New Advances in Palliative Care

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 14555

Special Issue Editors


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Guest Editor
Department of Anesthesiology, Intensive Care, Palliative Medicine and Pain Therapy, HELIOS Klinikum Schleswig, 24837 Schleswig, Germany
Interests: palliative care; death; dying; home death; hospital death; tele-palliative care
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Guest Editor
Institute for General Medicine, Johannes Keppler University Linz, 4040 Linz, Austria
Interests: health promotion; health care delivery; health education and promotion; preventive medicine; primary care medicine; family medicine; palliative care

Special Issue Information

Dear Colleagues,

Today, palliative care is seen as an essential part of healthcare. According to the the World Health Organisation’s (WHO) definition, “Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” Nevertheless, it is often associated with cancer and oncology patients, and both professionals and the public are lacking awareness that other patient groups with chronic life-limiting diseases, different ethnicities and diverse backgrounds may benefit from the provision of palliative care by community health services and/or specialized palliative care teams. New approaches to include all patients in need are paramount.

During the COVID-19 pandemic, palliative care provision was hampered, and new ways of providing palliative care during a pandemic had to be established. One method of communication during the pandemic was telemedicine and tele-palliative care.

There are many open questions concerning the inclusion of other groups than cancer patients in palliative care. Other questions are how to provide palliative care in pandemic times and along with curative intended therapy in intensive care and emergency medicine.

The goal of the Special Issue, “New Advances in Palliative Care”, is to highlight recent advances and challenges in palliative care that are connected to the inclusion of different patient groups in palliative care, palliative care in pandemic times, tele-palliative care and the use of modern technology in the field of palliative care. 

This Special Issue will be of interest for researchers and clinicians from various fields and for policymakers, officials and politicians who are responsible for public health decisions and policies for the future. Thus, manuscripts on advances in palliative care from a broad range of disciplines and on a wide range of topics are welcome.

We look forward to receiving your contributions

Dr. Georg Bollig
Prof. Dr. Erika Zelko
Guest Editors

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Keywords

  • palliative care
  • advances
  • home death
  • hospital death
  • tele-palliative care
  • diverse patient groups

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Published Papers (7 papers)

