Oncology nurses' lived experience of caring for patients with advanced cancer in healthcare systems without palliative care services.

Background: Caring for patients with advanced cancer is complex and challenging, requiring varied expertise, including symptom management, communication skills, care coordination and emotional resilience. Within existing literature, the lived experiences of oncology nurses are poorly articulated in countries with a lower income where formal palliative care (PC) is absent.

Aim: To explore the lived experiences of Gazan oncology nurses who provide care to patients with advanced cancer in healthcare systems, without formal palliative care infrastructure.

Opioid Therapy for Cancer Pain in Vietnam: Knowledge, Attitudes, and Perceived Barriers Among Health Care Professionals, Policymakers, and Regulators.

Purpose: We aimed to assess knowledge, attitudes, and perceived barriers among health care professionals (HCPs), policymakers, and regulators in Vietnam related to opioid therapy for cancer pain.

Methods: We conducted a cross-sectional study in Vietnam from June to August 2022. Participants completed a questionnaire on their demographic characteristics, knowledge and attitudes toward opioid therapy, and barriers to accessing opioids for cancer pain.

Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology.

Context: Inequities and gaps in palliative care access are a serious impediment to health systems especially in low- and middle-income countries and the accurate measurement of need across health conditions is a critical step to understanding and addressing the issue. Serious Health-related Suffering (SHS) is a novel methodology to measure the palliative care need and was originally developed by The Lancet Commission on Global Access to Palliative Care and Pain Relief. In 2015, the first iteration - SHS 1.

Inclusion of Social Work in Comprehensive Palliative Care to Address Psychosocial Needs of Advanced Cancer Patients in Vietnam.

The need for psychosocial care among patients with serious illnesses and available social work services continues to be great, especially in low- and middle-income countries. To evaluate the specific needs of Vietnamese cancer patients' quality of life (QOL), prevalence and severity of symptoms including depression and anxiety, and caregiver burden were assessed. Data on QOL, mood, caregiver burden, and other parameters were collected through face-to-face and phone- interviews.

Palliative care need in the Eastern Mediterranean Region and human resource requirements for effective response.

Integration of palliative care into health care systems is considered an ethical responsibility, yet no country in the Eastern Mediterranean Region (EaMReg) has achieved integration. Data on palliative care need and cost are crucial forEaMReg health care planners and implementers in the region. Using data from the Lancet Commission on Palliative Care and Pain Relief, we estimated the number of people in each EaMReg country who needed palliative care in 2015 and their degree of access.

Integrated Hospital- and Home-Based Palliative Care for Cancer Patients in Vietnam: People-Centered Outcomes.

Context: Hospital-based palliative care (PC) linked to palliative home care is rarely accessible in low- and middle-income countries (LMICs).

Objectives: To study people-centered outcomes of a palliative home care team based at a major cancer center in Vietnam.

Methods: The palliative home care team, consisting of at least one physician and one nurse, provided home PC when needed by patients of the cancer center who lived within 10 kilometers.

Effect of Training on Physicians' Palliative Care-Related Knowledge and Attitudes in Vietnam.

Context: Palliative care remains largely inaccessible in low- and middle-income countries (LMICs), and efforts to increase access are impeded by lack of training of proven effectiveness for physicians.

Objectives: To measure the effectiveness of palliative care training for Vietnamese physicians.

Methods: The palliative care-related knowledge, attitudes, and self-assessment of Vietnamese physicians were studied prior to a basic course in palliative care (baseline), just after the physicians completed the course (post), and 6-18 months later (follow-up).

Frequency and duration of suffering of cervical cancer patients and caregivers: Results from an international Delphi study.

This paper describes a Delphi process executed between August and September, 2020, to identify types of physical, psychological, social and spiritual suffering and their severity, prevalence and duration associated with cervical cancer to enable estimation of the global and regional palliative care needs of these cervical cancer patients and their family caregivers. Patients were dichotomized into decedents (those who died of cervical cancer in any given year) and non-decedents (those who had cervical cancer in any given year but did not die in that year). A two-round web-based Delphi study was conducted using a panel of 12 experts with first-hand experience taking care of cervical cancer patients and their family caregivers, two from each World Health Organization (WHO) region.

Bridging gaps to universal palliative care access in Chile: serious health-related suffering and the cost of expanding the package of care services.

Background: The Lancet Commission on Palliative Care (PC) and Pain Relief quantified the burden of serious health-related suffering (SHS), proposing an Essential Package of PC (EPPC) to narrow the global PC divide. We applied the EPPC framework to analyze PC access in Chile, identify gaps in coverage, and provide recommendations to improve PC access.

Methods: Total SHS and population in need of PC was estimated using official 2019 government data.

Association Between Primary Decision-Maker and Care Intensity Among Patients With Advanced Cancer in Mainland China.

In China, decisions regarding the treatment of seriously ill patients are usually made by family caregivers. This study aimed to explore the association between the primary decision-makers and the intensity of care given to patients with advanced cancer in China. We conducted a survey of family members and other caregivers representing 828 cancer patients who died between July 2013 and July 2016.

