Abstract Objectives Patients receiving oncology palliative care experience substantial psychological distress, emotional suffering, and complex symptom burden. This study aimed to evaluate the effects of a nursing-led predictive symptom management program incorporating selected laboratory indicators on psychosocial outcomes, symptom burden, quality of life, functional status, and clinical parameters among patients receiving oncology palliative care. Methods A quasi-experimental study was conducted on 150 adult cancer patients receiving palliative care in a governmental hospital in Al-Kharj, Saudi Arabia. Participants were assigned to an intervention group ( n = 75) or a control group ( n = 75). Effects were assessed at baseline and after a 6-week intervention by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale, Eastern Cooperative Oncology Group Performance Status, and selected routine laboratory parameters. Results The intervention resulted in a significant decrease in total symptom burden compared with the control group (ESAS total score: 34.04 ± 8.86 vs. 41.51 ± 8.48; p < 0.001; Cohen’s d = 0.86) and significant improvement in pain scores ( p = 0.003). No statistically significant between-group differences in anxiety, depression, quality of life, or functional status were observed post the 6-week intervention. Some laboratory parameters, including hemoglobin, sodium, potassium, and calcium, differed significantly between groups at specific follow-up time points. C-reactive protein correlated weakly and positively with symptom burden ( r = 0.180; p = 0.028). Significance of results A nursing-led predictive symptom management program incorporating clinical assessment and laboratory monitoring may effectively reduce symptom burden and improve comfort among patients receiving oncology palliative care. However, longer interventions including structured psychosocial support as well as emotional evaluation and supportive care strategies may be required for psychological distress and quality-of-life outcomes.
Abstract Objectives To identify factors associated with caregiver burden among caregivers of patients enrolled in a home-based palliative care program in Bogotá, Colombia. Methods This analytic cross-sectional study included 208 caregivers of patients receiving home-based palliative care in Bogotá between 2022 and 2024. Data were collected on caregivers’ sociodemographic, psychological, and caregiving-related characteristics. Caregiver burden was assessed using the Zarit Burden Interview ( ZBI ), while depression, anxiety, and stress symptoms were assessed using the Depression, Anxiety and Stress Scale-21. Patient sociodemographic and clinical data were also collected. Multiple linear regression analysis was used to identify caregiver- and patient-level variables associated with caregiver burden. Results The median age of caregivers was 56 years. Most caregivers were women (86%) and relatives (74%). Although 69.2% had higher education, 79.8% lacked formal caregiving training and 73.6% provided care without financial compensation. The mean ZBI score was 42.5 ± 12.9, with 40.4% of caregivers experiencing mild to intense burden. Additionally, 40.4% reported depressive symptoms, 38.9% anxiety, and 47.1% stress. Caregiving support ( β = −6.31; P = 0.009) was associated with lower burden scores, whereas caregiver motor limitations ( β = 4.78; P = 0.045) and caregiver depression ( β = 3.81; P = 0.034) were associated with higher burden scores. Significance of results Caregiver burden was associated with caregiver depression and motor limitations. Interventions aimed at strengthening caregiving networks, providing psychological support, and addressing caregivers’ physical health are essential to reduce burden and improve the well-being of both caregivers and patients.
Abstract Objectives Existential factors such as loss of meaning play a central role in suicide-related vulnerability, yet most prevention interventions target symptom reduction. We aimed to systematically review the effects of meaning-based interventions on suicide-related outcomes and characterize the mechanisms through which these effects operate. Methods A systematic review was conducted following PRISMA 2020 guidelines. Six databases (PubMed, Web of Science, CINAHL, PsycINFO, Research Information Sharing Service, and Korean Studies Information Service System) were searched from inception to April 2026. Studies were included if they evaluated meaning-based interventions and reported suicide-related outcomes. Risk of bias was assessed using RoB 2 for randomized trials and RoBANS for nonrandomized studies. Given heterogeneity across populations, interventions, and outcomes, findings were synthesized narratively by domain. Results Ten studies were included (7 randomized controlled trials, 2 quasi-experimental studies, and 1 secondary analysis). Meaning-based interventions most consistently improved existential outcomes, including meaning in life, spiritual well-being, and quality of life. Emotional outcomes showed partial and heterogeneous effects. Suicide-related outcomes, including hopelessness, demoralization, and suicidal ideation, generally showed reductions, although effects varied across studies. Mechanistically, most studies showed patterns of indirect pathways, whereby improvements in existential variables co-occurred with reductions in emotional and suicide-related outcomes. Significance of results Meaning-based interventions may reduce suicide-related vulnerability primarily by enhancing existential resources rather than directly targeting symptoms. These findings support integrating meaning-centered approaches into suicide prevention strategies and highlight the need for longitudinal and mediation-based studies to examine causal mechanisms.
Abstract Objectives Family caregivers play a fundamental role in addressing the spiritual needs of patients receiving palliative care, particularly in cultures where spirituality is deeply embedded in daily life. This study explored how Hindu family caregivers perceived spiritual care, the ways they incorporated spiritual practices into caregiving, and the challenges they experienced while supporting relatives with palliative care needs. Methods A descriptive qualitative study was undertaken with 12 Hindu family caregivers recruited through purposive and snowball sampling in Kuantan, Malaysia. Individual semi-structured interviews were conducted, and the data were analyzed using Braun and Clarke’s thematic analysis to identify recurring patterns across participants’ experiences. Results Three interconnected themes emerged: Perceiving Spiritual Care as a Source of Meaning and Hope, Integrating Spiritual Practices into Family Caregiving, and Navigating Emotional and Practical Challenges in Spiritual Caregiving. Participants described spiritual care as fostering inner peace, hope, and acceptance through practices such as prayer, temple worship, chanting, and family support. Caregivers viewed themselves as facilitators of both spiritual and emotional well-being while simultaneously facing emotional exhaustion, caregiving demands, and limited access to spiritual support services. Significance of results The findings demonstrate that spiritual care is a shared responsibility between healthcare professionals and family caregivers in palliative care. Recognizing and supporting culturally grounded spiritual practices may strengthen holistic nursing care, promote family-centered care, and enhance the quality of palliative services for culturally diverse populations.
