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.
Background: There are barriers to the practice of palliative care in intensive care units (ICUs) and cardiology, considering that these settings are designed with high technological resources aimed at cure. Aims: To conduct a network analysis on the perceptions of medical professionals and nurses regarding the quality of palliative care provided in their ICU. Methods: A cross-sectional network analysis study was conducted between October and December 2024 with intensivist nurses and physicians from five university hospitals in Brazil. The Palliative Care Quality Questionnaire for Intensive Care Units (QCP-UTI) was used. Results: The items QCP-UTI 3 (investigating and respecting patient and/or family preferences regarding care and treatment goals), QCP-UTI 4 (communication with team members about the emotional needs of the patient and/or family), and QCP-UTI 6 (attention to the emotional and practical needs of patients in the terminal stages of illness and their families) showed greater closeness and higher betweenness centrality. Conclusions: These factors share a common theme of defining goals and care objectives for end-of-life patients in intensive care. It can be concluded that these factors may be central to actions aimed at enhancing the quality of care provided, supporting organisational strategies, and establishing clear protocols and processes for such care.
BACKGROUND:People living with and beyond cancer frequently experience cognitive and psychosocial difficulties, yet structured rehabilitation remains limited. Extended reality offers immersive and adaptable tools that may help address these supportive care needs. AIM:To synthesise evidence on extended reality interventions for cognitive and psychosocial rehabilitation in cancer care. METHODS:An integrative review was conducted using Whittemore and Knafl's framework. Literature published between 2014 and 2025 was identified through searches of major electronic databases and manual reference screening. Study quality was appraised using the Mixed Methods Appraisal Tool, and findings were synthesised thematically. RESULTS:A total of 14 studies met the inclusion criteria. Two primary functional domains emerged: cognitive rehabilitation, including improvements in attention, executive function and psychosocial rehabilitation, including reductions in anxiety, depression, fatigue and improvements in quality of life. Across studies, extended reality interventions-predominantly virtual reality-were generally feasible, well accepted and associated with high engagement and minimal adverse effects, although methodological heterogeneity remained substantial. CONCLUSIONS:Extended reality, particularly virtual reality, shows promise as a feasible and acceptable approach to supporting cognitive and psychosocial rehabilitation in cancer care. IMPLICATIONS FOR PRACTICE:Extended reality, particularly virtual reality, may be considered as a complementary approach to support cognitive and psychosocial rehabilitation in people living with and beyond cancer. Clinicians may consider integrating extended reality into supportive cancer care while recognising that further high-quality evidence is needed to inform routine clinical implementation.
BACKGROUND:In the Philippines, breast cancer is the primary cause of cancer-related death and the most common cancer among women worldwide. In addition to its physical effects, the condition significantly affects psychological health, with loneliness, uncertainty and low social support being associated with emotional distress. AIM:The purpose of this study was to examine the associations of intolerance of uncertainty, social support and loneliness with psychological distress among Filipino women with breast cancer. METHODS:Using a descriptive-correlational design, a total of 121 patients with breast cancer were recruited from support groups and organisations in Metro Manila. Standardised instruments were used to collect the data. Descriptive and inferential statistics were used to analyse the data. RESULTS:Participants reported moderate to high levels of anxiety, stress and depression, along with moderate to high levels of intolerance of uncertainty and loneliness. Psychological distress variables were positively associated with intolerance of uncertainty and loneliness (P<.001), whereas social support was negatively associated with these outcomes (P<.001). CONCLUSIONS:Psychological distress among women with breast cancer was associated with intolerance of uncertainty, loneliness and social support. These findings suggest that psychosocial factors may be relevant considerations in psychosocially informed cancer care for women with breast cancer. IMPLICATIONS FOR PRACTICE:Routine assessment of psychological distress, intolerance of uncertainty, loneliness and available social support may help identify women with breast cancer who are at risk of poor psychological outcomes. Integrating psychosocial assessment and supportive interventions into oncology care may promote more comprehensive, patient-centred care.
