the interdisciplinary case conference could be another way to increase the effects of the intervention by empowering patients to not just passively receive the intervention. Trial registration: DRKS00017795 German Clinical Trials Register, 17Nov2021, version 05. [ABSTRACT FROM AUTHOR]

Background: The district nurse is identified as a keyworker in community based palliative care. However, a dearth of research exists on trainees' views and understanding of adopting the role upon qualification. Aims: The aim of this study was to explore the understanding and perceptions of district nurse trainees in relation to the palliative care key worker role. Methods: Data was gathered via online semi-structured interviews (n=10) and the results were analysed using a thematic model. Findings: The four evolving themes included: understanding of the palliative care key worker role scope and function; the level of preparation for the role; a juggling act and embedding the role in practice. Conclusion: The themes highlighted various drivers and barriers that reflect a degree of incongruence with policy and practice. Recommendations to standardise the palliative care key worker role, underpinned by formal preparation and clearly defined responsibilities may enhance future development and implementation of the role. [ABSTRACT FROM AUTHOR]

Background: End-of-life care pertains to the healthcare and assistance that patients have when confronted with a life-threatening disease. Many medical personnel in Iraq are still uninformed about and undertrained in handling the EOL issue, despite the country's growing need for EOL treatment. The study aim to assess the direction of nurses' attitude regarding care of dying patients at oncology centers, examine the relationships between nurse's attitude and demographic variables. Materials and Methods: A cross-sectional design was conducted on Iraqi nurses in Middle Euphrates at three centers (N =150). Data analysis included descriptive statistics and Kruskal-Wallis H, Mann-Whitney U analysis. Results: shows that the total mean score for nurses attitudes was positive (93.39 (SD ±30.28), analysis reveals it is evident that there are statistically significant differences between those who are provided care for dying patients or not in terms of their attitude (p= 0.000) also nurses who attended educational session had significant differences than not attended. Therefore, end-of-life care education is necessary for nurses. [ABSTRACT FROM AUTHOR]

Background; End-of-life care pertains to the healthcare and assistance that patients have when confronted with a life-threatening disease. Many medical personnel in Iraq are still uninformed about and undertrained in handling the EOL issue, despite the country's growing need for EOL treatment. Objectives of the study were to assess the nurses' knowledge regarding care of dying patients at oncology centers, examine the relationships between nurse's attitude and demographic variables. Methodology: A cross-sectional design was conducted on Iraqi nurses in Middle Euphrates at three centers (N=150). The results shows moderate mean score for nurses knowledge in these area. Analysis reveals it is evident that there are statistically significant differences among various education levels in terms of their knowledge (p=0.000) and a statistically significant distinction among nurses with varying years of experience in the oncology unit regarding their knowledge (p = 0.000).Therefore, end-of-life care education is necessary for nurses, and palliative care education on clinical skills and the shortcomings of effective care delivery need to receive greater attention. Include palliative education in the basic nursing curriculum as well. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the validity and reliability of the "Spirituality in Palliative Care Scale" among nurses in Türkiye. Methods: The study was carried out with a methodological design. The study population consisted of nurses working in internal medicine and surgical clinics at a training and research hospital located in the western part of Türkiye between November 15, 2022, and April 12, 2023. The data for the study were collected through face-to-face interviews with nurses during their weekday break times in the clinics they worked. Results: Considering the opinions of the experts, the content validity indices of the scale items ranged between 0.88 and 1.00. As a result of the factor analysis, the number of items in the scale decreased from twelve to eight. The total variance explanatory value of the acceptance and spiritual nursing behaviors subscale was 35.010%, that of the ability to be mindful subscale was 30.783%, and that of the Spirituality in Palliative Care Scale was 65.792%. The factor loadings of the scale items ranged from 0.636 to 0.852. The Cronbach's alpha coefficient for the scale with eight items was found to be 0.851, for the ability to be mindful subscale was 0.728, and for the acceptance and spiritual nursing behaviors subscale was 0.843. Conclusion: It was determined that the Turkish version of the Spirituality in Palliative Care Scale met the validity and reliability criteria at an acceptable- level. The scale, which has an important place in the evaluation of Spirituality in Palliative Care, can be used in clinical studies. [ABSTRACT FROM AUTHOR]