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11 pages, 221 KiB  
Article
“What Do You Get? Nothing”: A Qualitative Analysis of the Financial Impact of Family Caregiving for a Dying Relative at Home in Germany
by Sally Pieper, Alina Kasdorf, Raymond Voltz and Julia Strupp
Healthcare 2025, 13(7), 810; https://doi.org/10.3390/healthcare13070810 - 3 Apr 2025
Viewed by 293
Abstract
Background/Objectives: As a result of demographic change in Germany, the number of people in need of care is steadily increasing, with a correspondingly larger proportion of care being provided by family members at home. Family caregivers face significant challenges in providing such [...] Read more.
Background/Objectives: As a result of demographic change in Germany, the number of people in need of care is steadily increasing, with a correspondingly larger proportion of care being provided by family members at home. Family caregivers face significant challenges in providing such care, particularly when balancing work responsibilities. Many experience a loss of income due to reduced working hours or the necessity of leaving the labor market. Additional caregiving costs, such as medical expenses, transportation, and home modifications, further exacerbate their financial burden. Methods: This study consists of an online survey, which included the German version of the Carer Support Needs Assessment Tool (CSNAT), designed to assess the support needs of family caregivers. Respondents were asked to describe their support needs in open-text responses. To illustrate their experiences, a qualitative content analysis was conducted. Results: Out of the 320 questionnaires, 304 of them contained open-text responses that could be analyzed. Important themes included the need for support in the workplace, financial security, and assistance with administrative barriers. In addition to more flexible working hours and greater understanding from employers, the need for financial compensation for loss of working time was expressed. Conclusions: Despite a growing awareness of the gaps in support, the needs of family caregivers remain inadequately addressed, leaving them financially burdened and unsupported. Ultimately, this study calls for a re-evaluation of societal attitudes toward caring, arguing for greater recognition of the economic contributions of family caregivers and the implementation of supportive policies. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
11 pages, 238 KiB  
Article
Volunteer Services in Palliative Care by Third Age University Students
by Gönül Düzgün, Yasemin Kılıç Öztürk, Gökşen Polat and Sevnaz Şahin
Healthcare 2024, 12(24), 2591; https://doi.org/10.3390/healthcare12242591 - 23 Dec 2024
Viewed by 805
Abstract
Background: Volunteering is a type of support that provides high motivation and supports social participation during the active aging process without any financial reward. Volunteering services provided by an active older person not only provide free services to the community where needed but [...] Read more.
Background: Volunteering is a type of support that provides high motivation and supports social participation during the active aging process without any financial reward. Volunteering services provided by an active older person not only provide free services to the community where needed but also help individuals feel valued by creating a social environment, thereby increasing their resilience. The aim of this study was to determine the views on volunteering in palliative care services among older individuals over the age of sixty who attend the Ege University of the Third Age [U3A] and outline the volunteer profile of older students after receiving palliative care training. Methods: This study was conducted using a qualitative research method. The study population consisted of seventy students from the Ege U3A in İzmir who met the inclusion criteria. Before the training, the U3A students were given a brief pre-test about palliative care and volunteering, followed by 2-day, 16 h basic palliative care training. After the training, the students were asked to respond to written questions about volunteering in palliative care, and their responses were collected in their own handwriting. For the data analysis, a thematic content analysis was conducted using MAXQDA 20, a qualitative data analysis program. Results: In this study, the average age of the 70 University of the Third Age students were 67.47 (60–89) years. The participants were 75% women; 85% were married, 40% lived with their spouse, and 37.14% had been students at the University of the Third Age for 3 years. After the thematic analysis, six main themes emerged: physical and social support, educational support, medical/clinical support, financial support, spiritual support, and caregiving for pediatric patients. Conclusions: In our study, it was clearly observed that older students enrolled in the Ege U3A, who had a high potential for volunteering, were willing to work voluntarily in palliative care within the limits of their physical abilities and resources. This research, which aimed to create a volunteer profile in palliative care, allowed older students to find suitable roles for themselves and increased their motivation to provide this unpaid service. Based on this, it aimed to establish an effective start and an encouraging practice for the development of a pilot study, which is needed for Türkiye. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
18 pages, 293 KiB  
Article
Preparedness for Caregiving Role and Telehealth Use to Provide Informal Palliative Home Care in Portugal: A Qualitative Study
by Paula Caetano, Ana Querido and Carlos Laranjeira
Healthcare 2024, 12(19), 1915; https://doi.org/10.3390/healthcare12191915 - 25 Sep 2024
Cited by 1 | Viewed by 1740
Abstract