BACKGROUND:Palliative care aims to improve quality of life for patients and families facing serious illness, yet access is often limited by workforce shortages, geographic barriers and patient preferences. Telenursing may address these challenges by enhancing access to care, symptom management, and support for patients and caregivers. AIM:Guided by the Donabedian model, this study evaluated a customer relationship management-enabled telenursing intervention in a Saudi tertiary hospital by describing users and care delivery patterns, assessing changes in symptom severity, and exploring the relationship between medication interventions and symptom improvement. METHODS:A single-group pre-post design was used to assess changes in symptom severity following the intervention. This real-world approach was appropriate for end-of-life care settings where randomisation and control groups are difficult to implement; findings are therefore exploratory. RESULTS:Telenursing may improve symptom management and care coordination in palliative care, particularly for pain, insomnia and constipation. CONCLUSIONS:Structured remote symptom assessment can help identify unmet needs and support responsive care, although controlled multi-centre studies are needed to confirm effectiveness and sustainability.
Background: Multiple barriers and facilitators affect nurses' implementation of advance care planning for patients with heart failure. However, differences in nurses' perceptions according to their experience with advance care planning remain unclear. Aims: This study examined factors associated with advance care planning implementation among Japanese nurses. Methods: In this cross-sectional study, 1250 cardiology hospitals were selected using prefecture-based stratified sampling. Nurses were classified into three groups according to their experience with advance care planning, and factors associated with the implementation of advance care planning were analysed. Findings: A total of 238 nurses responded. Participation in workshops and training sessions had the strongest influence on advance care planning implementation. With greater experience of advance care planning, items related to anxiety were more prevalent than those related to reduction. Conclusions: Establishing an educational framework that reflects the characteristics of Japanese nurses is essential for promoting its implementation. In addition, a multidisciplinary approach is recommended to address nurses' anxiety. Implications for practice: Providing structured education and training on advance care planning may enhance nurses' confidence and implementation of advance care planning in patients with heart failure. Multidisciplinary support should also be incorporated to address nurses' anxiety and facilitate the integration of advance care planning into routine clinical practice.
BACKGROUND:At Walsall Healthcare NHS Trust, high referral volumes were overwhelming the community palliative care team, leading to delays in triage and patient contact alongside existing workloads. To improve this, a triage nurse role was introduced to assess and allocate new referrals, supported by a triage tool. This streamlined the review of clinical information and enabled timely telephone contact and appropriate clinical nurse specialist visits. AIMS:To enhance patient care by systematically evaluating clinical performance and attitudes towards the newly implemented triage tool, as well as assessing the team's wellbeing with a focus on reducing team pressure and redirecting the triage process. METHOD:This clinical audit evaluated a service improvement initiative using a mixed-methods approach. An anonymous questionnaire was sent to the clinical nurse specialist and administrative teams to gather views on the triage tool. An audit of referral-to-first-contact times was also conducted using 20 randomly selected patient records (10 pre- and 10 post-implementation) from the team database. The audit was carried out by the care group quality nurse to reduce bias. Pre- and post-implementation groups were comparable, with no other significant service changes during the period. RESULTS:Results showed that using the triage tool improved the time from referral received to first patient contact, and supported team wellbeing through the process of clearly defining roles and responsibilities. CONCLUSION:The implementation of a triage tool has enabled a more efficient and systematic method for prioritising patient referrals and allocating workload and resources equitably.
BACKGROUND:Family caregivers of patients with cancer often experience physical, emotional and mental challenges. However, there is limited research on the impact of caregiving on family caregiver's sleep. This study evaluated the effectiveness of brief mindfulness-based interventions and educational interventions in improving mindfulness, self-compassion and sleep quality in family caregivers in Jordan. METHODS:A quasi-experimental study was conducted with 48 family caregivers assigned to either the mindfulness-based interventions (25) or the educational intervention (23) group. Mindful Attention Awareness Scale, Self-Compassion Scale-Short Form and Pittsburgh Sleep Quality Index were used post-interventions to assess outcomes. RESULTS:The mindfulness group demonstrated significant improvements in mindfulness, self-compassion and sleep quality, with medium to large effect sizes (Cohen's d=0.36-2.01, P<.001). The educational group showed significantly smaller improvement than those in the mindfulness group, with no significant improvement in quality of sleep. CONCLUSIONS:Brief mindfulness-based interventions are effective in enhancing mindfulness, self-compassion and sleep quality among family caregivers, surpassing the benefits of educational interventions. These findings suggest that mindfulness-based interventions should be incorporated into caregiving support programmes to improve the wellbeing and outcomes of family caregivers.