Background: Palliative care provides holistic support, addressing physical, psychological, social, emotional, and spiritual dimensions of suffering, known as "total pain", to improve patients' quality of life. Patients often rely on healthcare professionals, particularly nurses, for support. This study aimed to develop and validate questionnaires assessing nurses' perceptions of psychological, social, and spiritual issues in palliative care and their effectiveness in managing them. Methods: Two self-rated questionnaires were created: the Psychological, Social, and Spiritual Problems of Palliative Patients' Questionnaire and the Effectiveness in Coping with the Psychological, Social, and Spiritual Challenges of Palliative Care Patients. The study surveyed 237 nurses caring for palliative patients in Split Dalmatian County, Croatia. Results: The questionnaires demonstrated high reliability with Cronbach's α values of 0.98 and 0.99. Factor analysis revealed four factors for the first questionnaire and three for the second. Nurses primarily perceived patients as experiencing fear and emotional/spiritual suffering, with the greatest difficulty coping with the fear of the disease outcomes. Nurses acknowledged the need for improvement in addressing patient challenges, highlighting gaps in the Croatian system. Conclusions: Ongoing efforts are crucial to prioritize palliative care globally, with nursing professionals playing a vital role in symptom management. [ABSTRACT FROM AUTHOR]

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The editorial discusses the importance of developing holistic healthcare practitioners who prioritize patient well-being by addressing physical, emotional, social, and spiritual needs. Strategies include integrating knowledge across disciplines, cultivating empathy and compassion, promoting patient-centered care, and emphasizing self-care and well-being for practitioners. Recognizing cultural diversity and addressing skills gaps are also crucial in delivering inclusive and comprehensive care. The editorial highlights the significance of resilience, empathy, and self-care in enhancing patient outcomes and fostering a culture of respect and trust in healthcare. [Extracted from the article]

Background: The provision of high-quality palliative care is important to nursing practice. However, caring for palliative care patients and their families is challenging within a complex everchanging health environment. Nonetheless the caring, artistic role of the nurse is fundamental to the care of the patient and family. However, this role is currently being overshadowed by the technical and scientific elements of nursing. Methods: A scoping review was conducted utilising Arksey and O'Malley's framework to identify the role and contribution of nurses in caring for patients with palliative care needs. An open time period search of eight electronic databases (MEDLINE, CINAHL, Academic Search Complete, PsycINFO, EMBASE, Web of Science, Scopus and Cochrane Library) was conducted on the 8th of March 2023 and updated on the 30th of April 2024. Screening was performed independently by two reviewers against eligibility criteria with meetings between authors to discuss included papers and form a consensus. Data was extracted relating to palliative care nursing, methodology, key findings, and recommendations. The analysed and summarised data was mapped onto Oldland et al seven domains framework: (a) medical/nursing and technical competence, (b) person centred care, (c) positive interpersonal behaviours, (d) clinical leadership and governance, (e) promotion of safety, (f) management of the environment, and (g) evidence-based practice. Results: Fifty-five papers met the criteria for this review which describes the role and contribution of nurses in caring for palliative patients across all domains of professional practice. The review found the leading areas of nurse contribution were person centred, interpersonal and nursing care aspects, with leadership, managing the environment, patient safety and evidence-based practice evident but scoring lower. The contribution of the nurse in palliative care supports a biopsychosocial-educational approach to addressing the physical, emotional and social needs of patients with palliative care needs and their families across the care continuum. Conclusion: Nurses in palliative care engage in a wide range of roles and responsibilities in caring for patients and their families with palliative care needs. However, there remains minimal evidence on the assessment, intervention, and evaluation strategies used by nurses to highlight the importance of their role in caring for patients and their families in this area. The findings of this review suggest that the artistic element of nursing care is being diluted and further research with a focus on evidencing the professional competence and artistic role of the nurse in the provision of palliative care is required. In addition, research is recommended that will highlight the impact of this care on patient and family care outcomes and experiences. [ABSTRACT FROM AUTHOR]