Background/Objectives: Given the increasing occurrence of long-term illnesses, it is imperative to focus on adequately preparing and assisting those who assume the responsibility of caregiving. Our study aims to explore whether caregivers feel prepared to provide informal palliative home care, their experiences, and [...] Read more.
Background/Objectives: Given the increasing occurrence of long-term illnesses, it is imperative to focus on adequately preparing and assisting those who assume the responsibility of caregiving. Our study aims to explore whether caregivers feel prepared to provide informal palliative home care, their experiences, and the usefulness of telehealth in managing daily activities. Methods: Using a descriptive qualitative research design and a purposeful sampling technique, thirteen primary family caregivers who provide informal palliative home care were recruited. Data collection was conducted through face-to-face individual interviews conducted from May 2023 to July 2023. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: Caregivers were mainly female (n = 8) with a mean age of 59.5 years (SD = 9.42). Based on our findings, three overarching themes emerged: (1) becoming a caregiver, (2) support-from-home palliative care team, and (3) telehealth in palliative home care. The reasons that influence the preparedness of family caregivers include their own desires, health conditions, their range of responsibilities, and the consequences that arise from the situation’s complexity. Telehealth helps fulfill the patient’s wishes to be at home in EoL and provides caregivers with access to professional guidance and support. Conclusions: Specialized home-based palliative care teams must be aware of caregivers’ self-assurance, knowledge, skills, and aptitudes in carrying out daily responsibilities and in managing emotions to improve preparedness for caregiving, loss, and its aftermath. The provision of professional PC services in the home along with a robust support system for informal caregivers is invaluable. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
11 pages, 1741 KiB  
Article
Exploring End-of-Life Care for Patients with Breast Cancer, Dementia or Heart Failure: A Register-Based Study of Individual and Institutional Factors
by Terje P. Hagen and Erika Zelko
Healthcare 2024, 12(9), 943; https://doi.org/10.3390/healthcare12090943 - 4 May 2024
Cited by 2 | Viewed by 1724
Abstract
Objective: To examine variations in end-of-life care for breast cancer, heart failure, and dementia patients. Data and methods: Data from four Norwegian health registries were linked using a personal identification number. Longitudinal trends over 365 days and the type of care on the [...] Read more.
Objective: To examine variations in end-of-life care for breast cancer, heart failure, and dementia patients. Data and methods: Data from four Norwegian health registries were linked using a personal identification number. Longitudinal trends over 365 days and the type of care on the final day of life were analyzed using descriptive techniques and logistic regression analysis. Results: Patients with dementia were more commonly placed in nursing homes than patients in the two other groups, while patients with heart failure and breast cancer were more frequently hospitalized than the dementia patients. Breast cancer and heart failure patients had a higher likelihood of dying at home than dementia patients. The higher the number of general practitioners, the higher was the probability of home-based end-of-life care for cancer patients, while an increasing non-physician healthcare workers increased the likelihood of home-based care for the other patient groups. Conclusions: Diagnoses, individual characteristics, and service availability are all associated with the place of death in end-of-life care. The higher the availability of health care services, the higher also is the probability of ending the life at home. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
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20 pages, 3115 KiB  
Article
Dementia Education for Workforce Excellence: Evaluation of a Novel Bichronous Approach
by Leah Macaden and Kevin Muirhead
Healthcare 2024, 12(5), 590; https://doi.org/10.3390/healthcare12050590 - 5 Mar 2024
Viewed by 1943
Abstract
Dementia education and training for workforce development is becoming increasingly important in bridging knowledge gaps among health and social care practitioners in the UK and internationally. Dementia Education for Workforce Excellence (DEWE) was developed during the COVID-19 pandemic, blending both synchronous and asynchronous [...] Read more.
Dementia education and training for workforce development is becoming increasingly important in bridging knowledge gaps among health and social care practitioners in the UK and internationally. Dementia Education for Workforce Excellence (DEWE) was developed during the COVID-19 pandemic, blending both synchronous and asynchronous instruction and delivered across three different contexts: care homes, home care, and nurse education within the UK and India. This study aimed to evaluate DEWE using mixed methods with online survey data analyzed descriptively and interview data analyzed thematically. Integration of survey and interview data aimed toward a comprehensive evaluation of this novel approach for dementia workforce development. Thirty-four social care practitioners and nurse educators completed the online survey demonstrating high-level learner satisfaction, learning gains, behavioral change, and motivation to share new knowledge. Four key themes developed from the analysis of interviews (n = 9) around participants’ pursuit of new knowledge; delivery modes in DEWE; learning gains and impact of DEWE; and adaptations for future program implementation. Findings suggest DEWE is an innovative resource that promotes person- and relationship-centered dementia care across all stages of one’s dementia journey. Cultural adaptations are recommended for international delivery to ensure contextual alignment and maximum impact. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