AIM:To analyse indicators of the nursing outcomes classification 'dignified life closure' for patients receiving end-of-life care. METHOD:A cross-sectional, quantitative study with 52 patients using an instrument with 25 indicators for the nursing outcome. Data were analysed using descriptive and inferential statistics, with a p-value of 0.05. RESULTS:Most participants were women with religious beliefs, with an average age of 60.65, and cancer as the primary diagnosis. Statistically significant associations were found between the primary diagnosis and indicators such as 'maintains a sense of control over remaining time' (P=0.034) and 'expresses preparedness for death' (P=0.032). Correlations were also observed between religion and 'expresses hope' (P=0.025), age and 'completes significant goals' (P=0.021), and duration of palliative care and 'maintains physical independence' (P=0.033). CONCLUSION:Nurses should focus on educational activities to improve the quality of life for palliative care patients.
BACKGROUND:Recognising patients' preferences for end-of-life care and enabling people to die in their preferred location is critical to effective palliative care delivery. AIM:To evaluate patients' end-of-life choices for death and consumer satisfaction with support provided. METHODS:This single-centre, prospective, cohort study included patients that accessed a private health insurance funded community palliative care programme. FINDINGS:Over 5 years (August 1, 2016 to July 31, 2021) of the 779 patients admitted to the community specialist palliative care service, 608 died. Among those who died, 39.5% died at home, 40.1% in an in-patient palliative care unit and 20.4% elsewhere. Overall, 85.7% achieved their preferred place of death, with high rates of adherence across different settings: 79.0% for home, 91.5% for in-patient palliative care unit and 100% for acute in-patient setting. Satisfaction with services was high. CONCLUSIONS:Key components to achieving a high preferred place of death include enhanced in-home support, case-managed community specialist palliative care and dedicated access to multidisciplinary team members.
BACKGROUND:Prostate cancer is the most common male malignancy, yet prevention and early detection efforts show inconsistent uptake worldwide. AIM:To identify which strategies and contextual factors enhance, or hinder, the effectiveness of prostate cancer prevention and screening. METHODS:An integrative review yielded 19 peer-reviewed studies. Quality was appraised using Critical Appraisal Skills Programme; data were thematically synthesised. RESULTS:Five themes surfaced. (1) Cultural attitudes-fear of digital rectal examination reduces participation, but tailored messaging can overcome this resistance. (2) Chemoprevention-finasteride and dutasteride cut incidence of prostrate cancer by ≈25 %, however, there are side effects which must be managed. (3) Biomarkers-the prostate-specific antigen test is the most widely used screening test, but the prostate cancer antigen 3 test is more accurate but increases costs. (4) Access models-mobile units, mass screening and theory-based education triple to six-fold prostate-specific antigen uptake in under-served groups, showing that low-barrier delivery can offset stigma. (5) Lifestyle-low-fat diets and micronutrients offer modest protection against prostate cancer, while obesity raises high-grade risk, highlighting synergy between behavioural and clinical interventions. CONCLUSION:Integrating accurate diagnostics, culturally sensitive education, low-barrier outreach and lifestyle counselling offers the strongest pathway to equitable, sustainable prostate cancer control. Future studies should evaluate cost effectiveness and long-term adherence in diverse settings.
BACKGROUND:Nurses often intervene to extend patients' lives. However, sometimes patients may request euthanasia, and this situation can potentially affect their subsequent care. AIM:To examine the relationship between the caregiving behaviours of nurses caring for dying patients and their attitudes towards death and euthanasia in Türkiye. METHODS:The study involved 229 intensive care nurses. Data collection was carried out using Attitudes Towards Euthanasia scale, and the caring behaviours assessment tool nursing version-short form. FINDINGS:The termination of nursing care interventions for patients, defining euthanasia as a right to die and believing that individuals should have the right to euthanasia emerged as factors contributing to nurse's attitudes towards euthanasia and patients at the end of life. Also, the willingness of nurses to provide care for patients in the terminal stage, their thoughts that euthanasia can be applied to patients in the terminal stage, their questioning the reason for this request if their patients want euthanasia, and their attitudes towards death, emerged as factors contributing to the caring behaviours of nurses. CONCLUSION:Nurses should be aware of their attitudes towards dying patients and death, and they should be able to identify the effects of negative attitudes on the care they provide to terminally ill patients. They should also work on improving their caregiving behaviours.