Background: Innovative small-scale facilities for dementia focus on providing quality of life and maintaining the functional abilities of residents while offering residents a home for life. To fulfill the home-for-life principle, palliative care approaches are necessary to maintain quality of life in these facilities. Few studies have reported on how palliative care is provided to residents in small-scale facilities. The aim of our review is to determine the extent to which palliative care approaches are reported in small-scale facilities. Methods: A scoping review of the literature using recommended methods from the Joanna Briggs Institute. Four databases, CINAHL, PubMed, PsycINFO, and Web of Science, were searched for studies published from 1995 to 2023. One reviewer completed the title, abstract and full-text screening and data extraction; two additional team members piloted the screening and extraction process and met with the main reviewer to make decisions about article inclusion and ensure consistency and accuracy in the review process. The extracted data was open-coded and analyzed using thematic analysis. The data was then synthesized into themes using palliative care domains for dementia. Results: Of the 800 articles obtained in the search, only ten met the inclusion criteria: six from Japan, two from the Netherlands, and one each from Austria and the United States. In most small-scale facilities, palliative care is important, with facilities prioritizing family involvement and person-centred care, minimizing resident discomfort and enhancing residents' remaining abilities until the end of life. The included studies did not discuss palliative care policies or professional staff training in depth. Conclusions: This study provides an overview of the literature on palliative care in small-scale facilities for individuals with dementia. Most facilities focus on residents' wishes at the end of life to enhance comfort and provide a home-like environment. However, more research is needed to further understand the quality of palliative care approaches in these homes. [ABSTRACT FROM AUTHOR]

AbstractThrough a mixed-methods approach (randomized controlled trial and thematic analysis of pre and post-service-learning reflections), this study evaluated the impact of a student death doula service-learning experience on nursing students’ palliative competencies and learning experiences. The intervention group underwent a 2-day student death doula training workshop followed by a 6-month service-learning experience, while the control group received standard palliative care education. Attitudes toward the care of the dying significantly improved for the intervention group but not for compassion competence and palliative care knowledge. Six themes were developed: (1) Motivations for being a student death doula, (2) Improved perceptions of palliative care patients, (3) Perceptions of a good death, (4) Confidence in caring for palliative care patients, (5) Understanding the multifaceted nature of palliative care, and (6) Joys and challenges during service-learning. Service-learning helped students to understand palliative care patients and acquire confidence in engaging with them. [ABSTRACT FROM AUTHOR]

Background: Nurses working in palliative and end-of-life care settings face significant emotional challenges due to the demanding nature of their profession. This study aimed to explore the emotional resilience of these nurses, understanding the factors that contribute to their resilience, the impact on their professional well-being and performance, and strategies to enhance resilience. Methods: A qualitative study was conducted involving 15 registered nurses from various healthcare facilities in Riyadh, Saudi Arabia. Data were collected through semi-structured interviews, document analysis, and observational data. Thematic analysis was employed to identify recurring themes. Results: The study identified three key themes: Emotional Challenges and Resilience-Building, Support Systems and Resources for Resilience, and Professional Growth and Fulfillment as Resilience Factors. The findings revealed the emotional toll of patient suffering, highlighting resilience-building strategies, such as peer support, mindfulness, and reflective practices. Support systems, including workplace support, organizational resources, and mentorship, were identified as crucial for fostering resilience. Professional growth, a sense of purpose, and recognition emerged as factors contributing to resilience. Conclusions: This study underscores the importance of emotional resilience for nurses in palliative and end-of-life care settings. Healthcare organizations can enhance resilience by implementing resilience training, providing counseling services, fostering a supportive culture, and offering professional development opportunities. Addressing the emotional needs of nurses is vital for their well-being and the delivery of compassionate care. [ABSTRACT FROM AUTHOR]

