Background: There are multiple models for integrating hospital-based palliative care into healthcare systems. Further research is needed to inform best practice palliative care provision in hospitals. Aims: To identify palliative care delivery models in hospitals. Methods: A systematic scoping review was performed by an extensive search in PubMed, EMBASE, Google Scholar, ScienceDirect and Magiran to recognise relevant publications that reported hospital-based palliative care delivery models/frameworks from 2010 to 2024. A Mixed Methods Appraisal Tool was used for quality assessment of the retrieved reports. Findings: A total 28 reports were identified that described six broad classes of hospital-based palliative care models/frameworks. The delineated models included provider-based, technology-based, element-based, issue-based, time-based and standards-based. Conclusions: This study draws on insights from hospital-based palliative care models to support decision-makers in adopting evidence-informed palliative care delivery models and frameworks, while promoting alignment between organisational missions and quality improvement strategies. Implications for practice: Findings can inform context-sensitive, evidence-informed interventions to address barriers to integrating palliative care into routine hospital services, particularly in low- and middle-income countries, and improve timely access for patients and their next of kin.
Background: Artificial intelligence has the potential to improve symptom management and enable early intervention for patients receiving chemotherapy. Aims: To review applications of artificial intelligence in oncology nursing for chemotherapy-related symptom management, focusing on benefits, challenges and future directions. Methods: A structured literature review was conducted using PubMed, Scopus and Web of Science, focusing on peer-reviewed studies from the past decade addressing artificial intelligence applications in chemotherapy symptom management. Findings: Artificial intelligence technologies (including machine learning, natural language processing, clinical decision support systems and digital health tools), can support real-time symptom monitoring, prediction of adverse events and personalised interventions. Patient-generated data from self-reporting and wearable devices may enable earlier identification of complications and improve symptom tracking and patient engagement. However, most applications remain at an early stage. Key challenges include algorithmic bias, limited interpretability, data privacy and security, lack of standardisation and interoperability, workflow integration and training and infrastructure requirements. Conclusions: Artificial intelligence could support proactive and personalised symptom management in oncology nursing through continuous monitoring, predictive assessment and earlier intervention. Successful implementation requires robust validation, representative datasets, transparent algorithms, effective data governance and integration into clinical workflows. Implications for practice: Oncology nurses should develop skills in using artificial intelligence-enabled tools while recognising their limitations. Artificial intelligence should complement, rather than replace, clinical judgement, with further research needed to establish its effectiveness and safety in practice.
Background: The self-efficacy of healthcare professionals is critical to the effective delivery of palliative services. In the context of palliative care, self-efficacy refers to a healthcare provider’s confidence in their ability to competently assess patient needs, communicate effectively and provide appropriate palliative interventions and support. Aims: This study examined the effectiveness of the Modified Self-Efficacy in Palliative Care Scale as a reliable and valid instrument for measuring self-efficacy among long-term care staff, with the broader goal of supporting improvements in palliative care practice. Methods: A cross-sectional research design was used. Data were collected from nurses working in long-term care settings using the Self-Efficacy in Palliative Care Scale, and analyses were conducted using SPSS statistical software. Reliability and item homogeneity were assessed through Cronbach’s alpha coefficients, while the validity of the scale was examined using exploratory factor analysis. Results: Cronbach’s alpha values for the overall scale and its subscales ranged from .88 to .97, demonstrating strong internal consistency. Corrected item-total correlation coefficients ranged from .61 to .90 across all items, indicating good item homogeneity. Exploratory factor analysis, supported by parallel analysis, identified a three-factor structure consisting of communication, patient management and multidisciplinary teamwork. Factor loadings exceeded .60, and the model demonstrated acceptable fit. Conclusions: The findings support the reliability and validity of the Modified Self-Efficacy in Palliative Care Scale for use among nurses in long-term care settings. The instrument appears to be a valuable measure for assessing nurses’ confidence in delivering palliative care and for evaluating interventions designed to strengthen palliative care competencies. Implications for practice: The redeveloped Modified Self-Efficacy in Palliative Care Scale for long-term care settings may serve as a practical tool for enhancing palliative care delivery and improving the quality of life of residents receiving care.
Background: Access to palliative care remains insufficient in low- and middle-income countries, including Mexico. The World Health Organization identifies six components for integrating palliative care into health systems: health policies, essential medicines, service delivery, education, research and community empowerment. Aims: To compare Mexico’s palliative care model with the World Health Organization framework, identifying gaps and priorities for improvement. Methods: A qualitative comparative review examined national legislation, clinical guidelines, peer-reviewed literature and reports from national and international organisations against the six components of the World Health Organization framework. Findings: Mexico has made progress in legislation, specialised services and professional education. However, services remain concentrated in urban areas, with limited access in rural communities and insufficient paediatric provision. Restricted opioid access, gaps in professional training, financial constraints and uneven implementation of existing policies hinder equitable care. Research and data collection also remain limited. Conclusions: Strengthening palliative care in Mexico requires integration into primary healthcare, improved access to essential medicines, effective implementation of existing legal frameworks, dedicated funding and stronger research capacity. Implications for practice: Expanding nursing and multidisciplinary training, supporting community-based services and raising awareness of patients’ rights could improve access to timely, equitable and person-centred palliative care. Particular attention is needed for rural populations and children.
BACKGROUND:Spiritual care is often underprovided in nursing practice due to insufficient education and training. Online education may offer an effective strategy to bridge this gap. AIMS:To determine the effect of an online palliative care education programme on the perception of spirituality and spiritual care among Iranian nursing students. METHODS:This two-group, quasi-experimental study was conducted on 60 nursing students enrolled in the sixth semester or higher at Gonabad University of Medical Sciences, Iran. They were selected using convenience sampling based on the study inclusion criteria, and were allocated into intervention and control groups. Students in the intervention group participated in four educational sessions about palliative care. Data were collected using a demographic questionnaire and spirituality and spiritual care measurement scale. The data were analysed using SPSS version 20 by independent and paired t-tests, Chi-square and analysis of covariance at the significance level of 0.05. FINDINGS:The two groups were comparable with respect to demographic characteristics (P>0.05). However, significant baseline differences were observed in spirituality, spiritual care and overall attitude scores. To address these baseline imbalances, analysis of covariance was performed, adjusting for pre-intervention scores. The results of analysis of covariance demonstrated that the educational intervention had a significant and substantial effect on students' perceptions of spirituality and spiritual care after controlling for baseline differences (P<0.001). CONCLUSIONS:Participation in an online palliative care education programme may be associated with improved perceptions of spirituality and spiritual care among nursing students. IMPLICATIONS FOR PRACTICE:Integrating structured online training into undergraduate nursing curricula may better prepare future nurses to deliver holistic patient-centred care.