AIM:To assess the quality of life of relatives of palliative care patients and to raise awareness about practices that may improve it. METHODS:In this cross-sectional analytical study, the data collection form and the SF-36 Quality of Life Scale were applied to the participants. The study was conducted with 409 relatives of patients who cared for inpatients in the Palliative Care Department of Izmir City Hospital between 25.02.2024-25.08.2024. RESULTS:Among the caregivers included in the study, 71.1% neglected themselves, 69.7% had restricted social lives, 61.9% had sleep problems, and felt that their quality of life had declined since becoming a caregiver. However, receiving professional training about the caregiving process and being informed about legal rights increased the quality of caregiver's lives. CONCLUSION:Family physicians should focus on both caregivers and patients, supporting caregivers psychosocially, and provide education on palliative care and legal rights.
BACKGROUND:The roles played by community nurses in caring for dying patients and their families are critical to deliver quality palliative care within the public healthcare system. AIM:To explore the perceptions of family caregivers of patients receiving palliative care regarding the roles of community nurses in providing palliative care within a Thai context. METHOD:A purposive sample of 16 primary palliative caregivers was used. In-depth interviews were conducted October-November 2021. A phenomenographic approach was employed for data analysis of variations in the roles of community nurses providing palliative care. FINDINGS:Three main roles were revealed: (1) identifier; (2) manager of clinical uncertainty and (3) family caregiver advocate. CONCLUSIONS:Community nurses should address the needs of patients and their family caregivers. Healthcare systems should strengthen the roles of community nurses by providing specialised training and fostering partnerships with family caregivers as advocates during palliative care.
BACKGROUND:Despite the increasing recognition of palliative care in the management of heart failure (HF), many patients continue to experience unmet care needs due to the delayed integration of supportive services. Identifying these needs is crucial for enhancing patient-centered care and informing healthcare policies. This qualitative study aimed to explore the palliative care needs of patients with HF. METHODS:This qualitative study employed a directed content analysis approach. Semi-structured in-depth interviews were conducted with 22 adult patients with heart failure in Ahvaz, Iran. Data collection continued until saturation, ensuring no new themes emerged. To ensure the trustworthiness of the findings, Lincoln and Guba's criteria were used. RESULTS:A total of 22 adult patients with heart failure participated in the study, with a mean age of 58.45±18.07 years. Data analysis revealed eight main categories of needs, including 'care structures and processes', 'physical aspects', 'psychological aspects', 'social aspects', 'cultural aspects', 'end-of-life care', 'ethical and legal aspects' and 'spiritual and existential aspects' with 30 subcategories. CONCLUSION:This study highlights the urgent need for early and thorough palliative care in heart failure management. By meeting patients' diverse needs with team-based, patient-focused methods, we can enhance quality of life, manage symptoms better and reduce healthcare challenges. These results are important for clinical practices and policies, supporting the creation of specialised palliative care programmes for heart failure patients.
BACKGROUND:Artificial intelligence is emerging as a valuable tool in oncology nursing surveillance by supporting early detection of patient deterioration, real-time monitoring and timely nursing interventions. Despite growing interest, evidence remains fragmented and implementation issues are not yet well established. AIM:This study systematically reviewed empirical evidence on artificial intelligence applications in oncology nursing surveillance, identified key barriers and facilitators to implementation and evaluated implications for patient safety, continuity of care and nursing quality. METHODS:A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Peer-reviewed studies published in English from 2015 to early 2024 were screened using predefined eligibility criteria. Of 447 records identified, 105 studies met the inclusion criteria and were included in the qualitative synthesis. FINDINGS:The included studies showed that artificial intelligence was used across several areas of oncology nursing surveillance, including risk prediction, early warning systems, tumor detection, radiomics, symptom monitoring and patient-reported outcomes. Common artificial intelligence approaches included machine learning, deep learning, natural language processing and explainable AI. Findings suggest that these tools may improve accuracy in clinical decision support, strengthen early identification of complications and enhance monitoring efficiency. However, key barriers persisted, including data heterogeneity, small and retrospective datasets, limited external validation, workflow integration difficulties, high costs and privacy concerns. CONCLUSION:Artificial intelligence-enabled surveillance shows promise, but broader adoption requires validation, integration and nursing-led co-design.