Introduction: Nursing home residents often have life limiting illnesses in combination with multiple comorbidities, cognitive deficits, and frailty. Due to these complex characteristics, a high proportion of nursing home residents require palliative care. However, many do not receive palliative care relative to this need resulting in unmet care needs. To the best of our knowledge, there have been no literature reviews to synthesise the evidence on how nursing home staff identify unmet palliative care needs and to determine what guidelines, policies, and frameworks on identifying unmet palliative care needs of nursing home residents are available. Aim: The aim of this scoping review is to map and summarise the evidence on identifying unmet palliative care needs of residents in nursing homes. Methods: This scoping review will be guided by the JBI Manual for Evidence Synthesis. The search will be conducted in CINAHL, MEDLINE, Embase, Web of Science, APA PsycINFO, and APA PsycArticles. A search of grey literature will also be conducted in databases such as CareSearch, Trip, GuidelineCentral, ClinicalTrials.gov, and the National Institute for Health and Care and Excellence website. The search strategy will be developed in conjunction with an academic librarian. Piloting of the screening process will be conducted to ensure agreement among the team on the eligibility criteria. Covidence software will be used to facilitate deduplication, screening, and blind reviewing. Four reviewers will conduct title and abstract screening. Six reviewers will conduct full text screening. Any conflicts will be resolved by a reviewer not involved in the conflict. One reviewer will conduct data extraction using pre-established data extraction tables. Results will be synthesised, and a narrative synthesis will be used to illustrate the findings of this review. Data will be presented visually using tables, figures, and word clouds, as appropriate. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Delivering bad news is a sensitive and challenging aspect of nursing healthcare, requiring a holistic approach that respects patients' preferences, cultural values, and religious beliefs to promote adaptation to the person's state of health. Aim: We aim to map the evidence of the dimensions present in the communication and management of bad news by nurses to a person in a palliative situation, their caregivers, and their family members. Methods: Based on the Joanna Briggs Institute methodology, the search was conducted through MEDLINE Complete (EBSCOhost), CINAHL Complete (EBSCOhost), SciELO, and the Open Access Scientific Repository in Portugal. From a total of 756 articles, 14 were included, published between 2018 and 2023. Results: Structure components in bad news are influenced by the characteristics of the palliative patients, their caregivers, their family members, the nurses, and the organizational environment. Promoting the quality of the communication process is desirable through continuous and advanced training in end-of-life care, training in bad news, religiously and culturally sensitive nursing interventions centered on hope and maintaining faith, emotional management, and the utilization of a checklist protocol. Conclusions: Honest communication allows people to actively participate in the decision-making process and in the trajectory of the care plan that is focused on themselves and their preferences, which has outcomes in functional capacities and readaptation. [ABSTRACT FROM AUTHOR]

Purpose: This study identified the mediating effect of resilience on the relationship between job stress and the professional quality of life of hospice and palliative care nurses. Methods: The participants included 136 hospice and palliative care nurses from 13 inpatient hospice and palliative care wards at a tertiary hospital in a metropolitan city in South Korea. Data were collected from February 2022 to March 2022. Hayes' PROCESS macro 3.5 was used to test the significance of the parameter's indirect effects. Professional quality of life was divided into three subdomains: compassion satisfaction, secondary traumatic stress, and burnout. Results: As a mediator, resilience had both direct and indirect effects on the relationship between job stress and the compassion satisfaction of hospice and palliative care nurses. Furthermore, there were both direct and indirect effects on the relationship between job stress and secondary traumatic stress. Finally, although there was no direct effect on the relationship between job stress and burnout, there was an indirect mediating effect. Conclusion: This study confirmed the direct effect of compassion satisfaction on job stress and the professional quality of life of hospice and palliative care nurses, as well as the mediating effect of resilience on job stress and burnout. To improve the professional quality of life of hospice and palliative care nurses, it is necessary to develop and apply programs that enhance resilience in order to promote its mediating effects on compassion satisfaction and burnout. [ABSTRACT FROM AUTHOR]