Caregivers' Knowledge of and Attitude towards Palliative Care in Iran.

Background: Addressing the palliative care needs requires clinicians to have sufficient knowledge of and positive attitudes toward palliative care. The study aimed to determine nurses' and physicians' knowledge of and attitudes towards palliative care in Iran.

Methods: This descriptive cross-sectional study was conducted in 2021 on 493 physicians and nurses, selected through convenience sampling.

Palliative care models and innovations in 4 Eastern Mediterranean Region countries: a case-based study.

Background: There is a global agreement that palliative care should be universally accessible. However, in low- and middle-income countries and conflict zones, most people lack access to it. In the Eastern Mediterranean Region (EMR), no country has achieved integration of palliative care into its health care system, and only 4 countries have better-than-isolated palliative care provision.

The Eastern Mediterranean Regional Palliative Care Expert Network: Designing a roadmap for palliative care development in the region.

Since 2014 WHO has been advocating for the integration of palliative care into health systems. Although there has been some progress in the development of palliative care in the Eastern Mediterranean Region, many countries in the region still have no palliative care activity and none has achieved integration. The WHO Regional Office for the Eastern Mediterranean has been engaged in activities aimed to develop palliative care in the region since 2010.

Integrating locally-attuned palliative care into health care systems in the Eastern Mediterranean Region.

At the 2014 World Health Assembly (WHA), the ministers of health of all 194 World Health Organization (WHO) Member States affirmed that palliative care, the prevention and alleviation of pain and suffering of any kind associated with serious illness, "is an ethical responsibility of health systems". The Assembly acknowledged "the urgent need to include palliation across the continuum of care, especially at the primary care level," and emphasized that "inadequate integration of palliative care into health and social care systems is a major contributing factor to the lack of equitable access to such care." This WHA Resolution (WHA 67.

Decolonizing end-of-life care: lessons and opportunities.

While palliative care should be universally accessible [1], the specific types and severity of illness and suffering vary by geopolitical situation, socioeconomic condition, and culture [2]. The meaning of suffering and death vary similarly [3]. As such, palliative care should consider local culture when considering the needs of individual patients and families.

Analyzing the Unique Needs of International Palliative Care Learners Attending a United States-Based Palliative Care Education and Practice Course.

Many seriously ill patients in need of palliative care (PC) globally never receive it, partly due to a lack of well-trained providers. We analyzed feedback from international participants in a U.S.

Implementing Palliative Care Training in the Caribbean: Development and Assessment of a Basic Palliative Care Training Course in Jamaica.

Context: The majority of people in need of palliative care (PC) in low- and middle-income countries lack access to it and suffer unnecessarily as a consequence. This unmet need is due, in part, to the lack of trained PC providers.

Objectives: This study aims to assess the effects of regional training in PC for doctors, nurses, and pharmacists in the Caribbean through assessment of participant satisfaction, anticipated course impact on participants' clinical practice, barriers to changing practice, and perceived course impact on achievement of key PC milestones.

Symptom prevalence, burden and correlates among people living with HIV in Vietnam: a two-centre self-report study.

Physical and psychological symptoms among people living with HIV (PLWH) adversely affect quality of life and treatment adherence. Study objectives were: (i) to determine validity and reliability of a Vietnamese translation of the Memorial Symptom Assessment Scale-Short Form (MSAS-SF) among PLWH in Vietnam; (ii) to measure prevalence and burden of physical and psychological symptoms using the MSAS-SF including the Global Distress Index (GDI), Physical Distress subscale (PHYS), and Psychological Distress subscale (PSY); (iii) to identify symptom burden risk factors. We recruited 567 patients.

Augmented Package of Palliative Care for Women With Cervical Cancer: Responding to Refractory Suffering.

The essential package of palliative care for cervical cancer (EPPCCC), described elsewhere, is designed to be safe and effective for preventing and relieving most suffering associated with cervical cancer and universally accessible. However, it appears that women with cervical cancer, more frequently than patients with other cancers, experience various types of suffering that are refractory to basic palliative care such as what can be provided with the EPPCCC. In particular, relief of refractory pain, vomiting because of bowel obstruction, bleeding, and psychosocial suffering may require additional expertise, medicines, or equipment.

Essential Package of Palliative Care for Women With Cervical Cancer: Responding to the Suffering of a Highly Vulnerable Population.

Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of interventions, medicines, simple equipment, social supports, and human resources, and is designed to be safe and effective for preventing and relieving all types of suffering associated with cervical cancer.

Cervical Cancer-Associated Suffering: Estimating the Palliative Care Needs of a Highly Vulnerable Population.

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.

Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature.

Innovation in a Crisis: Lessons Learned from the Rapid Development of an End-of-Life Palliative Care Unit during the COVID-19 Pandemic.

COVID-19 strained our nation's hospitals and exposed gaps in care. As COVID-19 surged in Boston in March 2020, we worked to rapidly create a Palliative Care Compassion Unit (PCCU) to care for those dying of COVID-19 or non-COVID-19-related illnesses. The PCCU provided interdisciplinary end-of-life care, supported families, and enabled surge teams to focus on patients needing life-sustaining treatments.