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22 pages, 2361 KiB  
Article
Palliative Care Survey: Awareness, Knowledge and Views of the Styrian Population in Austria
by Ulrike Spary-Kainz, Nicole Posch, Muna Paier-Abuzahra, Melanie Lieb, Alexander Avian, Erika Zelko and Andrea Siebenhofer
Healthcare 2023, 11(19), 2611; https://doi.org/10.3390/healthcare11192611 - 22 Sep 2023
Cited by 3 | Viewed by 2212
Abstract
Background: No population-based data on awareness and knowledge of palliative care currently exist in Austria. We therefore conducted a survey to determine the general awareness and knowledge of palliative care in Styria, a federal state in Austria. We also asked participants to imagine [...] Read more.
Background: No population-based data on awareness and knowledge of palliative care currently exist in Austria. We therefore conducted a survey to determine the general awareness and knowledge of palliative care in Styria, a federal state in Austria. We also asked participants to imagine what services they would need as a patient or family member, where they themselves would like to receive such services, and what fears they imagined patients with a terminal illness would have. Methods: A descriptive cross-sectional survey consisting of 18 questions that address several aspects of palliative care was carried out in the adult population of Styria, Austria, from October 2019 to March 2020. Results: A total of 419 questionnaires were analyzed, whereby 70.3% of respondents had at least heard of palliative care. Of these, significantly more were female, had a university degree and were aged 50 to 64. The main goal of palliative care was chosen correctly by 67.1% of participants, with the proportion of correct answers increasing in line with education and reaching 82.0% among university graduates. Overall, 73.2% believed that the greatest need of terminally ill persons was a reduction in physical suffering, whereas the greatest perceived need of relatives was the availability of specialist care around the clock. About one-third believed that the greatest fear of palliative patients was that of death, which was chosen significantly more often by men than women. If terminally ill, some 39% of respondents would wish to be looked after at home by professional carers, and women and people that had completed high school chose this answer significantly more often. The most desired service that should be provided to patients and relatives was home pain management at 69.9%, followed by time off for family caregivers at 58.0%. This item was chosen significantly more often by women. Conclusions: To facilitate the care of severely ill patients at home, it would make sense to develop targeted information campaigns. These should also attempt to deliver targeted information to less informed groups of people, such as young, poorly educated men, in order to raise their awareness of the difficulties and challenges of providing care to terminally ill patients and thus increase the acceptance of support options. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
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26 pages, 1666 KiB  
Systematic Review
Emerging Therapeutic Strategies for Diffuse Intrinsic Pontine Glioma: A Systematic Review
by Shahrukh Farrukh, Shagufta Habib, Amna Rafaqat, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Karla Robles-Velasco, Miguel Felix and Ivan Cherrez-Ojeda
Healthcare 2023, 11(4), 559; https://doi.org/10.3390/healthcare11040559 - 13 Feb 2023
Cited by 5 | Viewed by 3755
Abstract
Background: Of all central nervous systems tumors, 10–20% are located in the brainstem; diffuse intrinsic pontine glioma (DIPG) is diagnosed in 80% of them. With over five decades of clinical trial testing, there are no established therapeutic options for DIPG. This research article [...] Read more.
Background: Of all central nervous systems tumors, 10–20% are located in the brainstem; diffuse intrinsic pontine glioma (DIPG) is diagnosed in 80% of them. With over five decades of clinical trial testing, there are no established therapeutic options for DIPG. This research article aims to collate recent clinical trial data and provide a landscape for the most promising therapies that have emerged in the past five years. Methods: PubMed/MEDLINE, Web of Science, Scopus, and Cochrane were systematically searched using the following keywords: Diffuse intrinsic pontine glioma, Pontine, Glioma, Treatment, Therapy, Therapeutics, curative, and/or Management. Both adult and pediatric patients with newly diagnosed or progressive DIPG were considered in the clinical trial setting. The risk of bias was assessed using the ROBINS-I tool. Results: A total of 22 trials were included reporting the efficacy and safety outcomes among patients. First, five trials reported outcomes of blood–brain barrier bypass via single or repeated-dose intra-arterial therapy or convection-enhanced delivery. Second, external beam radiation regimens were assessed for safety and efficacy in three trials. Third, four trials administered intravenous treatment without using chemotherapeutic regimens. Fourth, eight trials reported the combinations of one or more chemotherapeutic agents. Fifth, immunotherapy was reported in two trials in an adjuvant monotherapy in the post-radiotherapy setting. Conclusion: This research article captures a clinical picture of the last five years of the direction toward which DIPG research is heading. The article finds that re-irradiation may prolong survival in patients with progressive DIPG; it also instills that insofar palliative radiotherapy has been a key prognostic choice. Full article
(This article belongs to the Special Issue New Advances in Palliative Care)
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